iPixel Laser in Madrid: Acne Scars, Texture and Pores

The iPixel is the fractional ablative Er:YAG laser head of the Alma Harmony XL Pro platform, and it is used to work on depressed acne scars, uneven texture and, with more cautious expectations, visible pores. At Santé Madrid the medical team recommends it after assessing your skin, because not all scars respond the same way and the recovery from an ablative laser needs some planning. In this guide we explain how fractional erbium works, which types of scar exist, how many recovery days the sources describe, how to care for your skin afterwards in Madrid's climate and who should wait.

Key points

The iPixel is a 2940 nm Er:YAG laser: according to the manufacturer, its high absorption by water makes it suitable for skin resurfacing.

Because it is fractional, it treats microscopic columns of skin and leaves intact skin between them, which supports healing.

Acne scars are not all the same: rolling scars and shallow boxcar scars usually respond better to resurfacing than ice pick scars.

The manufacturer describes a moderate recovery of 3 to 7 days, with peeling, redness and small grid-like crusts.

Active acne is treated before scars. Results vary from one skin to another, and scars are not expected to disappear completely.

What the iPixel Er:YAG is and how a fractional ablative laser works

Alma's Harmony XL Pro is a platform with several heads, and the iPixel is the one that emits an erbium laser, Er:YAG, at a wavelength of 2940 nm. On the official Harmony XL Pro page, the manufacturer explains that high absorption by water makes this laser suitable for resurfacing, that is, the controlled renewal of the surface layers of the skin, and for removing benign lesions. On the same page it describes it as a fractional ablative laser, indicated for deeper resurfacing, pronounced texture irregularities and scars.

Ablative means that it vaporises a very thin part of the tissue. Fractional means that it does not do so across the whole surface, but in microscopic columns separated by untreated skin. A randomised clinical trial on fractional erbium and acne scars summarises it this way: the laser acts on the epidermis and the dermis, creating small zones of microdamage separated by zones of healthy tissue, and that intact skin supports rapid healing. The same authors note that the 2940 nm wavelength matches the absorption peak of water. Through that repair, the aim is to renew the surface and stimulate remodelling of the dermis.

We explain the other heads of the device in our guide to the Harmony XL Pro laser in Madrid. In Madrid we also have a CO2 laser, and we cover the comparison between the two in a separate article.

Types of acne scars and how each one usually responds

Before talking about sessions, it helps to know which scar you have. A review on the evaluation and treatment of acne scars explains that in most cases inflammation destroys collagen and leaves atrophic, that is, depressed, scars. Less often the opposite happens and hypertrophic or keloid scars form, which need a different approach. The review divides atrophic scars into three types, and it is common to have several at once.

Scar type	What it looks like	What the review says about resurfacing
Ice pick	Narrow, less than 2 mm, V-shaped and very deep	Its depth makes it resistant to conventional resurfacing; with fractional ablative laser the effect is only modest
Boxcar	Round or oval, 1.5 to 4 mm, with sharp vertical edges	Shallow ones respond to resurfacing; deep ones are more resistant
Rolling	Wide, up to 5 mm, with an undulating surface caused by bands that pull the skin from below	Resurfacing helps, but the deep component also needs treating
Hypertrophic or keloid	Raised, from excess collagen	Not the indication for this treatment and needs a different assessment

That is why the plan is almost never a single laser for everything. The review suggests treating first the redness that accompanies some scars and then the relief, combining techniques according to the scar type. Another randomised study of 90 patients treated with 2940 nm Er:YAG concluded that the treatment mode should be chosen according to the severity of the scar: the most intense mode improved more, but also caused more pain and more pigmentation.

Texture and pores: what it can offer and where the limits are

People who come in about scars often also notice uneven texture and visible pores. Uneven texture is one of the indications the manufacturer attributes to the iPixel on the Harmony XL Pro page, together with resurfacing and scars. By renewing the surface and stimulating remodelling of the dermis, the skin can look and feel more even.

With pores it is wise to be more cautious. A study on lasers for enlarged facial pores explains that pores are the openings of the pilosebaceous follicles and are not fixed structures: sebum production, skin elasticity, hair thickness, age, hormones and exposure to ultraviolet radiation all play a part. The authors point out that there is currently no universally approved or effective treatment for enlarged pores. That is why, in our plans, pores are usually a secondary goal within texture work, not the main reason to choose an ablative laser.

If your main concern is pores or mild texture without scars, there may be options with less recovery. We explain them in our article on microneedling for pores, texture and marks.

Sessions and recovery: what the sources say

There is no number of sessions that suits everyone. On its Harmony XL Pro page, Alma states 1 to 3 sessions for the iPixel depending on treatment intensity, spaced 4 to 6 weeks apart. Clinical studies use different schedules: in the randomised trial on fractional erbium, one group received 6 laser sessions over 6 months, at intervals of 4 weeks. That is why the doctor proposes the exact number based on the scar type, the chosen intensity and how your skin responds, and reviews it during follow-up.

As for recovery, the manufacturer describes it as moderate: 3 to 7 days of peeling, redness and small grid-shaped crusts, which correspond to the treated columns. This is an expected reaction and it is best not to pick them off.

It is also worth knowing that improvement does not appear overnight. The review on acne scars notes that collagen remodelling can continue for months after an ablative laser, and that complete resolution of scars is the exception rather than the rule. Results vary from one skin to another. The realistic aim is an improvement in relief and texture.

Risks and who should wait

An ablative laser opens small, controlled wounds in the skin, so it has risks you should know about. The review on acne scars lists post-procedure redness, infection, poor wound healing, hyperpigmentation and, paradoxically, new scarring. For fractional Er:YAG specifically, the same review reports mild redness and describes no serious effects such as scarring or long-lasting colour changes. In the study of 90 patients, all with skin types III and IV, pigmentation after treatment increased with the more intense modes, which is why parameters are chosen with caution.

Order matters. The review stresses that active acne should be under control before treating scars, so as not to create new lesions in areas already treated. If you still have breakouts, the first step is a different one: the Harmony XL Pro has the ClearSkin head, designed for active acne, and you can read more on our acne laser page.

These situations largely match the exclusion criteria of the randomised study, which left out people who were pregnant or breastfeeding, had hypertrophic scarring, active herpes simplex or conditions that impair wound healing.

Aftercare in Madrid: dry air, heating and sun

Madrid has a continental climate, with dry air, very sunny summers and cold winters in which indoor heating tends to dry the air even more. Skin freshly treated with an ablative laser has lost part of its barrier for a few days, so these factors may be more noticeable: tightness, more visible peeling or an itchy feeling. Urban pollution can also irritate sensitive skin.

The doctor gives you specific instructions according to the parameters, but they usually go along these lines:

Very gentle cleansing and a repair cream that keeps the skin hydrated while it renews.
Do not pick off crusts or peeling skin.
No acids, retinoids or exfoliants until the doctor says so. In the randomised study, patients were asked to avoid vitamin A derivatives and alpha hydroxy acids for 1 to 2 weeks.
Avoid strong sun and use broad-spectrum sunscreen, a cap and sunglasses when you go out, as patients in that study were also told.
Avoid saunas, intense heat and very demanding exercise for the days we tell you.

Because of the sun, many people prefer autumn and winter, although then you need to offset the dryness from heating with more hydration. It is not a fixed rule: the doctor discusses the most suitable timing with you based on your schedule and your skin.

How we work at Santé Madrid

Our clinic is at C. de Amador de los Ríos, 1, Chamberí, 28010 Madrid. This is what the process usually looks like when you come in about acne scars or texture:

First consultation. You can start with a free aesthetic assessment with a Beauty Coach or with a medical consultation for €50. We review whether the acne is still active, your medication and your sun exposure.
Scar assessment. The Santé Madrid medical team identifies which types of scar you have, whether there is associated redness or pigmentation and whether the iPixel is the right option or another one should come first.
Plan. The doctor decides the intensity, the approximate number of sessions and whether to combine the laser with other techniques, such as microneedling or treatment of redness.
Session. Cleansing, topical anaesthetic if needed, eye protection and treatment area by area.
Follow-up. We review recovery and response before each new session and adjust the plan.

You can read more about the treatment on our ablative laser page. The treatment is performed by the medical team after the assessment. Results vary from one skin to another, and our aim is a realistic and safe plan, not a promise of results.

Frequently asked questions

What type of acne scars does the iPixel treat?

Mainly atrophic, that is, depressed, scars. Rolling scars and shallow boxcar scars usually respond better to resurfacing than ice pick or deep boxcar scars, which often need a combination of techniques. Raised scars need a different assessment.

How many days of recovery do I need?

The manufacturer describes a moderate recovery of 3 to 7 days, with peeling, redness and small grid-like crusts. It depends on the chosen intensity, and the doctor will tell you more precisely before the session.

How many sessions will I need?

There is no fixed number. The manufacturer states 1 to 3 sessions depending on intensity, spaced 4 to 6 weeks apart, and studies use different schedules. The doctor proposes a plan based on your scars and adjusts it during follow-up.

Does the iPixel close pores?

It can improve overall texture. But pores depend on sebum, elasticity, age and hormones, and there is no universally effective treatment for them, so it is not advisable to choose an ablative laser for pores alone.

Can I have the iPixel if I still have acne breakouts?

The right approach is to control active acne first and treat the scars afterwards, so as not to create new lesions in areas already treated. For active acne there are other options, such as the ClearSkin head.

Does it hurt?

Because it is an ablative laser, it is usually felt more than a non-ablative laser. Topical anaesthetic can be applied beforehand, and the sensation depends on the area and the intensity.

When is a good time to have it in Madrid?

Many people prefer autumn and winter, when it is usually easier to avoid tanning. What matters is arriving untanned, protecting yourself from the sun afterwards and setting aside a few quiet days.

The iPixel Er:YAG can be a useful tool for depressed acne scars and uneven texture when the skin is prepared, the acne is under control and the scar type is chosen well. It requires a few days of recovery and consistent care, especially against the sun and dryness of Madrid. The first step is an assessment with the Santé Madrid medical team.

iPixel Er:YAG: Acne Scars, Texture and Pores in Madrid

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