How many PicoSure sessions will I need?
It depends on what the pigment is and how deep it sits. A picosecond laser delivers energy in trillionths of a second and shatters pigment into fragments, which the body clears; how Pico works, and its limits explains the mechanism. The count then depends on the target.
For tattoos, a systematic review of picosecond lasers (eight trials, 160 human participants) found 69 to 100 per cent of mainly black and blue tattoos showed over 70 per cent clearance after 1 to 10 treatments, with most studies at medium to high risk of bias. For freckles and sun spots (solar lentigines), a review of 41 trials gave picosecond success rates of 67.9 to 93.02 per cent, and several trials measured the result after a single session. For Hori's naevus, a pooled analysis of six studies (318 patients) found near-complete clearance after the first session in only 8.8 per cent, improving with more sessions, and a Singapore review averaged 3.82 sessions. The honest range is therefore one to several, set by the diagnosis. The page on melasma, sun spots and Hori's naevus helps tell them apart.
Does PicoSure hurt?
Usually a little, so it is fair to expect some discomfort. Pain appears among the reported effects in the tattoo review and the sun spot review, which calls mild pain common. The sensation varies by person and by area, and no source read for this article gives a pain score, so none is claimed.
Whether to use numbing is decided by the doctor. How numbing cream works, and why more is not safer, is covered in numbing cream before treatment.
What does skin look like afterwards, and for how long?
Redness is the most documented change. In a Singapore review of 29 patients with dermal pigment, 37.9 per cent had post-laser redness, and 3.4 per cent had transient paler skin, with no permanent pigment change seen. Reviews also list blisters, swelling and pinpoint bleeding among the effects reported with tattoo treatment.
Treated spots may also darken and flake before they fade; this is commonly described, but no source read gives a number of days, so none is given here. Your doctor explains the timeline for the spot being treated.
What aftercare and sun precautions matter?
Sun protection is the main one, because freshly treated skin can answer sun with more pigment. A daily broad-spectrum sunscreen, shade, and leaving crusts or flakes alone are the general principles; the doctor gives specific instructions for the area treated.
No trial read for this article tested a specific aftercare routine, so these are general principles for pigment-laser aftercare, not tested intervals.
Why is darker skin a special case?
Because skin rich in melanin answers injury with extra melanin. In a trial of 27 patients with skin types III to V, a conventional 532 nm picosecond technique recorded post-inflammatory hyperpigmentation in 64 per cent at two weeks and 88 per cent at six months, against 8 to 36 per cent at those times with a fractional technique. In the pooled Hori's naevus analysis, the rate was 21.1 per cent, all transient. These are different conditions and techniques, so the numbers cannot be compared directly.
They show the skin's answer matters as much as the laser. The page on pigment laser side effects on Asian skin goes through darker patches, pale spots and what lowers the risk.
Why does melasma need caution?
Because it is a condition that can flare with heat and injury. A meta-analysis of six trials found a 1064 nm picosecond laser reduced melasma scores without significant side effects, while a 755 nm laser was not better than topical lightening agents and caused post-inflammatory hyperpigmentation; results were highly heterogeneous.
In practice, melasma is not treated as a spot. Whether a laser belongs in the plan at all, and which one, is decided after diagnosis; can laser make melasma worse explains why. PicoSure at The Retreat Clinic is performed by Dr Ong, who decides suitability at the visit.
