What Is Pico Laser? What It Treats and How Many Sessions

Pico laser (picosecond laser) is a laser that delivers energy in extremely short, picosecond-level pulses (one trillionth of a second), so it focuses on breaking up pigment through vibration rather than heat. It is therefore popular for caring for melasma, freckles, dark spots, post-acne marks, improving skin texture, and tattoo removal, usually as a course of several sessions. Results vary by individual.

What is pico laser?

Pico laser is a newer laser technology developed from earlier laser families. Its key feature is the speed at which it delivers energy: a “picosecond” refers to an extremely short unit of time on the order of one trillionth of a second. When energy is delivered over a shorter time, the heat that builds up in the skin tends to be lower, which makes pico laser a popular option for caring for pigment concerns in Asian skin.

In dermatology, pico laser is often discussed in the context of tattoo removal and the treatment of certain pigmented lesions, and academic reviews have concluded that it is a useful tool in this group. However, the level of evidence for some indications, such as melasma, is still moderate, because the number of randomized controlled trials remains limited. Having it done by an experienced doctor to assess whether it suits each person’s skin is therefore important.

How does pico laser work (picosecond-level energy)?

Pico laser works on the basis of what is called the “photoacoustic effect,” or a light-sound effect. That is, when light energy is delivered over an extremely short picosecond-level time, that energy is absorbed by the pigment and converted into tiny vibrations that help shatter the pigment into smaller particles, rather than primarily using heat to burn it away as earlier-generation lasers did.

When pigment is shattered into smaller pieces, the body gradually clears those particles away through natural processes. Academic literature on tattoo removal explains that the main mechanism of pico laser is shattering pigment with acoustic force (photoacoustic), with a heat component (photothermal) as a secondary element, which helps reduce damage to the skin surrounding the pigment compared with lasers that rely primarily on heat.

In addition, in modes that use a beam-shaping lens to spread the energy into tiny spots, this concentrated energy may also stimulate the production of collagen and elastin in the skin layers, through thermal and mechanical mechanisms, without removing the top layer of skin in an ablative way. This is the basis for using pico laser to improve skin texture and care for acne marks.

What can pico laser treat?

Pico laser is commonly used to care for several groups of skin concerns, with a focus mainly on pigment concerns, which can be summarized as follows:

• Melasma: May help melasma look lighter in some people, with most studies using low-energy modes over multiple sessions. However, melasma can recur, so ongoing care and sun protection are needed.
• Freckles and dark spots: This is a group that pico laser often responds to well in many people, with studies evaluated by polarized-light photography reporting changes in certain pigmented marks as early as after a few sessions. Results depend on the type of mark and the individual.
• Post-acne marks (red/dark marks after acne): May help marks look lighter when done together with appropriate skin care.
• Acne scars and uneven texture: In fractional mode, studies report improvement in fine lines, texture, and pores after several sessions.
• Enlarged pores: May help improve skin so it looks smoother by stimulating collagen.
• Tattoo removal and certain pigmented marks: This is one of the indications for which pico laser is noted in the academic literature, especially multicolored tattoos that earlier-generation lasers found difficult to manage.

Assessing whether each person’s skin concern is suitable for pico laser, and which mode should be used, should be under the consideration of an experienced doctor.

Summary table: what pico can help treat and approximate number of sessions

Note: The figures are approximate values from studies and general use. Results vary by individual and the doctor’s assessment.

How many modes does pico laser have?

In general, pico laser usually has several operating modes to suit different skin concerns, which the doctor selects according to the treatment goal. For example:

• Pigment-focused mode: Uses energy in a form that focuses on shattering pigment, suitable for freckles, dark spots, and tattoos.
• Low-energy diffused mode (toning): Often used for melasma and for evening out skin tone, using gentle energy over multiple sessions.
• Fractional mode: Uses a beam-shaping lens to spread energy into tiny spots to stimulate collagen production, suitable for caring for acne scars, texture, and fine lines.

The number and names of modes may differ depending on the model and brand of the device. Adjusting the energy settings and choosing the mode appropriate for each person’s skin is something that should be under a doctor’s care.

Does pico laser hurt?

The sensation during pico laser is often described as like a light rubber-band snap or brief, pinpoint warmth, which overall most people can tolerate. The level of sensation depends on several factors, including the mode and energy used, the area treated (some areas, such as around the nose or cheekbones, may be more sensitive), and each person’s individual sensitivity.

In some cases, the doctor may consider applying a topical numbing cream beforehand to help reduce discomfort. After treatment, there may be mild redness or swelling in the treated area, which is a natural response of the skin and usually gradually improves.

How many pico laser sessions until you see results?

A common question is how many sessions it takes to see a change. The answer is that it depends on the skin concern and how each person responds, but a general reference from research is as follows.

In melasma, there are randomized studies in which participants received pico laser 3 times, spaced about 4 weeks apart, and another study using a specific-wavelength mode reported an average of about 3-4 sessions, finding that the melasma severity score (MASI) decreased by roughly one third from baseline at an average follow-up of about 8 weeks in the studied group.

In acne marks and skin texture improvement, academic reviews indicate that clinical improvement is often seen after about 3-4 sessions, spaced about 3-4 weeks apart. Tattoo removal usually requires more sessions, depending on the color, size, and depth of the pigment.

In summary, pico laser is usually an ongoing course rather than a single session, and the results obtained vary by individual. The doctor will assess and plan the appropriate number of sessions after examining the skin.

How do you care for skin after pico laser, and what should you avoid?

Aftercare is a key factor that helps the skin recover well and lowers the chance of post-inflammatory hyperpigmentation (PIH), which is seen more often in people with darker skin. What you should generally do and avoid includes:

What to do

• Apply sunscreen regularly and reapply during the day, because sun protection is a measure that research indicates can help reduce the risk of post-inflammatory hyperpigmentation.
• Avoid sunlight during peak hours (roughly 10:00 a.m.-4:00 p.m.), wear a wide-brimmed hat, or use an umbrella.
• Apply moisturizer to keep the skin hydrated and help it recover.
• Strictly follow your doctor’s advice.

What to avoid in the early period

• Avoid intense sun and tanning/tanning beds.
• Skip scrubs or strong exfoliation and irritating products in the early period, as advised by your doctor.
• Avoid very hot water, saunas, and heavy exercise that causes a lot of sweating in the early period.
• Do not pick or scratch the treated skin.

Mild redness, slight swelling, or light flaky peeling in the early period is common and usually improves gradually within a few days. If you have abnormal symptoms, such as unusually severe redness, pain, or a wound, you should consult the doctor who performed the treatment.

Why do pico laser prices differ between places (beware non-standard devices)?

Pico laser prices seen in the market have a wide range. There are several factors that cause prices to differ, for example:

• Device model and standard: Devices that are certified to standards and properly maintained usually have higher costs.
• Mode and number of shots used: Each treatment uses different energy and a different number of shots according to the skin concern and area.
• Size of the area and complexity of the concern: Complex concerns or large areas may require more time and resources.
• Experience of the doctor and team: Proper assessment and appropriate settings are an important part of the result.

What to watch out for is unusually low-priced promotions, which can sometimes come from using non-standard devices or inappropriate settings, which may affect safety and results. Choosing a clinic with an experienced doctor and a standard-compliant device is therefore more important than looking at price alone. At Onnyx Clinic, prices are quoted as ranges according to the skin concern and care plan. Ask for details via LINE.

Read more about our Pico Laser service to better understand your skin concern.

Consult the Onnyx Clinic medical team

If you are considering pico laser to care for melasma, freckles, dark spots, acne marks, or to improve skin texture, a good starting point is to have an experienced doctor assess your skin first, to plan the mode and number of sessions suitable for you. Message us to talk and ask about price ranges via LINE @onnyxclinic. The Onnyx Clinic team is happy to advise.

References

• American Academy of Dermatology — Lasers and lights: How well do they treat acne scars, wrinkles, and other skin conditions?
• Picosecond Laser Treatment for Tattoos and Benign Cutaneous Pigmented Lesions (Secondary publication) — PMC
• Comparison of the efficacy and safety of picosecond Nd:YAG laser (1,064 nm), picosecond alexandrite laser (755 nm) and 2% hydroquinone cream in the treatment of melasma — PMC
• Efficacy and Safety of Treatment with Fractional 1,064-nm Picosecond Laser with Diffractive Optic Element for Wrinkles and Acne Scars — PMC
• Interventions to Prevent Postinflammatory Hyperpigmentation After Laser and Energy-Based Device Treatments: A Systematic Review and Network Meta-Analysis — PMC
• Evaluation of the Efficacy of the 755 nm Picosecond Laser in Eliminating Pigmented Skin Lesions after a Single Treatment — PMC