Pico Laser Benefits: What Pico Laser Is Used For, and Its Limits
Medical Director Dr Sin Yong explains what pico laser is, which of its benefits are supported by studies, what pico toning does for the face, and where pico laser is the wrong tool.
WhatsApp to Enquire →Key facts ↓The main benefits of pico laser are lightening defined brown spots such as sun spots and freckles, gradually evening out tone, reaching deeper pigment, breaking up tattoo ink and, in fractional mode, modestly improving texture. Its pulses last trillionths of a second, so pigment breaks apart with less heat, which matters in Asian skin. It does not lift, treat redness or lighten your natural colour. See pico laser in Singapore.
- Evidence map: a systematic review of 77 studies rated the evidence level I for tattoo removal, level II for melasma and rejuvenation, level II to III for scars and level I to IV for benign pigmented spots [1].
- Asian skin: pooled data on 200 Asian patients found 56 in 100 rated excellent for pigment clearance three months after picosecond laser, and 3 in 100 poor; 532, 755 and 1,064 nm performed similarly [2].
- Pico vs Q-switched: in a 20-person split-face trial for sun spots, darkening after treatment (PIH) occurred on 5 in 100 picosecond sides against 30 in 100 Q-switched sides, and clearance was better with picosecond [3].
- One session: in 20 women with skin types III and IV, 40 of 43 sun spots cleared by more than three-quarters after a single 532 nm picosecond session [4].
- Texture: six fractional picosecond sessions reduced acne scar volume by about 24 in 100 on 3D imaging, still present three months later, in 20 adults [5].
What is pico laser, and why does the pulse length matter?
A pico laser is a laser whose pulses last a few hundred picoseconds, trillionths of a second. The name describes the pulse, not a treatment. Older Q-switched pigment lasers pulse in nanoseconds, roughly a thousand times longer. When energy arrives that quickly, a pigment granule or ink particle absorbs it before heat has time to spread, and it breaks apart under a pressure wave (a photoacoustic effect). The body then clears the fragments over the following weeks.
Less heat spread is the practical point. In Fitzpatrick skin types III to V, common in Singapore, heat and inflammation are what prompt post-inflammatory hyperpigmentation (PIH), the dark marks that can follow laser. A shorter pulse lowers that stimulus but does not remove it. In a randomised split-face trial of sun spots, PIH followed on 5 in 100 picosecond-treated sides and 30 in 100 Q-switched sides, with better clearance on the picosecond side [3]. Wavelength then decides depth: 532 nm stays near the surface for crisp brown spots, while 785 nm and 1,064 nm pass deeper for dermal pigment, toning and dark ink.
Pico laser benefits: which are backed by studies?
The useful question is not what pico laser can do in general, but what it does well for which problem, and how strong the evidence is. A systematic review of 77 studies to late 2019 graded the evidence by use [1]. The table below combines that grading with how each use is usually planned.
| Use | What studies report | Typical course | Evidence level [1] |
|---|---|---|---|
| Sun spots and freckles | 40 of 43 sun spots cleared by more than three-quarters after one 532 nm session in Asian skin [4] | One to three sessions, four to eight weeks apart | I to IV |
| Mixed pigment in Asian skin | 56 in 100 rated excellent at three months in pooled data on 200 patients [2] | Depends on pigment type | Pooled analysis |
| Melasma | Picosecond and Q-switched 1,064 nm both improved melasma in an 18-person split-face trial; the picosecond side had less pain and redness [6] | A gentle course, then maintenance; control, not cure | II |
| Uneven tone and dullness | Gradual improvement with low-energy toning passes | A course of sessions | II (rejuvenation) |
| Acne scars and texture | About 24 in 100 reduction in scar volume after six fractional sessions [5] | Several sessions; a supporting role for deep scars | II to III |
| Tattoos | Strongest evidence of all uses | Many sessions, weeks apart | I |
Two things follow from this. Pico laser is most predictable for well-defined brown pigment and for ink. For melasma, texture and general rejuvenation the benefit is real but smaller and slower, and it depends on settings, spacing and sun protection as much as on the device. For pigment-by-pigment detail, see pico laser for pigmentation.
What is pico toning, and what does pico laser do for the face?
Pico toning is a technique rather than a separate machine: the picosecond laser is passed over the whole face at low energy with a large spot, several times, and repeated across a course. The aim is to break up a little scattered pigment at each visit without visible injury, so tone looks more even and the skin brighter. Most people are pink for a few hours and back at work the same day.
On the face, pico laser is used in three broad ways: targeted spot pulses for sun spots and freckles, toning passes for diffuse unevenness and as cautious support in melasma, and fractional modes that create tiny zones of change inside the skin for shallow texture and pores. Many plans use more than one over time, for example clearing defined spots first and toning the background afterwards. In melasma, toning that is too strong or too frequent can cause rebound darkening or pale flecks, which is why melasma care at IN Eternity Clinic is conservative and paired with sun protection and medical skincare. How pico toning compares with Q-switched toning is set out in laser toning vs pico toning.
What pico laser does not do, and who should wait
Pico laser does not lighten your natural skin colour; it removes excess pigment. It does not treat redness or broken vessels, which need vascular light, and it does not lift sagging skin. Raised brown growths such as seborrhoeic keratoses usually respond better to superficial resurfacing. Deep, tethered acne scars need subcision, CO2 or RF microneedling first; fractional pico plays a supporting part at most (see pico laser for acne scars).
Some people should wait. Tanned or sunburnt skin, recent retinoids or exfoliating acids, an active infection or cold sore in the area, recent oral isotretinoin and pregnancy all usually mean postponing pigment laser. A brown spot that is new, changing, irregular or bleeding is examined with a dermatoscope before any laser, because a laser can hide a lesion that needs a biopsy. Normal reactions and warning signs are covered in pico laser side effects, and the recovery timeline in pico laser downtime day by day.
How is pico laser used at IN Eternity Clinic?
Every plan starts with naming the pigment. Dr Sin Yong examines the skin in good light and with a dermatoscope, separates sun spots, freckles, melasma, post-inflammatory marks and deeper dermal pigment such as Hori's naevus, and only then chooses the platform, wavelength and number of sessions. Sometimes the answer is that laser is not the first step.
The clinic has two picosecond platforms. The DEKA TORO offers 785 nm picosecond output with 532 nm and 1,064 nm Q-switched output, and runs T2 Frax Radiance, which pairs pigment pulses with a thermal pulse aimed at collagen. The Fotona StarWalker PQX offers picosecond and Q-switched Nd:YAG pulses and runs R2 Glow, a brightening course of gentle passes, typically four to six sessions two to three weeks apart. Where skin is darker or has marked before, a test area may be advised. Costs follow the pigment and the number of sessions and are explained at consultation, before anything is done. Results vary, and suitability is decided at an in-person assessment.
What Dr Sin Yong looks for
- What the pigment is: sun spot, freckle, melasma, post-inflammatory mark or deeper dermal pigment.
- How deep it sits, which decides the wavelength.
- Skin type and any history of dark marks after spots, peels or earlier laser.
- Recent sun, tanning, retinoids or acids that mean waiting.
- Any spot that is new, changing or irregular, which is checked before laser.
General clinical observations used at consultation; they describe what is checked, not any individual result.
Frequently asked questions
What are the benefits of pico laser?
Pico laser can lighten sun spots and freckles, even out tone with toning passes, reach deeper pigment such as Hori's naevus, break up tattoo ink and, in fractional mode, modestly improve texture. Its very short pulses break pigment with less heat, which can lower the risk of dark marks in Asian skin. Results vary and depend on what the pigment is.
What is pico laser?
Pico laser is a laser that fires pulses lasting trillionths of a second. Pigment and ink absorb the energy so quickly that they shatter mainly by pressure rather than heat, and the body clears the fragments over the following weeks. The term describes the pulse, so the same device is set up differently for each problem.
What is pico toning?
Pico toning is a gentle technique in which a picosecond laser is passed over the whole face at low energy, repeated over a course of sessions. It aims to even out tone and brighten dull skin gradually, with pinkness for a few hours. It is also used cautiously as support in melasma, alongside sun protection and skincare.
Is pico laser good for the face?
For brown spots, freckles, uneven tone and some post-acne marks on the face, pico laser is a useful tool when the pigment has been identified first. It is less useful for redness, sagging or deep scars. In melasma it can help as part of a wider plan, but strong settings can make melasma worse.
What is pico laser used for?
The main uses are sun spots, freckles, post-inflammatory marks, selected melasma, deeper pigment such as Hori's naevus or naevus of Ota, tattoos and dull, uneven tone. Fractional modes are also used for shallow texture and pores. The evidence is strongest for tattoos and defined brown spots.
How many pico laser sessions do I need?
Many sun spots and freckles need one to three sessions, four to eight weeks apart. Toning, melasma care, deeper pigment and tattoos need longer courses. The estimate is given after examination and reviewed as your skin responds, and sessions are spaced so the skin settles fully between them.
Does pico laser lighten skin colour?
No. Pico laser removes excess pigment such as spots and marks; it does not change your natural skin colour. Overly frequent or strong toning can leave pale flecks, which is why sessions are spaced, energy is kept moderate and progress is checked against photographs taken in the same light.
Is pico laser safe for Asian skin?
It is widely used in Asian skin, and its shorter pulse produces less heat than older Q-switched lasers. The risk of temporary darkening is lower but not zero, so settings, spacing and sun protection matter, and tanned or irritated skin is not treated that day.
Book an assessment
IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, Singapore 228210. By appointment with Medical Director Dr Sin Yong. Monday to Saturday, 11am to 8pm. WhatsApp or call +65 8815 3008. At IN Eternity Clinic a consultation fee applies, and it is waived if you go ahead with any medical treatment; the fee is S$120.
International KOL — CLASSYS · HIRONIC · DEKA · ALMA · FOTONA · LUTRONIC
References
- Wu DC, Goldman MP, Wat H, Chan HHL. A systematic review of picosecond laser in dermatology: evidence and recommendations. Lasers Surg Med 2021;53(1):9-49. doi:10.1002/lsm.23244
- Dong W, Wang N, Yuan X, Zhang W. Treatment of pigmentary disorders using picosecond laser in Asian patients: a meta-analysis and systematic review. Dermatol Ther 2021;34(1):e14709. doi:10.1111/dth.14709
- Kim JY, Yang J, Huh G, Choi YJ, Kim WS. A split-face, single-blinded, randomized controlled comparison of 532 nm picosecond Nd:YAG laser versus 532 nm Q-switched Nd:YAG laser in the treatment of solar lentigines. Ann Dermatol 2020;32(1):8-13. doi:10.5021/ad.2020.32.1.8
- 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;50(8):851-858. doi:10.1002/lsm.22820
- Brauer JA, Kazlouskaya V, Alabdulrazzaq H, et al. Use of a picosecond pulse duration laser with specialized optic for treatment of facial acne scarring. JAMA Dermatol 2015;151(3):278-284. doi:10.1001/jamadermatol.2014.3045
- Feng J, Huang L. Comparison of picosecond and nanosecond Nd:YAG 1064-nm lasers in the treatment of melasma: a split-face randomized clinical trial. Plast Reconstr Surg 2023;151(4):772-777. doi:10.1097/prs.0000000000009994
These sources describe mechanisms and general evidence. They are not a promise of any individual result; suitability is decided at an in-person assessment.