Picosure, At A Glance
- Best Results2-4 sessions
- Treatment Recovery1-3 days
- Procedure Time20 min
- Skin SpecialistDavin Lim, Nurse
- Duration of Results6-10+ months
- AnaestheticNumbing gel
- Back to Work1-3 days
- Cost$-$$
Picosure Toning
I started using Picosure in 2015, however in 2022 I have replaced this laser with the newer Picosure Pro. This new update has made a good laser even better. The Picosure Pro is excellent at treating pigmentation especially in Asian & ethnic skin types.This laser can treat melasma pigment in addition to early acne scars.
FactsFacts on Picosure Rejuvenation
- The Picosure Pro version is the second generation released in 2022
- The new laser has increased power; this means fewer treatments
- Picosecond lasers work by transferring energy to the upper layers of skin
- This releases growth factors that stimulate collagen & remodel acne scars
- Picosure Pro is also used to treat pigment in ethnic skin
- Picosure is also very good at minimalizing pore size
What skin conditions can be treated with Pico lasers like Picosure?
Picosure
Picosure is used in my practice to address-
- Skin rejuvenation in ethnic skin
- Pigmentation due to sun & age spots in all skin
- Melasma pigment
- Tattoos
- Enlarged pores
- Fine lines and wrinkles
- Acne scars
- Birthmarks
- Uneven skin tone
What is Picosure Pro good at doing?
The main advantage of Picosure Pro laser is skin rejuvenation & pigment clearance in ethnic skin types. This is because this laser targets the pigment in darker skin types, allowing for more efficient skin rejuvenation.
Picosure Pro also stimulates collagen to reduce fine lines, wrinkles & reduces pore sizing.
What makes Pico lasers unique?
Minimal downtime laser treatment is the point of difference for Picosure Pro & Picoway treatments. Your skin recovers within 12 to 36 hours after laser resurfacing.
Pico lasers are inherently much safer than other lasers in the context of treating ethnic skin types, including Asian, Latino & Middle Eastern patients. These lasers provide higher energy levels over a very short pulse duration (a pico second).
How does Picosure fractional laser work?
Picosure laser delivers this energy in short bursts, over a trillion of a second. This energy burst is then broken down to smaller ‘fractions.’
Energy then hits the upper layers of skin, sparing the lower part. This is important as this gives rise to quick recovery times. High energy displaces molecules in the upper skin, causing collagen stimulation in the deeper areas of skin. This is what we call the ‘Spring’ effect – treat the top to remodel the deeper dermal layers.
The result is a reduction of skin pigmentation, but also collagen remodelling, resulting in less acne scars, better skin texture, decrease in wrinkles and improvement in skin tone.
What are some of my favourite combinations with Picosure Pro?
I use Picosure Pro & –
- Dermal fillers: Fillers replace volume loss, in addition to stimulating collagen
- Anti-wrinkle injections: This reduces frown lines
- RF treatments: This provides lifting & imporves skin tone
- PDO Threads: To improve skin laxity & improves firmness
Is Picosure or Pico laser effective in treating acne scars?
Very early and mild acne scars can respond to Pico laser resurfacing. This applies across the board to include all Pico lasers, including Picosure Pro, Picoway & others.
To date I have treated many acne scars with pico over the past 7 years, & in the context of significant atrophic scars, the results across the pico board, are marginal at best. Pico lasers are best applied to the following types of scars-
- Mild & early acne scars.
- Scars that are pigmented, namely grade 1 PIH or PIE scars.
- Scars that are associated with enlarged pores.
- As above in darker skin types.
My most frequent application for Picosure & Picoway in the context of acne scars is in the management of post inflammatory hyperpigmentation or dark marks after acne.
What is more effective -Picoway or Picosure?
These are my thoughts. I have just under 2 years hands on with the Picoway, 5 years on the Picosure, & only 2 months (at the time of writing) on the Picosure Pro.
Picoway is better at treating POST INFLAMMATORY HYPERPIGMENTATION. So, if you have PIH, get Picoway using the 532 & 1064 handpicks.
Picosure (Pro) is better at treating pigmentation, especially in Asian skin. Why? Because they have a fractional high power 755 wavelength that Picoway does not. Picoway 730 is not fractional, however some operators use the 532 fractional. Whist this can be highly effective in reducing pigment in ethnic skin, it has a higher chance of PIH or iatrogenic post inflammatory hyperpigmentation.
View our Treatment Gallery
Is Picosure the best treatment for melasma?
Picosure Pro has an on-label indication for the management of melasma. The mainstay of melasma management is medical, whilst lasers & peels are adjunctive.
Fraxel & fractional lasers, often flare up melasma, however used correctly, & in conjunction with medical therapy, Picosure Pro can reduce melasma pigmentation.
Is Picosure that much better for treating tattoos?
Pico lasers including Picosure, Picoway & Picoplus can give an initial advantage for fading tattoos. Picosure, was the first laser to treat tattoos in 2014. The new Picosure Pro is even better as it is more powerful. Picosure Pro is best for green tattoos, then black, followed by red.
This photo was with the first generation Picosure, I wonder what the second generation can do?
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📸What the photo shows: The possibility of dermal remodeling with this laser, sure pigment is improved, but check out the #collagen stimulation with much less wrinkling (and probable elastosis)
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🔫How was it done? I really pushed this laser to the max using the Focus setting. I think it was over 3,000 shots with a lot of dwell time with the second treatment. I covered her with tyrosinase inhibitors and short cse CS ointments post treatment
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😀What is Picosure good for? It is an awesome laser for-
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👍🏾Ethnic skin rejuvenation with mixed pigmentation, both epidermal and dermal
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👉🏾Enlarged pores in darker skin types
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👉🏾Fine wrinkles in darker skin types
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👊🏽Early macular (flat) PIH / grade 1 #acnescars
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🎨Green tattoos
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😎Dr Davin Lim
Dermatologist
Brisbane🇦🇺
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#cynosure #picosure #picoway #picoplus #picolaser #skinlightening #skinbrightening #melasma #laserskintreatment #ethnicskin #hyperpigmentation
I do love pico lasers, they are great for post inflammatory hyperpigmentation & treating dyschromia in ETHNIC & DARKER Skin types. They are used far too often for treating #melasma, atrophic acne scars & photorejuvenation in lighter skin types
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📊Data: I suspect the actual satisfaction rate of pico lasers in the context of melasma is much lower than 39.3%, as this data is from my recent algorithmic quiz. It relies on an accurate diagnosis in the first place. I suspect in the context of melasma, it’s probably around the 20-27% depending on variables
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😀The satisfaction rate may be higher than the efficacy. when pico was applied to acne scarring, the efficacy is extremely low (in the context of volumetric changes), however patients report high satisfaction in other aspects of skin, namely pores & general pigment (including PIH)
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👊How we employ pico: PIH, resistant forms of #melasma, general dyschromia in darker skin types, Ota, Ito, pore sizing in ethnic skin, early acne scars with little volumetric loss
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🤓When I still use nano: CALM, melasma, age spots & lentigines in skin type 1- 2 & some 3. Traumatic tattoo (very predictable), drug induced pigmentation (some)
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😩What pico is NOT great for: Atrophic acne scars, melasma, solar keratosis, one session skin rejuvenation in lighter skin types (fractional laser does a much better job), in fact simple Jessner-TCA will outperform the most expensive pico laser in this context. Any day, any time. Also depends on the company. Enlighten by Cutera has a very long pulse duration, Cynosure Picosure has a good 755 but really dismal 532 & a laughable 1064
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👉Tips: Based upon this data, you have a higher rate of pico not working for your presumed melama, so think about that. In fact, one in four cases you will be forking out a sh*t load of 💰$ 💰to get worse skin. Roll the dice 🎲🎲
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😎Dr Davin Lim
Dermatologist.
Brisbane🇦🇺
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#dermatologist #drdavinlim #brisbanedermatologist #picosure #picoway #enlightenpico #picolaser #picotoning #skinlightening #skinbrightening #melasma #melasmatips #melasmasolutions #melasmacure #melasmaskincare #skinbrighteningtips #cosmeticclinicbrisbane #dermatology #skinexpert
What is the best laser for skin rejuvenation?
Three factors determine what is the BEST treatment.
Firstly, the diagnosis. This is essential. Pico lasers have the advantage over other lasers in darker or ethnic skin. This applies to pigment, dull skin, enlarged pores & wrinkles.
Secondly your skin type. If you have darker skin, Pico lasers are probably the best & safest. If you have lighter skin types, fractional non-ablative & ablative lasers or even simple medium depth chemical peels will give you better results than pico.
Thirdly, downtime. If this is an issue, then pico laser resurfacing is probably the treatment that will give you the fastest recovery.
How many treatments will I need?
2-4 sessions, 3-6 weeks apart. It really depends on your skin type & concern. As a guide-
- Asian skin rejuvenation including fine lines: 2-4 sessions
- Melasma: 5-8 sessions
- Enlarged pores: 2-4 sessions
- Fine lines & wrinkles: 2-4 sessions
How long does each Picosure laser treatment take?
This depends on the area treated. For acne scars, the average treatment time is 5 minutes, whilst skin rejuvenation may take 10-15 minutes.
Is Picosure Focus Fractional laser painful?
It depends on the settings. For melasma treatments no numbing cream is required. For skin rejuvenation including pigment, wrinkles & dull skin, we numb up the skin 30 to 40 minutes prior to treatment.
How long will it take me to recover from Picosure laser?
You will be red for only an hour or two following Picosure laser. With higher settings you maybe red & swollen for up to 48 hours.
I prescribe anti-inflammatory ointments for faster recovery.
Does Picoway laser tighten skin?
No. Pico lasers only treat the upper layers of skin. They are used to treat pigmentation, pores, and fine lines/wrinkles.
Skin tightening can be achieved with radio frequency devices, collagen-stimulating threads, HIFU or Ultherapy and deeper laser resurfacing.
Does Medicare pay for Picosure or Pico laser?
For cometic cases, the answer is no. Medicare does provide a rebate for the management of birthmarks including CALM, Ota, Ito, Hori’s & other rare cases.
There is no rebate for the treatment of melasma or post inflammatory hyperpigmentation.
Davin’s Viewpoint Picosure laser
Picosure was the World’s first no downtime fractional laser that gives consistent results, improving skin texture & skin tone. That was in 2015. It has taken 7 years before Picosure 2 enters the market. Even then, this mark two versions has a moderate increase in power. Their functional wavelengths have not changed.
Back in 2015, the technology and science behind this laser is mind-blowing. Unlike other fractional lasers back then, Picosure concentrates a tremendous amount of energy in the upper layers of skin. This accounts for the ‘no downtime’ effects of this laser. So, if it doesn’t hit the lower layers of the skin, how does it work so well on fine to medium wrinkles?
The tremendous energy developed by Pico displaces electrons in the epidermis or upper layers of skin. This shatters pigmentation particles but also starts a chain reaction of events that release chemicals from cells. These chemicals in turn stimulate and remodel collagen in the deeper layers of skin. The result is an improvement in acne scars, sun damage, and wrinkles.
I updated my pico in 2020 with newer third-generation devices, namely the Picoway. This laser gives far more flexibility than Picosure. The absolute majority of treatment do not require numbing gel & is much better tolerated. The various functional wavelengths mean that many different types of pigment can be effectively & safely treated.
Does this mean that Picosure is a bad laser? Absolutely not. I do believe that Picosure has a very narrow application window, namely the treatment of non-specific pigment in ethnic or darker skin types.
