What is Pico laser?
Pico laser is one of the many kinds of laser used to treat skin pigmentation, mild scars and tattoo removal. In laser terminology, pico means the duration of laser in the skin for each shot (pulse duration) is a trillionth of a second.
How is it different from the well-established pigment reducing Nano laser?
Pico laser which was approved by the American FDA in 2012 is an evolution of Nano laser. Nano laser was first discovered in 1962 and it helped physicist, Nicolaas Bloembergen, won a Nobel prize in 1981. Nano laser has been the work horse for skin doctors since the 90s. While the pulse duration of a Pico laser is one trillionth of a second, the Nano laser is longer in one billionth of a second. With shorter pulse duration and higher peak power in the Pico laser, scientists hope to address the shortcoming of Nano laser in treating coloured or non-black tattoos such as blue, green, yellow and red. On this ground, Pico laser has gained an edge over Nano laser. On the contrary, its shorter pulse duration shows weakness in treating moderate to severe scars when compared to Nano laser.
Which laser is more painful or uncomfortable?
Both lasers produce heat and tingling sensation on the skin but it is terribly subjective to each individual. The same lady going through the same laser therapy with the same setting may have an utterly different sensation when she is having menses or emotional irritability. In general, both are quite acceptable although on areas with more facial hair or near the eyes, one may feel just a tad more. For those who demand absolute pampering, topical numbing cream could restore tranquility.
Which laser has less down time or recovery time?
Both Nano and Pico lasers are typical lunch-time therapies as there is zero down time except when treating scars, sun spots or lentigines where localized redness can last for 3-7 days. The redness can be concealed with cosmetics or tinted sunscreen so there is no need to quarantine at home.
Which is better for the treatment of common and hardy skin pigmentation such as melasma?
Firstly, one must be made to understand that melasma is a skin pigmentation that has no cure and it is under multiple influences such as genetic, gender (female to male ratio of 9 to 1), sun exposure, hormonal imbalance, vascularity, skincare, medication and etc. Controlling melasma requires minimizing pigment production and maximizing excessive pigment removal. This is a constant process that begs discipline. Both Nano and Pico lasers selectively break down black pigmentation in melasma by utilizing sound wave that contains high energy. Fragmented pigment particle is cleared by the body immune system.
Nano laser is deemed to be superior at fragmenting bigger pigment particle while Pico laser is better for the opposite. How much does this mean in the real world? Not much, really. A simple imbalance on any of the above influential factors can easily nullify the differential between these lasers.
Should I give Nano or Pico laser a try to lighten and control my melasma?
If you have identified the aggravating factors and exhausted all means to improve it and yet expectation is not met then the answer is a clear yes.
Which laser is better for me?
While Nano laser has been the reliable work horse for treating various skin conditions for many years with plenty of credible research papers to back it up, Pico laser is a relatively new kid on the block. Its technology, application and treatment outcome are still being studied and refined across the globe. Novelty has certainly not stopped Pico laser from joining the elite group of dermatology lasers in recent years. This is partly due to the efficient social media, mushrooming of aesthetic services and global unprecedented high liquidity from money printing.
At this very moment, there is no clear evidence to suggest which laser is better for melasma but you must be aware that unless and until your risk factors are well controlled, either laser will not bring much joy in the long-run.
A multifactorial approach is the holy grail in caring for melasma. Hence, Nano or Pico laser is by no means the do-it-all solution. Do have a good chat with your service provider over issues pertinent to your health, lifestyle, budget, expectation, past treatments and etc. A good service provider can sell you hope but a caring provider will walk the fine lines with you, rain or shine. Remember, the devil is in the detail. In the end, you may not need the lasers at all.
