Blog > Pigmentation > Pico Laser vs. Q-Switched Laser for Pigmentation Treatment

Pico Laser vs. Q-Switched Laser for Pigmentation Treatment

Laser treatments have become a popular option for individuals dealing with pigmentation issues. Freckles, melasma, age spots, solar lentigines, and post-inflammatory hyperpigmentation (PIH) are the most frequent skin concerns. With ongoing technological advancements, there are numerous treatment options for pigmentation removal, including the Nd:Yag Laser and the Pico Laser.

Laser, an acronym for Light Amplification by Stimulated Emission of Radiation, is a key technological development of the modern world. Beyond its use in defense, space exploration, and manufacturing, lasers are also widely applied in medical treatments. Aesthetic skin procedures use lasers to address skin concerns like pigmentation, acne, scars, wrinkles, and fine lines.

In Singapore, laser treatments are particularly common for removing pigmentation. Two types of lasers frequently used for this purpose are the Nd:Yag Laser and the Pico Laser. To determine which laser is effective for pigmentation removal, it's important to understand the different types of pigmentation issues.

Types of Pigmentation 

Depending upon the factors and causes, pigmentation appears in the form of different skin conditions. Some of the common types of pigmentation include the following:   

Melasma

Melasma is a skin condition that causes light brown to grey patches to appear on the surface of the skin, typically on the face. It is most commonly seen  in Asian women aged 20 to 40 years old. Melasma generally develops in pregnant women and is believed to be brought on by hormonal changes [1]. Hormonal imbalances caused by the use of birth control pills and other hormonal therapy may also increase the risk of developing melasma.

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Freckles

These are the tiny brown spots that form as a result of a genetic predisposition to overproduce of melanin from ultraviolet (UV) radiation stimulation. Freckles are commonly seen in fair skinned people and generally disappear with the onset of winter.

Freckles are classified into two groups - ephelides and lentigines. Both types are triggered by sunlight. However, ephelides are more affected by genetic factors while lentigines are caused by photodamage to the skin [3].

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Sunspots

Also known as age spots, liver spots or solar lentigines, sunspots are linked to excessive sun exposure over prolonged periods of time [2]. The light to dark brown colored spots appearing on the skin are caused by photodamage. Over time, UV rays accelerate the production of melanin in the skin, end up overproducing melanin, resulting in a sunspot.

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Post-Inflammatory Hyperpigmentation (PIH)

Post-Inflammatory Hyperpigmentation appears as flat spots of discoloration on the skin and is usually caused by injury or inflammation inflicted on the skin [4]. These patches can range in colour from pink to red, brown or black. The colour largely depends on the skin tone and the depth of discoloration. 

Common causes of PIH include acne, eczematous dermatoses, trauma, surgery and burn injuries [5]. People with darker skin tones are more likely to suffer from this condition. This manifests as blotches of light or dark brown skin or pink-coloured skin. 

Laser treatments for Hyperpigmentation  

How do Q-switched laser and Pico laser treatments work?       

Lasers work by bypassing the outer skin layer and penetrate down to the deeper layers to target the excess melanin pigmentation. They essentially focus photo-acoustic and thermal energy on the melanin and break down the pigments into smaller particles. These particles can then be removed by the body’s natural lymphatic system. The thermal energy also boosts collagen production and helps rejuvenate the skin tissues. Lasers operate at different wavelengths or frequencies, each one capable of targeting a particular chromophobe (color) and layer (or depth) of the skin. 

When it comes to removing skin pigmentation, the Q-switched laser and Pico laser have emerged as popular treatment options. When you’re contemplating laser treatment for skin pigmentation problems, it’s natural that you want to know which is the right option for you.  

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What is a Q-Switched Laser? 

The Q-Switched Laser is the commonly used laypersons name for a nanosecond (10-9 seconds) Nd YAG (1064 nm) laser. A Q-Switch is actually the shutter mechanism used to emit the ultrashort bursts of laser light.  

The Q-Switched nanosecond 532 nm/ 1064 nm Nd YAG Laser is a non-invasive laser that generates high-intensity pulsed beams of light that last a mere billionth of a second. Using these ultra-short pulses of laser light at a wavelength of 1064nm, the laser is able to target the melanosomes in the dermal melanocytes [6]. 

With pulse durations of nanoseconds, this laser frequency of either 532 nm or 1064 nm matches the melanosomes that are targeted during treatment. Due to the theory of selective photothermolysis, the photoacoustic and thermal energy produced at high speed. This is absorbed mainly by the targeted melanocytes which rapidly expand and shatter into minuscule particles.

The nanosecond 1064 Nd YAG Laser was one of the first treatment modalities to be found effective for a range of skin conditions, including melasma, wrinkles, acne, and even tattoo removal. 

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What is a Pico Laser? 

A Pico or picosecond Laser is a new development that is a laser that has an even shorter pulse duration of 10-12 seconds, or a trillionth of a second. The first picosecond laser used for pigment removal was the 755 nm Alexandrite Laser. 

Pico laser technology, which includes an additional 755 nm wavelength, is a non-invasive laser treatment used to address pigmentary disorders. Initially used as a tattoo removal treatment, Pico lasers have become an increasingly popular treatment for acne scarring and photoaging.

The laser comes in different wavelengths – 532nm, 755nm, 1064nm. These lasers are also able to specifically target damaged melanocytes at different depths of the skin. This makes it another safe and effective therapy for a range of pigmentation conditions [7]. 

The laser, as its name suggests, emits ultra-short picosecond laser pulses to generate intense energy to the tune of up to 1.8GW. As the Pico Laser has a pulse rate that is 100 times shorter than the nanosecond Laser, it targets pigmentation with more photoacoustic (sound) energy. This also results in less thermal energy on the skin. Thus, it reduces the chances of skin heating up and lessens the risk of hyperpigmentation. 

Other advantages of a picosecond frequency include a lesser number of treatment sessions as well as shorter recovery times. 

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Which laser is good for your pigmentation? Q-Switched laser or Pico laser?  

So, which should you choose?

According to different studies, different conclusions have been drawn. Several studies have shown that picosecond lasers can break down tattoo ink into finer particles than other types of lasers. The study found that 12 patients out of 16 received a good clearance with a picosecond laser than with a nanosecond laser (Q-switched laser) [8]. However, other studies have found virtually no competing difference in the effectiveness of both lasers.   

Both nanosecond lasers and Pico lasers are safe and effective to be used for pigmentation removal. However, not all lasers are equal in terms of properties and capabilities. In fact, what works for some might not work the same for others. Therefore, it becomes important to first evaluate your specific skin pigmentation issues and the factors at play to select the laser that is optimally suited for the purpose.

 We can see the difference between Q-switched lasers and Pico lasers in Singapore in the table below.          

Q-Switched laser VS Pico laser 

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Pico Laser

Q-Switched Laser

Pulse rate  

Emits pulses in picoseconds (10-12 , pulse duration 100 times shorter than Q-Switched laser). 

Emits pulses in nanoseconds (10-9 seconds). 

Results 

The Pico laser breaks down melanin into finer particles, enabling the body to process and eliminate these pigments quicker and efficiently. 

The Q-switched laser is capable of breaking down melanin well, though not as fine as the Pico laser, so it may take longer to achieve results when treating stubborn pigments. 

Effectiveness 

Skin pigmentation can be treated in fewer sessions. 

Skin pigments that are stubborn will require a number of sessions. 

Safety

Less risk of tissue damage and therefore safer. 

Compared to Pico lasers, Q-Switched laser pulses are on the skin for a longer period of time, causing heat, which may result in tissue damage. 

Pico and Q-switched laser technologies offer significant hope for patients with pigmentation disorders, but they are not the only effective options. Other lasers, such as the Picosecond 755 nm Alexandrite laser, yellow 577 nm laser, and Erbium2940 nm laser, can also be used in combination to treat hyperpigmentation effectively.

Since pigmentation can occur in both the epidermal and dermal layers of the skin, different laser types provide varying wavelengths of laser energy to target these different depths. Using a combination of lasers can efficiently lighten pigmentation, reduce the appearance of pores, fine lines, and wrinkles, and improve overall skin tone and texture.

Key Takeaways

Lasers have been shown to treat pigmentary concerns safely and effectively. However, it is important to understand that each type of laser has a specific wavelength and pulse duration, making them suitable for certain skin conditions.

As every pigmentation problem can be different, there is no ‘one size fits all’ treatment. Having a wide range of different types of layers, and the knowledge, skill and experiences to use the different wavelengths to their fullest potential, yielding optimal results.  

Instead of seeking the latest or most popular laser machine, consider these tips when choosing an aesthetic clinic for your skin condition. . Alternatively, consult an experienced aesthetic practitioner for a detailed assessment to understand your pigmentation concern and the appropriate treatments.