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Why the Pico Laser isn’t the sole answer to treating pigmentation: A doctor’s opinion

August 25, 2021

Whether you’re new to aesthetic treatments or not, you must have at some point read raving reviews about what the pico laser does for pigmentation. The pico laser is often associated with pigmentation removal, and it’s all for good reason — this medical-grade laser treatment, which has in the past few years given conventional nanosecond Q-switched lasers a run for their money, is well and highly known for its ability to work faster, better, and even safer (lesser side effects). 

To clarify, pico laser is not a brand or name of a laser machine; but rather a type of laser technology that operates in picoseconds or one trillionth of a second. Compared to Q-switched lasers —which fire laser beams in pulse durations of nanoseconds— the pico laser’s shorter pulse durations produce more of a photomechanical than photothermal effect, and as a result are able to shatter pigments more effectively with lower side effects. 

Whether or not pico lasers beat Q-switched lasers in terms of efficacy is still up for debate, you may read more in our pico laser guide. 

Does the pico laser really work?

Several studies have demonstrated the pico laser’s safety and effectiveness in treating the majority of common skin imperfections, including spots caused by sun damage and acne scarring. But does what work mean it’s optimal? 

At Ozhean Zoey Aesthetics, we pride ourselves on formulating solutions that’s only the best for our patients, even if it means going against the grain of what’s popular. While pico lasers certainly have their distinct advantages and strengths due to the intensity of their photoacoustic power, they might not be suitable for all types of pigmentation, and certainly should not be used in isolation if you want a satisfactory outcome. 

To elaborate, let’s first briefly discuss the different types of pigmentation in Singapore and the pico laser’s effect on each type.

Freckles and sun spots 

These are the most common type of pigmentation in Singapore (considering our climate) and are what we consider surface pigmentation since they occupy the superficial layer of the skin. Freckles and sunspots are the easiest to treat with the pico laser but have the highest chance of recurrence without adequate sun protection. 


Melasma is identified as irregular, uneven, butterfly-shaped pigmented patches that affect both sides of the face. Treating melasma is tricky because while it’s considered a deeper pigmentation, it must be treated with care to avoid post-inflammatory hyperpigmentation. Contrary to what many people think, pico lasers are actually too harsh for melasma. 

Post-inflammatory erythema 

Post-inflammatory erythema (PIE) is the redness you get after an acne outbreak due to underlying inflammation of the skin. As such, PIE responds best to lasers that tackle redness of skin, like the Pro Yellow Laser — but they must be treated early before they progress to post-inflammatory hyperpigmentation. 

Hori’s nevus 

These are deep, dense skin pigments that form from excessive melanin and melanocyte production. Treating Hori’s nevus effectively would require higher laser energies, like the Curas Advanced Nano Laser. 

Solar lentigines 

Solar lentigines are large sun spots more commonly found among seniors in Singapore. Like freckles, they can be easily treated with a pico laser. 

Post-inflammatory hyperpigmentation (PIH)

PIH can occur due to excessive damage to the skin, such as a deep scratch, acne, or excessive laser treatments. PIH is usually treated with pico toning (non fractional mode) or with advanced nano laser long pulse mode.  Pico fractional mode might be too harsh for PIH and may cause more PIH.   PIH that are older also tend to be deeper pigments for which a long pulse laser is more suitable for its resolution rather than a pico laser which acts more superficially.

Does pigmentation go away?

Yes, but only if you use the correct lasers. From what we described above, you can see that pico lasers work better for small and superficial pigmented moles, such as freckles and solar lentigines. 

Pico lasers do not work on conditions like Melasma and age-related hyperpigmentation, where there is often a background of vascular problems. They can temporarily remove some pigments, but these pigments will recur unless treated at the root with a vascular laser. 

In other words, pico lasers have their limitations as a standalone treatment and work best when complemented with other lasers. Many don’t know this, but a major cause of pigmentation is due to thin skin that comes with age, or a loss of collagen. Hence, some distinct collagen remodelling is necessary to treat and prevent pigmentation, which pico lasers are unlikely to do due to their inability to penetrate deep into the dermis. 

Taking all these into consideration, we thus came up with our PICOMAX program. This program consists of using three different lasers to treat pigmentation. They are: 

  1. Pro Yellow Laser to target the blood vessels and reduce facial flushing and redness of skin. Patients can expect an immediate brightening of the face, or “glass skin complexion”.
  1. Curas Advanced Nano Laser for deeper pigmentation like Melasma and Hori’s nevus. This laser also has a longer pulsed mode, which can effectively stimulate collagen remodelling. 
  2. Pico Laser to remove superficial pigments like freckles and sunspots, and stimulate collagen growth at the epidermis. 

Together, these three work together to clear all red, brown and black pigments. Safety is a number one concern at Ozhean, so our doctors guard this priority closely by delivering the safe optimal dose of laser each time to prevent complications like PIH while still ensuring distinct results. 


  1. Koren, A., Isman, G., Friedman, O., Salameh, F., Niv, R., Shehadeh, W., & Artzi, O. (2020). Evaluation of subject response following treatment for pigmentation or wrinkles using a diode laser. Journal of cosmetic dermatology, 19(6), 1371–1376. https://doi.org/10.1111/jocd.13200
  2. Weiss, R. A., McDaniel, D. H., Weiss, M. A., Mahoney, A. M., Beasley, K. L., & Halvorson, C. R. (2017). Safety and efficacy of a novel diffractive lens array using a picosecond 755 nm alexandrite laser for treatment of wrinkles. Lasers in surgery and medicine, 49(1), 40–44. https://doi.org/10.1002/lsm.22577
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