What is Pico Laser treatment ?

If you have arrived here, then you are probably thinking of getting a laser treatment for yourself or want to know more about the effectiveness and technology behind this treatment. Lots of questions in your mind like is it safe? Is it effective? Can it solve my skin problems? Well, today we are going to talk about laser treatment and specifically Pico laser.

1. What is laser and light skin treatment?

Anderson and Parish are two researchers who became the first to introduce and theorize laser treatment in 1983. The theory is simple but phenomenal and easy to grasp. The idea is that we can use light and laser properties to specifically target, destroy, or alter specific cells in the body. This allows for the resolution of a wide range of skin-related issues that were previously unsolvable or difficult to treat. Light and laser therapies have been used to treat a variety of dermatological and cosmetic conditions, such as birthmarks, acne, melasma, stretch marks, wrinkles, and pigmentation. IPL, Q switched laser, Pico Laser, non-ablative fractionated resurfacing laser, and ablative fractionated resurfacing laser are the five primary types of lasers and light treatment. (1) But today we are going to talk mostly about Pico Laser.

2. What is a Pico laser?

Pico laser stands for Picosecond Laser. Yes, a picosecond is a unit measurement for time. The picosecond laser is a revolutionary laser technology because of its much shorter pulse duration of only 1012 seconds which is a picosecond. (2) A shorter laser pulse length causes pigment fragmentation due to photoacoustic rather than photothermal effects. As a result, it is effective at pigment removal without causing injury to the surrounding tissues. (1)

3. How does the Pico Laser work?

By providing concentrated energy in a truly short pulse duration, the Picosecond laser has a lesser fluence and causes less heat discomfort to the surrounding tissue. It primarily produces photomechanical effects (PMEs) and stress destruction effects on targets. It can break down pigment particles into smaller pieces, allowing the immune system to eliminate the fragmented pigments more efficiently (3).

4. The Pico laser: Does it work?

Yes, it works!
The procedure is different from the other laser treatments that your dermatologist might administer. This specific lens transforms the powerful laser energy into a gentle pressure, in contrast to conventional laser acne scar treatments, which repeatedly expose your delicate skin to high temperatures. The pressurization procedure causes the energy to constrict your new skin cells, prompting them to produce new collagen and elastin painlessly. There will not be any burning or damage to the skin during this operation, and there will not be much recovery time either. All you will see is a healthier and more vibrant texture to your skin.

The amazing benefit of picosecond laser treatment.

a) Reducing melasma

Melasma is a common dermatological condition that mostly affects female patients. It involves hyperpigmentation that is chronic and recurring. Women who experience major hormonal changes because of pregnancy, hormone replacement treatment, or birth control pills, are more likely to develop melasma. They can appear anywhere in the body, commonly on the face but sometimes they can also appear on the neck, chest, and forearm. (1) Luckily, Picosecond laser therapy is a safe and effective way to address this problem. It effectively treats even the most severe cases of melasma since it immediately targets the discolored regions without harming the surrounding skin. (3)

b) Post-inflammatory hyperpigmentation (PIH)

Post-inflammatory hyperpigmentation is a complex condition characterized by abundant epidermal melanin, irritated/hyperactive melanocytes, basement membrane breaches, melanin incontinence, irregular dermal melanin deposition, melanophage development, hemosiderin deposition, and a complex of inflammatory factors. The most crucial factor to consider when treating PIH is avoiding additional irritation and re-induction of inflammation, which can lead to subsequent PIH. Thus, less irritation and a more efficacy regimen offered by Pico lasers are recommended. In simpler terms, the Pico laser causes less irritation and makes it more efficient and effective in treating hyperpigmentation.

c) Freckle and solar lentigines

Freckles and solar lentigines most commonly occur in the convex areas of the face including the nose and maxillary regions. Traditional QS lasers (Q-switched alexandrite laser yield as high as 76% improvement and >80% of cases achieve 50% improvement (5). However, these levels of improvement are still unsatisfactory. Other than that, the characteristic of Asian skin is prone to complications. Considering the less irritation and more efficient (LIME) property alone, the Pico laser is a good novel treatment for such conditions. It more efficiently breaks down melanin while causing less irritation and fewer complications. It has been reported that the Pico laser is highly efficient against solar lentigines, yielding a treatment response rate of 93.02% with >75% clearance with only a single treatment. Newer laser wavelengths with Picosecond technology allow deeper penetration and even fewer complications to the normal epidermal melanin while causing less irritation to hemoglobin and blood vessels owing to its high melanin-to-hemoglobin ratio (3). 

d) Skin wrinkles

Research proves that the Pico laser performance is amazingly effective in treating wrinkles and age-related problems due to the result showing that 90 % of the recipients were extremely satisfied with the outcomes (6).

e) Tattoo removal

A fantastic comprehensive study on the use of Pico lasers for tattoo removal was studied by Reiter et al. in 2016. It is concluded that the Pico laser had a strong photoacoustic impact that, in theory, might help remove a wider range of tattoo colors. Green, yellow, red, and purple tattoos have all been successfully removed with Pico lasers (7).

f) Acne scar, pores, and skin texture

In 2021, Lee et al. study the effectiveness and safety of treating acne scars and face wrinkles with a fractional 1,064-nm picosecond laser with a diffractive optic element. Dermatologists evaluated the mean global improvement scores at weeks 3, 6, and 14. Skin texture, depressions, pores, and skin profilometry revealed appreciable improvements. Skin firmness and overall elasticity both considerably increased by 10.96% and 9.04%, respectively (9).

5. Does a picosecond laser hurt?

Without anesthesia or numbing agents, most patients find the discomfort associated with Pico laser treatments to be low and manageable. However, if you are anxious or sensitive to pain, you should request a topical anesthetic before the procedure. This can lessen uncomfortable sensations and improve the comfort of the treatment. Pico laser therapy is by nature non-invasive. Thus, surgery is not required. Patients should therefore anticipate little downtime. Most patients equate the Pico laser’s sensation to the skin being flicked by tiny rubber bands, although because tattoos have a bigger pigment-filled surface area, there may be more discomfort during tattoo removal. Most patients claim it hurts more than getting a tattoo. If you are sensitive to pain, your doctor can administer numbing cream.

6. Downtime or side effect of Picosecond laser?

After each Pico laser session, some patients report minor side effects such as dry skin and moderate discoloration. The good news is that they vanish in a few days.

7. How many Pico laser treatments were necessary for you?

To reach the optimum look goals, most individuals often need 3 or 4 consecutive sessions. These treatments are spaced apart by at least two to four weeks, and if you have sensitive skin or a darker complexion, sometimes even eight weeks. Naturally, the number of treatments you require may vary depending on your unique treatment goals, so you might need more or fewer treatments than other individuals.

Fine lines and wrinkles
If fine lines and wrinkles are your main concern, you might only need two or three treatments to reduce their appearance. This is especially true if the severity of your fine lines and wrinkles is relatively modest. Additional treatments may be necessary for deeper or more dynamic wrinkles. This estimate for the number of treatments you will need also applies to treating skin laxity.

Pigmentation
It may take three or four treatments to address pigmentation issues like post-inflammatory hyperpigmentation, hyperpigmentation brought on by UV damage, dark spots, melasma, freckles, and other skin discolorations. You could require more than 4 treatments if your pigmentation issues are severe or include a larger area of skin.

Scar
Scarring includes both wound-related and acne-related scars. To decrease the visibility of scars and break down scar tissue, this therapy normally only needs 4 sessions.

Tattoo removal
It should only require between 3 and 5 treatments to completely remove the tattoo, depending on the pigmentation, style, and color of the individual tattoo.

8. How soon can you see outcomes?

Your skin’s inherent regeneration ability will eventually show the effects of this treatment. Most individuals see their first findings two to three weeks following their initial session. Up until the time of your last treatment, or until the best results have been obtained, your results will keep getting better. You might get improvements sooner or later than other patients, though, depending on your treatment objectives. It also depends on some factors including age and skin condition, skin cell turnover cycle, and level of elastin and collagen in your skin.

Age and skin condition
Because more effort needs to be done to reverse aging, mature skin often takes longer to show apparent effects from treatment. This is partly because the natural regeneration qualities being promoted by this treatment take longer to manifest. You might not see benefits for three to four weeks after your initial session depending on your specific skin problem, including your skin type, skin tone, and the seriousness of your skin concern.

Skin cell turnover cycle
How quickly you can see the results of your treatment may also depend on your skin cell turnover cycle. The typical skin cell turnover cycle is anywhere from 28 to 40 days long, which means it may take that long for new skin cells to rise to the top level of your skin. Again, those with mature skin have slower skin cell turnover cycles because of aging and may require more time to enjoy results.

The present level of collagen and elastin
The amount of collagen and elastin that is currently present in your skin may also influence how quickly you can see the improvements. Both the naturally occurring proteins collagen and elastin give the skin structural stability. Again, as collagen and elastin levels decline over time, younger patients have access to more of these resources and will experience quicker results than those with more advanced skin.

9. How long does a Pico laser last?

You might expect your initial course of treatment to have long-lasting effects. Most patients can anticipate experiencing the advantages of Pico laser treatments for at least six months before they begin to fade. In the case of specific issues like the removal of scars and tattoos, the results of this treatment are thought to be permanent. This is due to the precise method used to handle these issues and the fact that the Pico laser technology completely breaks apart the pigment in scars, pigmented lesions, and tattoos. Scarring and tattoo removal cannot be undone after treatment, unlike superficial skin flaws brought on by age, which reappear when the treatment’s effects wear off. Additionally, pigment abnormalities, such as colored scar tissue, may be permanently removed using this method. Depending on how long your results persist, we will decide how frequently you need to come in for treatment. To maintain your results, you might want to schedule a maintenance appointment every four to six months if you are having this treatment for fine lines and wrinkles.

10. What can I expect after the treatment?

As with most laser treatments, you can expect some redness and swelling. The redness usually gives patients a flushed appearance, but how much depends on how intense the operation is, and which places you are treating. It is immediately safe for you to go back to work or school. It normally takes a few hours to a day or two for the redness and swelling to go down. Although it is legal to wear makeup and be outside in the sun, it might be advisable to avoid doing so.

After the Pico treatment, there is very minimal chance of skin burning, but your skin will be much happier if you do not expose it to any more harmful UV rays. Certain scents and oils in makeup can clog your pores and prevent your skin from recovering. It is wise to refrain from using face powder or makeup because of this. However, lipstick, brow gel, and eye makeup are acceptable.

Avoid touching or scratching the treated area to get the optimum benefits. Tempting though it may be, doing this could irritate your skin and prevent it from healing. Instead, it is advised that you gently cleanse your face until the redness disappears. This entails washing your skin gently with cool water and an oil-free cleanser.

11. Can glass skin be achieved by Pico laser treatment?

Everyone is getting on board with the “Glass Skin” trend in Korean beauty. The phrase refers to having skin that is flawless and free of any pores, blemishes, or zits. Additionally, it refers to a specific shine on the skin, which is typically created with highlighter makeup.

In short, Pico laser treatment can undoubtedly aid in the removal of acne, scars, wrinkles, discoloration, and melasma that are preventing you from having “glass skin.” However, that appearance is the result of numerous procedures, products, and skincare commitments. Make an appointment with Klinik Hana to explore your options and hear the advice from our dermatologist for getting “glass skin”!

It is advised that you always seek the guidance of skilled cosmetic doctors on how to meet your aesthetic objectives. When a professional can provide you with accurate knowledge that has been supported by science, do not squander your time or money on life hacks, snake oil creams, or do-it-yourself fixes.

12. Are you suitable for Pico laser treatment?

The ideal candidate is someone who wishes to get pigmentation patches, or a healed tattoo removed and is in generally good health (about six months from the tattoo date). Any color and size are acceptable for tattoos. Pico laser treatment is not recommended for some people. Discuss other options with your dermatologist if you:

  • Hypersensitive to infrared wavelength light, taking medication that increases sensitivity to sunlight/UV rays or having seizures triggered by light.
  • Have an autoimmune disorder, including lupus or type 1 diabetes (type 2 may be acceptable if it is well controlled).
  •  Have melanoma, an active infection (such as herpes), psoriasis, or eczema in the area being treated.
  • Currently, take or have taken oral isotretinoin (commonly known as Accutane) within the past six months.
  • Pregnant or breastfeeding. There is no research to suggest laser tattoo removal may affect your or your baby’s health, but it is wise to not risk it.
  • Have a tan. Most practitioners recommend avoiding the sun or tanning (even using self-tanning creams) on the area for about four weeks prior to treatment.
  • Have a history of keloid scarring.
  • Additional precautions that may not exclude you from treatment but will be taken into consideration include taking blood thinners (anticoagulants can interfere with healing) and having a pacemaker or defibrillator. 
  • If the tattoo you want to remove is right over or within six inches of a medical device, it cannot be lasered.

13. How is this treatment done?

Your dermatologist will ask you about your medical history prior to the operation. Before the operation, make sure to let them know if you have any allergies or are taking any drugs. Lidocaine is an ingredient in most Belotero preparations. This particular form of local anesthetic aids in reducing injection pain. Ask your dermatologist about using a topical anesthetic before the surgery if you are worried about pain. Your dermatologist  may label the areas that will be treated with a marker before administering an injection. The region will then be cleaned using an antiseptic solution. Your dermatologist will use a fine-gauge needle syringe to inject Belotero once the area has been cleaned. After the injection, they could gently massage the area to help the filler spread out for a more natural look.

If you have read this far, Congratulations!!! You learned something new today and smarter than yourself yesterday. But for those of you who skipped until here, to simplify this article for you here is one sentence that can summarize it all for you. “Smart people make good technology, good technology solves your skin problems, you become prettier than your friends, you get more likes on instagram”. So what are you waiting for?

References :

1) Trivedi, M.K., Yang, F.C., &Cho, B.K. (2017). A review of laser and light therapy in melasma. International Journal of Women’s Dermatology 3 [1]: 11-20. Link Here

2) Haimovic, A., Brauer, J.A., Cindy Bae, Y.S. (2016). Geronemus RG. Safety of a picosecond laser with diffractive lens array (DLA) in the treatment of Fitzpatrick skin types IV to VI: a retrospective review. J Am Acad Dermatol. 2016;74(5):931–936. Link here

3) Wong, T.(2019). Picosecond laser treatment for Asian skin pigments: a review. J Cosmet Med 2019;3(2):55-63. Link Here

4) Jang, K.A., Chung, E.C., Choi, J.H., Sung, K.J., Moon, K.C., & Koh JK. (2000). Successful removal of freckles in Asian skin with a Q-switched alexandrite laser. Dermatol Surg. 2000 Mar;26(3):231-4.Link Here

5) Rashid, T., Hussain, I., Haider, M., & Haroon, T.S. (2022). Laser therapy of freckles and lentigines with quasi continuous, frequency-doubled, Nd:YAG (532 nm) laser in Fitzpatrick skin type IV: a 24-month follow-up. J Cosmet Laser Ther. 2002 Dec;4(3-4):81-5. Link Here

6) Weiss, R.A., McDaniel, D.H., Weiss, M.A., Mahoney, A.M., & Beasley, K.L., et al. (2017).Safety and efficacy of a novel diffractive lens array using a picosecond 755 nm alexandrite laser for treatment of wrinkles. Lasers Surg Med 2017;49(1): 40–44. d. Link Here

7) Saki, N.(2017). Picosecond laser applications in aesthetic dermatology. J Surg Dermatol 2017; Link Here

8) Reiter, O., Atzmony, L., Akerman, L., Levi, A., & Kershenovich, R., et al. (2016). Picosecond lasers for tattoo removal: A systematic review. Lasers Med Sci 2016; 31(7): 1397–1405. Link Here

9) Lee, C.H., Jin, E.M., Seo, H.S., Ryu, T.U., & Hong, S.P. (2021). Efficacy and Safety of Treatment with Fractional 1,064-nm Picosecond Laser with Diffractive Optic Element for Wrinkles and Acne Scars: A Clinical Study. Ann Dermatol.Jun;33(3):254-262. Link Here

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