Pigmentation Treatment with the Picosure Pro Laser

Pigmentation Treatment with the Picosure Pro Laser

By Dr Davin Lim, Procedural Dermatologist, Brisbane & Sydney

Pigmentation Treatment with the Picosure Pro Laser

At Cutis Dermatology, Brisbane, we have the Picosure, Picoway & the very latest Picosure Pro laser by Cynosure. The Picosure Pro is the best laser for overall skin rejuvenation, whilst the Picoway laser is good for deep pigmentation. This treatment series addresses pigmentation, fine lines, enlarged pores & blemishes- all with no downtime.

Picosure Pro Series Summarised

  • Picosure Pro is the leading laser for skin rejuvenation
  • This laser address pigmentation, dark spots, fine lines & enlarged pores
  • Each treatment takes less than 7 minutes to perform
  • A series of 4 sessions are performed 
  • Results are seen with the first laser treatment
  • There is no recovery time following Picosure Pro laser
  • Treatments start from $560 per session (series package)
  • Cutis is Brisbane’s leading laser clinic for Picosure treatments, we have been using this laser since 2015

What is the treatment like?

Picosure Pro  is the fastest pico laser available. Treatment is over within 7 minutes. We use extra-strength numbing gel with a cool air to ensure the treatments are comfortable. 

Picosure Pro Laser Brisbane

How soon before I see results?

Results are seen within one session, however for best results a series of 4 sessions is required. Laser sessions are spaced between 3 to 6 weeks apart. 

What is recovery like?

Recovery is super quick following pico laser resurfacing. Expect to be red for up to two hours after the laser. Your skin will be normal within 12 hours of treatment. If you have heavy pigmentation spots may temporarily darken for one week before lightening. 

picosure pro series

Will all types of pigmentation resolve with laser?

Picosure Pro can reduce many types of pigmentation, including age spots, sun damage, freckles, melasma & even deep pigmentation. Depending on the type of pigmentation, expect a 50 to 95% improvement with a series of laser sessions. 

What else will this laser treat?

Picosure will also address- 

  • Enlarged pores
  • Fine lines & fine wrinkles
  • Skin texture
  • Dark marks left from acne

Picosure gives unparalleled results without the downtime of fractional lasers, however the results are biased towards darker & ethnic skin. Why? Because it works by targeting pigment. Read below to understand the science of picosecond lasers. 

 

What is the cost of Picosure Pro?

The Picosure Pro package is $2240 for 4 sessions. 

Individual treatment: $700.

*A series of 4 sessions provides the best results. 

**Treatments are performed by my laser clinicians at Cutis Dermatology. 

*** Picosure treatments by Davin Lim; $1290 per session.

How are we different from other clinics that provide pico laser resurfacing?

Our specialist training makes the difference when it comes to unparalleled results. Our before & afters tell the story. 

My team & I are heavily involved in clinical trials, research & teaching. This enables us to be ahead of the curve when it comes to the most technologically advanced treatments. 

Will all spots go with pico lasers?

The Picosure Series is designed to improve all aspects of skin – namely to provide global improvement in skin texture & pigmentation after a series of laser treatments. This means some areas of pigmentation may remain. As a guide, you can expect to have 50- 95% of pigmentation cleared, depending on depth of pigmentation. 

This package is not designed for one (or a few specific spots). Whilst treatment of specific spots can be achieved with higher settings & more aggressive treatments, I do not expect my nurses to perform individual spot treatment as the risk of post-laser skin darkening is higher than employing lasers for general skin rejuvenation. For this reason, I am the one who performs individual spot treatment. 

*A package treatment by my nurses cost $560 per session, over 4 sessions. 

If I perform pico lasers, the cost is $1190 per session, factor in up to 3 sessions. Nurses use different settings as compared to myself. 

picosure-brisbane-laser

Who performs this treatment?

My nursing team at Cutis, Brisbane, performs pico laser resurfacing. They have extensive experience in the treatment of all skin types, including darker ethnic skin patients. 

I am involved in more challenging cases- examples include birthmarks, & resistant cases of pigmentation. In some cases I may elect to perform this procedure on your skin (cases where I deem higher risk). If this is the case, I will quote you on the day, including the projected number of treatments. 

What type of pigmentation is melasma & why is this more challenging than other forms of pigmentation to treat?

Melasma is a totally different form of pigmentation & is treated very differently using the Picosure laser. As a guide-

  • We use Picosure laser in a different setting to address melasma
  • Melasma treatments must address pigment production
  • Topical creams are prescribed
  • Tablets are occasionally prescribed
  • Unlike other forms of pigmentation, melasma is recurrent

picosure pro before and after

 

Which is better- Picoway or Picosure Pro?

It’s like asking- what is better, a spoon or a fork? It really depends on the application. Here is my view on pico lasers. Picoway is better for cases of post-inflammatory hyperpigmentation & deeper birthmarks like Hori & Ota. Picosure Pro is much better than Picoway for general pigmentation & melasma. Compared to Picoway, Picosure is-

  • Faster to perform
  • Easier to use (for most operators)
  • Has less downtime (755 compared to 532 wavelength)
  • Better outcomes for non-specific pigment including Asian or ethnic skin rejuvenation

95% of our pico laser treatments are performed on the Picosure Pro, 5% of cases using the Picoway by Candela. 

What is the difference between Picosure & Fraxel lasers? Which is better?

For lighter skin types; Fraxel laser is better as this laser addresses sun spots. For darker skin types, Picosure is better. At Cutis Dermatology we have over 45 laser and energy devices & we apply each one according to the clinical context. pigme

Will Picosure or Picoway tighten my skin?

No, but pico lasers will give the impression of skin tightening due to improvement in pigment. Pigment reduction will improve skin luminosity, meaning the bounce of light is better. This can give the impression of lifting & firming. 

Skin firming & lifting can be achieved with HIFU treatments, RF as well as collagen stimulating injectables such as Profhilo injections. The best treatment depends on your degree of skin laxity, age, skin thickness & expectations. 

What are other complementary treatments that pair well with picolasers?

Picosure Pro can be paired with RF microneedling using the Potenza, a treatment known as Cynoglow. Picosure addresses textural issues, whilst Potenza delivers collagen stimulation to the deeper layers of skin. Combined, this treatment improves pigment, pores, wrinkles & skin laxity. Best part? Minimal recovery, maximal firmness. 

Picosure Pro also pairs well with dermal fillers & collagen stimulating injections. Both act synergistically  to improve skin quality. 

Why are pico lasers the best choice for treating Asian & ethnic skin types?

Asian & darker skin types are tricky to treat, mainly with the risks of laser induced darkening or post-inflammatory hyperpigmentation. On the other hand, pico lasers will give a superior response in darker skin type compared to lighter skin type, simply because Picosure is the very first laser to be manufactured for treating darker skin individuals. The risks of paradoxical or iatrogenic post inflammatory hyperpigmentation is very low with pico, if executed correctly.  

Picosure Pro Asian Skin Laser Brisbane
Picosure Pro Laser

Davin’s viewpoint. Picosure Pro; not all lasers are created equally.

By far the most impressive laser we have at Cutis Dermatology, Brisbane. I term the Picosure Pro the generation 3 pico laser. Generation 1 being the very first Picosure in 2013, followed by Gen. 2 lasers by Candela, Cutera, Lumenis & others. In the meantime, Cynosure has worked in the background to upgrade & tweak their first generation laser. The result? More energy, more shot count with the fractional beams, a tunable spot size & a simple to use system that is head and shoulders ahead of the competition. 

The argument is not about the better laser, it is about the best wavelength & the power at that wavelength, not the overall power of the laser. Let us put negatives aside. If you want to treat rare conditions (but common in dermatologist clinics) like Hori, Ota & deep dermal lesions, buy a Picoway. Hell, we bought one & yes, it is better than Picosure Pro for these conditions (and also post-inflammatory hyperpigmentation). We need a Picoway (or a high powered 1064 laser) because these skin conditions like in the deeper parts of the skin, beyond the efficient (not effective) range of the 755 nm of Picosure Pro. 

The positives? For the other 90% of pico applications, Picosure is the far better laser. It is easier to use, & much easier to teach. This is super important for me because I can not possibly do all the pico treatments myself. My nurses and dermal therapists have voted the Picosure Pro as their favorite laser, ahead of the Hybrid & Fraxel fractional laser  systems. Why? Because results are predictable. Predictable results equals happy patients. The 755 has a much higher affinity for melanin over hemoglobin. 1064? Not bad, but the partial epidermal by-pass of this wavelength means over shooting of the epidermis. Why not 532 of Picoway? Too superficial, more pick up with hemoglobin meaning more bleeding, longer downtime higher PIH rate. What about a 730 full beam profile? Yes, great for isolated spots, but there is no function for higher power fractional beam. 

Picosure Pro, in the skin rejuvenation setting, produces far superior results in skin of color. Why? Because the 755 wavelength targets pigmentation. In darker skin types, skin contains more melanin- hence the color. With more melanin, the physics of pico lasing will yield more growth factors & hence the results for pigmentation, pores, fine lines, wrinkles etc… will be biased towards darker skin. Not to say this laser will not work for lighter skin types- especially if downtime is an issue. 

*I do not have Picosure Pro at our Sydney clinic as of 2023, however I will be aiming to have a system in 2024.

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