Laser · Pigmentation · Skin Resurfacing

Pico Laser

How this page was made

This page was written with AI assistance and reviewed against the sources listed under References below. It is general information only, not medical advice. See our full disclaimer for how SHEA creates and reviews treatment information.

What it is

Picosecond lasers deliver laser energy in extremely short pulses measured in picoseconds. Depending on the wavelength, device, and treatment settings, the energy can target pigment through a combination of photomechanical and photothermal effects.

Some picosecond laser systems can also be used with specialized fractional optics. Instead of treating pigment in the same way as a conventional pigment-targeting session, these attachments concentrate energy into microscopic treatment zones and have been studied for concerns such as acne scarring and skin texture.

“Pico laser” is a technology category rather than one standardized treatment. Different platforms use different wavelengths, pulse durations, optics, and treatment settings. Published results from one system should not automatically be applied to every device marketed as a pico laser.

Why people consider it

They are considering laser treatment for a specific pigmented lesion or uneven pigmentation
They are considering treatment for melasma and want to understand whether a particular picosecond device and protocol has supporting evidence
They are comparing picosecond technology with other pigment-targeting laser treatments
They are considering acne-scar or texture treatment using a picosecond device with a fractional or specialized optical attachment
They are considering picosecond laser treatment for tattoo removal

What the experience is like

The experience varies substantially according to what is being treated. A pigment-targeting session, tattoo-removal session, and fractional picosecond treatment can use different wavelengths, settings, attachments, and treatment schedules.

Temporary redness, swelling, discomfort, or changes in the appearance of treated pigment can occur after treatment. Recovery also varies according to the device and protocol. Some treatments involve little visible recovery, while more intensive or fractional treatments may produce more noticeable short-term skin changes.

Multiple sessions may be recommended for some concerns. Ask which device, wavelength, and treatment mode the clinic plans to use rather than relying on the term “pico laser” alone.

Limitations & considerations

Melasma needs to be treated differently from ordinary spots

Melasma is a chronic pigment condition that can improve and later recur. Picosecond lasers have been studied for melasma, but the evidence comes from different wavelengths, devices, settings, and combination treatments. A laser protocol that is appropriate for a discrete sunspot should not automatically be assumed to be appropriate for melasma. If melasma is your main concern, ask what diagnosis the clinic is treating and what evidence supports the specific device and protocol being offered.

Picosecond lasers are not interchangeable. Wavelength, device platform, optical attachment, fluence, and treatment protocol can materially change what is being treated and how the skin responds
Pigment changes, including post-inflammatory hyperpigmentation or hypopigmentation, are possible after laser treatment. Individual risk depends partly on skin type, the condition being treated, and treatment parameters
Melasma can recur after improvement, and current evidence does not establish one picosecond protocol as a universally effective long-term treatment
Evidence for acne scars comes from specific picosecond systems used with specialized fractional optics and should not be generalized to ordinary pigment-targeting pico treatments
Device-specific contraindications and precautions should be checked for the actual laser being used
No specific degree of pigment clearance, scar improvement, or other cosmetic outcome can be guaranteed

Evidence note

A prospective study of 20 participants with facial acne scarring evaluated six treatments using a 755 nm picosecond alexandrite laser with a diffractive lens array. Three-dimensional analysis found a mean 24.3% improvement in scar volume at the final treatment, with improvement maintained at one and three months afterward. The study involved one specific laser, optic, and treatment protocol, so the findings should not be interpreted as evidence that every picosecond laser produces the same acne-scar results.

A randomized multicenter split-face trial in 39 Korean participants with melasma compared daily 2% hydroquinone alone with 2% hydroquinone plus five weekly treatments using a 1064/595 nm picosecond laser. The combination side showed greater improvement during treatment, but most measured differences between the two sides were no longer present at follow-up. The study therefore supports that particular combination protocol rather than picosecond lasers as a category. The research was funded by Lutronic Corporation, the device manufacturer, and two authors disclosed consultancy relationships with Lutronic.

More recent systematic-review evidence also shows why melasma claims should remain cautious. A 2026 systematic review and meta-analysis of randomized trials evaluating picosecond alexandrite lasers for melasma found low-certainty evidence because the available trials were small and heterogeneous, and concluded that larger, longer-term randomized studies are needed to evaluate durability and recurrence.

References

Peer-reviewed literature.

1. 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 Dermatology, 2015;151(3):278–284.

Peer-reviewed · Prospective study (n=20) · 755 nm picosecond laser with diffractive lens array

2. Choi YJ, Nam JH, Kim JY, Min JH, Park KY, Ko EJ, Kim BJ, Kim WS. Efficacy and safety of a novel picosecond laser using combination of 1064 and 595 nm on patients with melasma: a prospective, randomized, multicenter, split-face, 2% hydroquinone cream-controlled clinical trial. Lasers in Surgery and Medicine, 2017;49(10):899–907.

Peer-reviewed · Randomized split-face trial (n=39) · Melasma-specific · Lutronic-funded · Author consultancy relationships disclosed

3. Assessing the Safety and Efficacy of Picosecond Alexandrite Lasers in the Management of Melasma: A Systematic Review and Meta-Analysis of Randomised Control Trials. 2026.

Peer-reviewed · Systematic review and meta-analysis · Low-certainty evidence