Pico: Is it Really Better?

One of the many questions I often get from young doctors venturing into aesthetics is :

Should I get a Picolaser?

Pico laser treatments has been the latest craze in recent times brought on by aggressivemarketing strategies by commercialised beauty and skincare providers. However, it is sometimes deceptive and irresponsible in nature.

Pico technology is in fact an interesting technology. Being able to limit the pulse duration of the laser into one trillionth of a second, the engineers behind this technology is indeed brilliant.

The baseline understanding of how pico works is that when the exposure of the laser pulse is limited to such a small fraction of a second (in the picosecond range), high peak energy is able to be delivered into the skin and be absorbed by the target particles (eg. melanin) without creating much injury to surrounding structures. The light energy converts to acoustic energy which creates a vibrational force within the melanin to shatter it into smaller particles, to be removed by our immune cells.

Looking into its mechanism of action, we can understand that Pico is indeed an amazing technology. However, it should be used with a thorough understanding of its action. Not all skin pigmentations can benefit from Pico treatments.

Image: Freckles

Epidermal pigments such as ephelids (freckles) and lentigenes (sunspots) can get great clearance quickly from Pico treatments. However, there are other lasers such as Q-Switched Nd:Yag lasers that can deliver effective results for these conditions too. Q-Switched lasers has a slightly longer pulse duration (in the nanosecond range) which delivers more energy to break the pigments.

Image: Melasma

Deeper pigmentations such as melasma is another major skin condition that affects many Asian skin types. One who's having such a condition shall seek proper treatments from qualified and certified medical aesthetic practitioners or dermatologists and not be duped into signing up for commercialised Pico treatments with the expectations that Pico itself will clear their melasma.

More often than not, melasma is heavily affected by many other factors such as skin structure integrity, hormonal disruptions, sleep disturbances, stress hormones and prior usage of hormonal contraceptive methods. In my practice, I look into all these factors, then stabilise and optimize them to get the best results for my patients. Pico lasers may be used as one of the treatment modalities, but usually not as a first-line treatment. Commercialised pico facials by unqualified beauticians is definately not the answer to treat melasma.

For skin rejuvenation and skin tightening, Pico can deliver enough energy to create Laser Induced Optical Breakdown, LIOB (not pulse induced). This is great to create multiple micro-cavitations in the skin dermis to promote skin regeneration. This is best enhanced with injectable regenerative treatments such as PRP, PDRN/PN, exosome or stem cell factors that should only be performed by licensed aesthetic doctors. There are also other types of lasers that gives fantastic and highly satisfactory results for skin rejuvenation and tightening, some with slightly more downtime such as Fractional CO2 lasers and some with zero pain such as Diode lasers (I shall write about it soon).

So, is Pico really the best type of lasers in the market? Yes, it may be for some treatments (such as epidermal pigments and tattoo removal) but not necessarily the first-line treatment for other types of skin conditions, pigmentations or rejuvenation.

To make sure you get the best out of a Pico laser treatment, do consult a certified and licensed aesthetic doctor to treat the core and root cause of your skin conditions.

To schedule a consultation with our certified doctors at Ava Clinic, kindly call

011-3965 0385.

Ava Clinic

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