In today’s post, let’s take a look at one of the hottest laser treatments available today: picosecond laser.  Believe it or not, the history of picosecond laser in dermatology dates to over 20 years ago when the initial experimental devices were used in laboratories to treat tattoos for research purposes [Ross, Anderson, Dover 1999, 2000]. It took over 10 years for the technology to mature enough to be available commercially with the first dermatologic picosecond laser hitting the market in December 2012 (Picosure, Cynosure). I was one of the first people to use that laser and was involved in early clinical trials that helped further develop its capabilities beyond tattoo removal [Wu et al 2015]. Over the past 8 years, I’ve acquired extensive clinical and research experience with almost every picosecond laser currently available including the Picosure, PicoWay® (Candela), Enlighten (Cutera), and PiQo4 (Lumenis).  Because of my expertise with this new technology, I hold an editorial board position with our national laser society (American Society for Lasers in Surgery and Medicine) and am a member of Medical Advisory Boards and Expert Educational Bureaus on picosecond laser. 

What are picosecond lasers and why are they important?

Picosecond laser is an exceptionally powerful and versatile laser platform with the ability to treat a large variety of cosmetic concerns including tattoo removal, sunspot removal, birthmark removal, scar revision, complete photorejuvenation and anti-aging. For those of you who are more scientifically inclined or want to dig deeper into the subject matter, have a look at this review article that I published recently [Wu et al 2021].

Why is picosecond laser so useful? The answer is because it is both safer and more effective than the previous generation of laser technologies. The name “picosecond” derives from the fact that these lasers fire at speeds on the order of trillionths of seconds – that’s super fast! It turns out that when a laser can fire that fast, the effects on the skin become more precise and more powerful, thus allowing us to effectively treat common cosmetic concerns with a higher degree of safety and efficiency. For example, using picosecond lasers, the number of treatments it typically takes to remove an unwanted tattoo is as little as half when compared to older laser technologies. Similarly, brown spots and birthmarks respond much better and much faster while certain things like anti-aging and scar revision simply couldn’t be done with the older tech. At Coal Harbor, I’m proud to offer the PicoWay® laser – the most advanced picosecond laser platform in the entire world and one that I have used in clinical trials and for real patient treatments for the past 8 years.

Looking at common treatment uses

Let’s focus on two of the most common and satisfying applications of picosecond laser: removing sun spots and total skin rejuvenation. I was one of the first people to establish safe and effective protocols for these treatments with picosecond laser [Wu et al 2015, Guss et al 2015]. Here are some examples of patients I treated for sun spot removal with an early picosecond laser:

PicoWay® treatment for sun spots

Unwanted sun spots are a very common complaint and they can occur in almost any individual of any skin type or ethnicity. As you can see, picosecond laser (when done properly!) can be extremely effective at reducing these blemishes. In the laser world, it’s well known that the darker your baseline skin tone is, the harder and more dangerous it is to treat with laser. One of the revolutionary advances of picosecond laser, however, is in the elevated safety and effectiveness in treating skin of color. That’s one of the major reasons this technology has really caught fire in almost every country across the globe.  That being said, fair-skinned individuals can also greatly benefit from this technology too.

Total skin rejuvenation is something else that I frequently use picosecond laser to achieve. This is another one of my patients:

PicoWay® treatment for skin rejuvenation

You can see that prior to treatment, she had some concerns regarding discrete sun spots, more diffuse patchy uneven discoloration, overall roughened skin texture, enlarged pore size, fine lines and wrinkles.  By using a more advanced version of picosecond laser, I was able to target each one of these concerns specifically and improve them all globally. Look at how soft, smooth, and luminous her skin looks after treatment. It’s positively glowing! Also, one feature I REALLY love about picosecond laser is that it’s usually much less painful than many other types of lasers that I use. That’s an important benefit to note since I believe in making every one of my treatment experiences as tolerable as possible.

Parting Words

I hope I’ve given an interesting brief overview of picosecond laser. It’s become one of my favorite laser technologies due to its safety, versatility, and tolerability. I’ve performed over 1500 treatments to date and almost all my patients have been extremely satisfied with them. Because it’s still such a new technology, a highly specialized experience and expertise is required to optimize its benefits. If you have a particular interest in getting picosecond laser treatment, please stop by my Rejuvenation clinic office and we can discuss whether or not it’s the right treatment for you!

Until next time,

Director of Cosmetic Dermatology
Rejuvenation Dermatology Group