Picosecond lasers are not only effective for pigmentation and tattoos, but also for scars and skin rejuvenation, creating innovative trends in dermatology. And while there are a number of picosecond lasers available, I have chosen PICOCARE from Wontech (Daejeon, Korea) because of its superior engineering and clinical performance. Its 450 ps pulse duration and 1.33 GW peak power provide excellent performance and great results. In my experience with PICOCARE, I have found that it is very versatile, effectively treats a variety of skin lesions and is safe even for darker skin types.
Compared to nanosecond lasers (one billionth of a second), picosecond lasers (one trillionth of a second) offer greater photoacoustic effect versus photothermal effect and, consequently, are associated with fast, efficacious and safe treatments. The picosecond pulse duration can shatter endogenous and exogenous macro-pigment particles into much finer micro-pigment particles, allowing more efficient macrophage clearance. It also produces less procedural discomfort and adverse effects such as vesiculation, purpura and post-inflammatory hypopigmentation.
PICOCARE’s dual wavelength (532 nm and 1064 nm) targets epidermal pigmented lesions (e.g. solar lentigines, freckles/ ephelides), epidermal pigmented birthmarks (CALM), dermal pigmented birthmarks (e.g. nevus of Ota, Hori’s nevus, epidermal nevus), and exogenous pigment (e.g. tattoo, iron-infusion staining). See Figures 1 and 2.
With a novel fractional handpiece, the ultra-short pulses and high-intensity energy generate laser-induced optical breakdown (LIOB). LIOB produces multiple plasma-induced micro-vacuoles within the skin layer (epidermis and/or dermis) without damaging the stratum corneum and dermo-epidermal junctions, resulting in fast and effective tissue repair and remodeling. PICOCARE’s HEXA Micro Lens Array (MLA) handpiece has various spot sizes from 3 – 10 mm, allowing physicians to perform more delicate treatments; 3 – 4 mm for acne scar treatment; and 8 – 10 mm for skin rejuvenation (improvements of enlarged pores, fine lines, wrinkles and uneven skin texture). See Figures 3 and 4.
After only one to three sessions, HEXA MLA rejuvenation is especially effective for enlarged pores, fine lines, wrinkles and uneven skin texture, as well as pigmentation. Since PICOCARE offers minimal procedural discomfort and downtime, with visible results, this treatment is popular among patients with busy lives who desire improved skin quality. See Figures 5 and 6.
PICOCARE is a valuable laser in my practice because it can effectively treat a range of skin conditions, and it is suitable for all skin types. My patients and I have been extremely satisfied with the great results achieved in the treatment of pigmentation, scars and skin rejuvenation. In addition, PICOCARE has recently been advocated for new indications, such as nail fungus and benign melanochia, further extending its versatility.
Adrian Lim, M.B.B.S., F.A.C.P., F.A.C.D.
Dr. Lim is one of Australia’s leading dermatological experts. He is a visiting dermatologist in the department of dermatology at the Royal North Shore Hospital, St. Leonards (Sydney, New South Wales, Australia) and the founder of uRepublic Cosmetic Dermatology and Veins in Sydney.
1. Bernstein EF, Schomacker KT, Basilavecchio LD, Plugis JM, Bhawalkar JD. Treatment of acne scarring with a novel fractionated, dual-wavelength, picosecond-domain Laser incorporating a novel holographic beamsplitter. Lasers Surg Med. 2017; 49:796–802.
2. Choi YJ, Kim JY, Nam JH, Lee GY, Kim WS. Clinical outcome of 1064-nm picosecond Neodymium–Doped Yttrium Aluminium Garnet laser for the treatment of hypertrophic scars. J Cosmetic Laser Therapy. 2018; DOI: 10.1080/14764172.2018.1469768.
3. Gold MH. Dual wavelength treatment protocol with a picosecond laser for the reduction of facial wrinkles, J Cosmetic Laser Therapy. 2018; DOI: 10.1080/14764172.2018.1481514.
4. Zaleski-Larsen LA, Jones IT, Guiha I, Wu DC, Goldman MP. A comparison study of the nonablative fractional 1565-nm Er:glass and the picosecond fractional 1064/532-nm Nd:YAG lasers in the treatment of striae alba: a split body double-blinded trial. Dermatol Surg. 2018; 0: 1-6.
5. Negishi K, Akita H, Matsunaga Y. Prospective study of removing solar lentigines in asians using a novel dual-wavelength and dual-pulse width picosecond laser. Lasers Surg Med. 2018; DOI: 10.1002/lsm.22820.
6. Chalermchai T, Rummaneethorn P. Effects of a fractional picosecond 1,064 nm laser for the treatment of dermal and mixed type melasma. J Cosmetic Laser Therapy. 2018; 20:3, 134-139, DOI: 10.1080/14764172.2017.1376098.
7. Artzi O, Mehrabi JN, Koren A, Niv R, Lapidoth M, Levi A. Picosecond 532-nm neodymium-doped yttrium aluminium garnet laser a novel and promising modality for the treatment of café-au-lait macules. Lasers Med Sci. 2018; 33: 693–697.
8. Levi A, Amitai DB, Mimouni D, Leshem YA, Arzi O, Lapidoth M. Picosecond 532-nm neodymium-doped yttrium aluminum garnet laser a promising modality for the management of verrucous epidermal nevi. Lasers Med Sci. 2018; 33:597-601.