Pico Laser Pigmentation Removal

Pico laser pigmentation removal is  safe and effective in treating a wide range of pigmentation conditions. These include common sun-induced freckles and solar lentigenes (sun spots). It has also been found to be effective in treating pigmented birthmarks such as Naevus of Ota and Cafe au lait macules (CALM). In addition, deep dermal lesions such as Hori’s Naevus have been found to respond positively to pico laser treatments. Pico laser treatments are also used in Post-inflammatory hyperpigmentation (PIH) resulting most commonly from acne.

Common Pigmentation Disorders

How does Pico Laser Pigmentation removal work?

Over the past few decades, there have been strides in laser technology. The principle of selective photothermolysis established in 1980s enabled lasers to selectively target melanin, haemoglobin and water within the skin. Primarily, lasers are classified as either long-pulsed (microseond to milliseconds) or short-pulsed (nanoseconds to picoseconds) in laser dermatology. 

Pico laser pigmentation uses picoseond lasers with high power and ultra fast laser pulses. Of interest, the ultra fast pulses (about a trillionth of a second!) generates a strong yet stable acoustic effect on the target pigments. This photoacoustic or photomechanical effect shatters pigments more finely without much collateral damage.  These finely shattered pigments are subsequently removed by the body’s natural healing processes.

Differences between Nanosecond and Picosecond Lasers.

Speed is the key determining factor. The ultra fast pulse released from the picosecond laser platform exerts a photoacoustic or photomechanical effect. Blasting pigments into smaller particles without overheating of the surrounding tissues allows lower downtime, side effects and fewer laser sessions. Picosecond laser treatments have a lower incidence of Post-inflammatory hyperpigmentation (PIH) compared to nano-second Q-Switched lasers.

The Picosecond Laser Difference:

Systemic Review of Picosecond Laser in Dermatology

Wu D.C et al (2021)

A review of the literature ranging from case series, retrospective analysis and randomized controlled trials suggests that Picosecond laser is more effective in some pigmentation disorders than others.

The levels of evidence are assigned to studies based on their quality of design, validity and applicability to patient care, viz. Level 1 and 2 evidence is stronger than Level 6 or 7.

For example, a patient with mixed pigmentation disorder such as freckles, solar lentigenes and melasma may notice that the former 2 conditions respond better to treatment than the latter. To date, the role of picosecond laser for Melasma remains mixed and unclear. The risks of recurrence, rebound and hypopigmentation (white spots) negates the use of Picosecond laser as monotherapy. 

The type pigmentation condition, your skin type and their differing response to laser treatment are considered at APAX Medical & Aesthetics Clinic. A consultation with Dr Moses Ng, an experienced and skilled laser surgeon, will determine the best Pico laser pigmentation removal treatment for you.

What's the downtime with Pico Laser treatment?

The pico laser’s ability to reach its target beneath the skin without overheating, while leaving the upper skin layer intact is advantageous. The delivery of ultra fast pulses with the pico laser pigmentation laser means that recovery is quick for most cases. Generally, most scabs fall off within a week.

 

Who is unsuitable for treatment?

The PICO Laser pigmentation removal treatment is suitable for most individuals who are in generally good health with reasonable expectations of the benefits of the procedure. 

PICO laser treatments, like any other medical procedures, has a few contraindications. Please let the doctor know if you have a medical history of the following conditions:

  • Active skin inflammation or infection
  • Open skin wounds
  • Herpes infection
  • Active Acne
  • Hypersensitivity or seizures to flashing lights
  • Medications that increases light sensitivity.

Are Pico laser treatments painful?

Most treatments are tolerated well. A tingling sensation is commonly felt. We use numbing cream prior to your treatment to maximise comfort and experience.

How soon can I see results?

Depending on the type of condition treated, you may notice early results after your first treatment session.

How do I take care of my skin after treatment?

A gentle cleanser and moisturizers are advisable to keep your skin clean and hydrated. You may be prescribed a topical antibiotic to minimize the risk of infections. Stay away from direct and prolonged sunlight, and protect yourself by using a sunscreen (SPF 50 and PA+++).

Avoid exfoliants, AHA/BHA and retinoids for at least one week after your procedure to avoid unwanted skin irritation.

How many sessions are required?

Pico laser pigmentation treatment depend on the size of treatment area and the type of pigmentation involved. A consultation and assessment of your skin type and medical history are factors we take in account when advising the costs of the treatment. An average of 4-6 treatment sessions are spaced at least 4 weeks apart.

More Information:

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References:

  1. Chan JC, Shek SY, Kono T, Yeung CK, Chan HH. A retrospective analysis on the management of pigmented lesions using a picosecond 755nm alexandrite laser in Asians. Lasers Surg Med 2016;48(1):2329.
  2. Kung KY, Shek SY, Yeung CK, Chan HH. Evaluation of the safety and efficacy of the dual wavelength picosecond laser for the treatment of benign pigmented lesions in Asians. Lasers Surg Med 2019;51(1):1422.
  3. Yu W, Zhu J, Yu W, Lyu D, Lin X, Zhang Z. A split-face, single-blinded, randomized controlled comparison of alexandrite 755-nm picosecond laser versus alexandrite 755-nm nanosecond laser in the treatment of acquired bilateral nevus of Ota-like macules. J Am Acad Dermatol 2018;79:479-86.
  4. Wu, D.C., Goldman, M.P., Wat, H. and Chan, H.H. (2021), A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations. Lasers Surg Med, 53: 9-49. https://doi.org/10.1002/lsm.23244