Is Picosure laser a better option for pigmentation and melasma treatment compared to other lasers?

Doctor's Answers 6

I totally agree with Dr Elias Tam that “There is no perfect laser for treatment of pigmentations”.

The analogy is like having the fastest sports car alone does not guarantee to bring you the Formula One Championship trophy. In fact, to even have a shot at the trophy, the sports car must be driven by an equally matched professional experienced driver.

In my own experience, pigmentation laser with the latest technology can certainly be very useful, but technology alone does not guarantee results.

In fact, I have come across very experienced doctors getting also really good results treating difficult and stubborn pigmentations with older laser models.

Thus the most important factor that determines good results from pigmentation laser is the clinical experience of the performing doctor.

Furthermore, other than melasma, there are other different types of pigmentation commonly seen on the face (eg freckles, solar lentigos, post-inflammatory hyperpigmentations etc), especially in the Asian skin types.

Treatments therefore will be tailored to the types of pigmentation and individual skin types, which can include other modalities eg topical lightening creams, chemical peels etc.

Depending on the types and severity of the pigmentations, sometimes just topical lightening creams and sun protection measures alone are sufficient to have good results.

So I would recommend you to speak to an experienced doctor whom you are comfortable with to discuss on the most suitable treatment options for you.

For more detailed information on the treatments of melasma and other commonly seen pigmentations, you can find out more in my "Ultimate Guide to Pigmentation Treatment in Singapore".

Picosecond lasers like the Picosure are an upgraded version of their Qswitch counterparts. Based on the science behind them, they are safer and more effective with removing pigmentation.

Fractional lasers are a useful alternative for certain types of pigmentation.

The experience and dedication of the physician behind the laser machine are just as important. Generally, the costs for pico lasers are pricier than Qswitch.

I fully agree with Dr Chua. Picosecond laser treatments are generally pricier than Q-switched ND-YAG laser treatments.

In addition, Picosecond lasers can be used to treat more stubborn pigment disorders that do not respond well to Q-switched ND-YAG lasers alone.

In clinics that have both Picosecond and Q-switched ND-YAG lasers, doctors can tailor a treatment plan using these two lasers to treat stubborn pigment disorders whilst keeping treatment prices more affordable.

Do note that Lasers are tools for your doctor. You need good technology and a well-trained doctor to give you good results. Both are equally important!

There is no perfect laser for treatment of pigmentation.

PICO refers to the picosecond pulse duration, and it may be of different wavelength.

There are various types of pigmentation and the treatment will defer. It may be just topical cream, oral medication, or light therapy such as laser or IPL.

PICO laser may be:

  1. PICOSURE
  2. PICOWAY
  3. DISCOVERY

Many more are coming on the way. There are also various types of fractional lasers, including CO2 and PICO.

To decide on the appropriate treatment, its best that you seek a proper assessment with your doctor.

Hello!

PicoSure is a good choice for treatment of pigmentation including melasma. As you have rightfully pointed out, picosecond lasers like PicoSure, deliver a strong pulse of energy over a very short picosecond interval to scatter pigmentation without heating up the skin significantly.

In my opinion, PicoSure is the gold standard for treatment of facial pigmentation.

PicoSure treatments are generally more expensive that Q Switched laser treatments but the price varies depending on the extent of treatment done. You should see an experienced doctor for a consultation before deciding if PicoSure is for you.

Cheers!

Dr. Terence Tan

I totally agree with Dr Elias Tam that “There is no perfect laser for treatment of pigmentations”.

The analogy is like having the fastest sports car alone does not guarantee to bring you the Formula One Championship trophy. In fact, to even have a shot at the trophy, the sports car must be driven by an equally matched professional experienced driver.

In my own experience, pigmentation laser with the latest technology can certainly be very useful, but technology alone does not guarantee results.

In fact, I have come across very experienced doctors getting also really good results treating difficult and stubborn pigmentations with older laser models.

Thus the most important factor that determines good results from pigmentation laser is the clinical experience of the performing doctor.

Furthermore, other than melasma, there are other different types of pigmentation commonly seen on the face (eg freckles, solar lentigos, post-inflammatory hyperpigmentations etc), especially in the Asian skin types.

Treatments therefore will be tailored to the types of pigmentation and individual skin types, which can include other modalities eg topical lightening creams, chemical peels etc.

Depending on the types and severity of the pigmentations, sometimes just topical lightening creams and sun protection measures alone are sufficient to have good results.

So I would recommend you to speak to an experienced doctor whom you are comfortable with to discuss on the most suitable treatment options for you.

For more detailed information on the treatments of melasma and other commonly seen pigmentations, you can find out more in my "Ultimate Guide to Pigmentation Treatment in Singapore".

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Acne scars and uneven skin texture can be improved using Mosaic or Fraxel whereas pigmentation is best treated using either Q-switched ND:Yag lasers or the newer Picosecond lasers. Mosaic vs Fraxel: Similarities Both lasers use fractional technology. The laser beams create heated columns of “thermal damage” throughout the treated tissue. This results in alteration of the collagen structure in the skin’s deeper layers which creates conditions that are ideal for collagen regeneration and increased elasticity. This results in shallower scars.

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Does melasma run in the family?

A genetic predisposition is one of the most important risk factors for the development of melasma (Melasma: A Clinical and Epidemiological Review; An Bras Dermatol. 2014). However, no definite clear pattern of inheritance has been identified so far. Most studies in various populations around the world in patients with melasma cite a positive family history and at least one relative with melasma, as high as 97% of first-degree relatives. However, there are other factors at play too, such as female gender, as you rightly pointed out, hormonal influence, pregnancy, and skin type/colour.

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