Pico Laser

Picosecond lasers

Above: Before and after treatment with Pico laser by Dr Bob Clinic for pigmentation concerns. Consent obtained for use of image

Schedule an appointment


You may be suffering from certain skin concerns whether it is pigmentations, scars, uneven skin tone or simply dull skin. You might have read about laser treatments for the skin, but there are so many different skin lasers out there, how do you know which one is the right one for you?

Aesthetic clinics as well as skincare centres are very aggressively marketing their pico laser treatments in your social media feed and search results.

There is just so much hype surrounding the use of pico lasers, but how much do we actually know about the technology? In this article, we peel away the layers of misleading marketing, and expose to you the technology and truth behind pico lasers.

What are pico lasers?

In the past, Q-Switched lasers were widely practised for removal of tattoos as well as treatment of acquired pigmentation disorders such as melasma, freckles, uneven pigmentation and dull skin.

The Q-Switched laser delivered pulses of high energy in nanosecond domain which is able to selectively target and destroy pigmentations so that your immune cells can eliminate it over time.

Compared to older CO2 lasers and Er:YAG lasers, Q-Switched Nd:YAG and Ruby lasers were relatively selective to pigmentations, and resulted in much lesser adverse affects and recovery time. However, it was soon realised that Q-Switched lasers resulted in a steady state after a certain number of treatments, and further treatments did not improve the condition. 

Moreover, prolonged treatment would result in various unwanted side effects were noted such as mottled hypopigmentation as well as postinflammatory hyperpigmentation. The rates of Postinflammatory Hyperpigmentation with Q-Switched lasers has been reported to be as high as 25%.

Picosecond lasers were later introduced, which delivered pulses in the picosecond domain. For reference, a picosecond is a trillionth of a second. Which means 0.000,000,000,001 seconds. 


Above: Before and after tattoo removal treatment at Dr Bob Clinic. Patient had previsouly had Q-Switched laser done, but the results did not improve with further treatments. Consent obtained for use of image.

Above: Before and after treatment with Pico laser by Dr Bob Clinic for pigmentation concerns. Consent obtained for use of image

Why deliver laser in picosecond duration?

The shorter the pulse duration, the less bulk heating is generated. But is that necessarily a good thing?

Shorter pulse durations would result in what is called a photo acoustic effect. The rapid heating and expansion of pigments results in a photo acoustic wave which shatters the pigment particles into tiny particles for elimination by your immune cells.

Photoacoustic effect differs from photothermal effect, where longer pulses of energy result in accumulation of heat in the pigment.

A lot of the unwanted adverse affects from laser treatments result from excessive energy causing tissue heating. This in turn could either damage our melanocytes, causing hypo pigmentation (white spots) or overstimulates them, causing hyperpigmentation (dark spots). In worst case scenarios you get a combination of both, resulting in mottled pigmentation.

Therefore, the Picosecond lasers are meant to result in better pigmentation clearance while minimising the adverse affects.

PicoPlus Laser

Picosecond laser is undoubtedly a revolutionary technology, and at the current moment there are only a handful of reliable manufacturers producing solid devices adopting this technology. However, there are still variations in terms of the wavelength, the pulse duration as well as the energy delivery amongst the laser devices.

PicoPlus is the latest Picosecond laser by leading aesthetic device manufacturer Lutronics. It was US FDA cleared in 2018, further establishing the safety and efficacy of the device. PicoPlus is also the 1st device approved by the Ministry of Food and Drug Safety (MFDS) for treating melasma.

PicoPlus is amongst the few Picosecond lasers that have been certified True Pico by a 3rd party, Korean Testing Laboratory. 


How is PicoPlus different from the rest?

PicoPlus offers extremely short pulse duration at 450ps compared to other well known brands of pico laser such as PicoSure and Pico Genesis at 750ps. PicoWay and PicoCare also operates at 450ps, whereas Discovery Pico can operate at 370ps. As mentioned earlier in this article, shorter pulse duration equals better safety.

Shorter pulse duration translates to better efficacy because the higher peak power achieved (laser pulse duration inversely related to peak power). Fotona Starwalker PQX with its shortest pulse duration has an extremely high peak power (2.7G) followed by PicoPlus and Discovery Pico both generating the second highest peak power (1.8GW).  PicoWay (0.9GW) and PicoCare (1.33GW) have lower peak powers despite also sharing the same 450ps pulse duration. PicoSure has the lowest peak power in this comparison (0.36GW).

Another factor that sets PicoPlus apart is the capability of producing 4 different wavelengths (1064nm, 532nm, 595nm, 660nm) to effectively target almost every type of skin concern, whether it is tattoos and acquired pigmentary disorders, acne and erythema, or even skin rejuvenation for scars and wrinkles. Fotona PQX provides access up to 5 different wavelengths, and PicoCare also has 4 different wavelengths. PicoSure and Pico Genesis has only 2 wavelengths whereas Discovery Pico and PicoWay has only 3 wavelengths. 

Bear in mind having access to the extra wavelengths are only beneficial in the hands of trained professionals. 

This study Choi, M.S., Seo, H.S., Kim, J.G., Choe, S.J., Park, B.C., Kim, M.H. and Hong, S.P., 2018. Effects of picosecond laser on the multi-colored tattoo removal using Hartley guinea pig: A preliminary study. PloS one, 13(9), p.e0203370. showing the effectiveness of different wavelengths in the removal of different coloured tattoos would give us an idea why it is important to have access to multiple wavelengths.

Taking all these factors into consideration, Dr Bob Clinic has chosen to work with the PicoPlus due to the short pulse duration (450ps), high peak power (1.8GW) and access to 4 different wavelengths. 

This study shows that a combination of 2 picosecond laser wavelengths, namely the 1064nm and 595nm wavelengths to be safe and effective for the treatment of melasma among Korean patients.

Choose an authorized provider

All the Pico Laser machines listed in this article have their own pros and cons. They are all able to deliver good results in the right hands. Bear in mind that there are counterfeit laser devices out there with dubious quality.

Nonetheless, even the best devices can be dangerous in the hands of an indiscriminate operator. There have been countless cases of patients getting side effects from lasers done by unauthorized operators.

Based on the Guidelines for Aesthetic Medical Practice released by the Malaysian Ministry of Health, only Registered Medical Practitioners with Letter of Credentialing and Privileging are allowed to operate lasers for treating pigmentations. The list of doctors with Letter of Credentialing and Privileging can be found on the official Malaysian Ministry of Health portal.

While you are deciding on which centre to go to to have your Pico laser done, please spare the time to check the credentials. Is the centre you going to a registered clinic? Is the laser going to be administered by a doctor? There are plenty of businesses out there masquerading as clinics. Do not fall victim to them.

New! Aliaxin dermal fillers