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Guide to Pico Laser Treatment in Singapore

Guide to Pico Laser Treatment in Singapore

Picolaser is short for “picosecond laser”, which refers to pigment lasers which fire an extremely quick burst of light measured in trillionths of a second. This small and intense burst of energy allows the targeting of microscopic pigment particles in the skin- melanin (skin pigment), hemoglobin (blood pigment) or tattoo ink, while sparing the normal skin- known as selective photothermolysis. The target pigment rapidly heats up and shatters into fine particles which are then cleared by the scavenger cells of the skin. Using special settings, picolasers can generate areas of Light Induced Optical Breakdown (LIOBs) in the skin- numerous microscopic controlled wounds that stimulates skin regeneration. The end result is removal of unwanted skin pigmentation and skin rejuvenation. 

Picosure laser diagram

Picosure closeup

Histology images

Understanding Skin Concerns Addressed by Picolaser Treatment

PicoSure is US FDA approved for the treatment of pigmentary disorders (freckles, lentigo, sun spots, age spots, melasma, Naevus of Hori, Naevus of Ota), tattoo removal and skin revitalisation (fine lines, pores and acne scars). 

 an individual with lentigo (sun spots) due sun exposure from sports and hiking

In the local context, unwanted pigmentation is the most common indication for Picolaser treatments. The tropical climate with high UV index gives rise to a high incidence of pigmentary disorders in the population. Pigmentation is considered undesirable, with Asian beauty standards putting emphasis on clear skin. 

Skin rejuvenation- the revitalisation of sun damaged and aged skin, is another common request. As part of the normal aging process, skin loses collagen and hydration and develops fine lines and wrinkles. This can be treated with PicoSure- the picolaser stimulates the skin to produce new collagen, resulting in younger looking and firmer skin with improvements in the signs of aging. 

Acne, acne scars and open pores are common especially amongst younger patients. PicoSure’s focus lens treatment is effective and resurfacing the skin to reduce the surface irregularities. 

Tattoo removal is PicoSure’s forte- black, blue and green tattoos are effectively targeted by PicoSure’s 755nm wavelength. Red, yellow and orange tattoos can be treated with a 532nm wavelength handpiece. Compared to the older generation of nanosecond lasers, picosecond lasers can remove unwanted tattoos with fewer sessions and lower risks of complications. 

Upper back of a woman with tattoo

Preparing for a Picolaser Treatment

During the consultation, the doctor will typically assess the skin to come to a diagnosis. The patient’s past medical history and previous aesthetic treatments will be reviewed. A treatment plan is discussed and the risks and benefits of the treatment explained. Contraindications to laser treatment include active skin diseases, open wounds, burns, photosensitivity, recent sun tan and certain medications. After laser treatment, skincare may need to be adjusted with the temporary cessation of actives such as retinols or acids. Potential side effects of laser treatment include: pigmentation flare up, hypopigmentation, burns, infection and herpes reactivation. An experienced doctor will minimize such risks with the use of appropriate laser settings and post laser skincare. After a PicoSure treatment, the skin is red and sensitive for 2-3 days. Light makeup can be applied and clients can resume work and indoor activities right away.  

The PicoSure Treatment Procedure   

A PicoSure treatment takes about an hour- the skin is cleansed and topical anesthetic (“numbing cream”) applied for 20-30 minutes. The PicoSure laser treatment takes about 10-15 minutes and typically involves 3 steps: targeted treatment of pigmented lesions using the Zoom lens, skin toning using the Clear lens and skin resurfacing using the Focus Lens. Cold air will be applied to the skin during treatment, which patients say feels like a light snapping sensation. Other safety measures taken include wearing protective eye shields and laser goggles, as well as performing the treatment in a dedicated laser room. 

Post-Treatment Care and Aftercare

Right after the treatment, clients are recommended to moisturize the skin and apply sunblock if going out. Skincare actives which may cause irritation such as Vitamin C, Retinols and Alpha/Beta hydroxyl acids should be stopped for 5-7 days. Clients are recommended to avoid direct sun exposure for 1-2 weeks, especially if being treated for pigmentation. Treatment intervals are once a month, with most clients reaching their desired goals within 4-8 sessions. Thereafter, maintenance treatments can be performed every 2-3 months.

Expected Results and Long-Term Benefits

Treatment intervals are once a month, with most clients reaching their desired goals within 4-6 sessions. Thereafter, maintenance treatments can be performed every 2 months. Certain skin concerns such as Melasma or Acne scars are known to be more difficult to treat may require more sessions of PicoSure laser- this will be discussed during the consultation. Results are long lasting- clients report improvement that lasts for over 12 months. For tattoo removal or acne scar resurfacing- results are permanent. In the case of pigmentation (especially melasma), there is a risk of new pigmentations developing due to sun exposure. 

Comparing Picolaser Treatment with Other Laser Treatments

Picolasers are viewed as an upgrade from the older generation of nanosecond pigment lasers “Q Switch lasers”- with pulse durations measured in picoseconds (a trillionth of a second) versus nanoseconds (a billionth of a second). The extremely short pulse width allows for the laser energy to be converted directly into mechanical energy (“photoacoustic effect”), shattering the targeted pigment into fine dust like particles which can be cleared by skin cells efficiently. 

Picolasers and ablative lasers such as fractional CO2 or Erbium Yag lasers are used for resurfacing of acne scars. Ablative lasers destroy parts of the skin, which heals over over a period of weeks- while the results are good, it comes with high downtime and high risk of complications such as hyperpigmentation or skin infection. Picolasers are able to achieve resurfacing of the skin with lower risks of complication.

Choosing the Right Clinic for Picolaser Treatment

Laser treatments are both a science and an art, experienced laser medicine practitioners have developed skill sets that can maximise patient outcomes while minimising risks. Mass market clinics advertising cheap deals often hire inexperienced staff who may not have the understanding required to deliver optimal results- possibly resulting in more treatment sessions required to achieve the desired outcome. The quality of the laser equipment used plays an important role- quality clinics often choose to work with equipment that is supported by clinical studies and have received US FDA approval. Google reviews or verified patient reviews on a website such as are good ways to read authentic testimonials. Singapore’s MOH regulations state that before and after treatment photos as well as testimonials cannot be publicly displayed by a clinic, but these can be shown during the consultation process. Treating pigmentation is a marathon and not a sprint, work with a trusted doctor and reputable skin care clinic to achieve your goals. 

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