Pico Laser (PicoSure / PicoWay)

A picosecond (trillionth-of-a-second) laser pulse is delivered to the target pigment. Because the pulse is so short, the laser's energy creates a photoacoustic shockwave rather than thermal spread — the shockwave mechanically shatters pigment particles into sub-melanosomal fragments. Over the following weeks, the lymphatic system clears the fragmented pigment via the body's normal clearance mechanisms. Because thermal spread is minimal, surrounding skin structures are largely undisturbed — collagen and cell architecture remain intact. The shockwave itself also triggers mild fibroblast activation, producing a secondary collagen-stimulation benefit.

Numbing cream applied for 30 minutes pre-treatment. Treatment itself takes 10–20 minutes depending on area. Patients describe the sensation as repeated rubber-band snaps with occasional warm-sting bursts. Immediately after: mild erythema (redness) for 2–6 hours; occasional pinpoint frosting where pigment was densest. Day 1–3: possible very fine crusting over deep pigment; cover with gentle sunscreen. Day 4–7: pigmented areas gradually fade or scab and lift (for sunspots). Pigment clearance builds over 4–8 weeks. Full course: 4–6 sessions for melasma or deep PIH, 3–5 for sunspots.

Pico lasers (the two dominant platforms: Cynosure's PicoSure and Candela's PicoWay) deliver energy in picoseconds — trillionths of a second — rather than the nanosecond pulses of older Q-switched lasers or the continuous thermal energy of fractional lasers like Fraxel. The key biological difference: a picosecond pulse creates a photoacoustic pressure wave that mechanically shatters pigment particles (melanin, tattoo ink, post-inflammatory pigmentation) into fragments small enough to be cleared by the lymphatic system — without generating the thermal spread that causes the hyperpigmentation risk of traditional lasers. This is why Pico is considered 'colourblind' — it can treat pigmentation in Fitzpatrick IV–VI skin types (Asian, Black, South Asian skin) without the significant risk of post-inflammatory hyperpigmentation that rules out Fraxel for those patients. Typical treatment series is 4–6 sessions spaced 3–4 weeks apart for melasma, PIH, or sunspots. Downtime is minimal: mild erythema and possible pinpoint frost for 2–6 hours, then essentially invisible recovery. Most patients return to work the same day. Evidence base (Choi et al. 2020, Wu et al. 2019) shows Pico matches or exceeds Q-switched Nd:YAG for pigmentation clearance with significantly lower PIH risk.