What it is
PicoSure uses pulses measured in picoseconds, a fraction of a billionth of a second. At that speed, the laser reaches pigment particles in the skin and shatters them mechanically, and the body then clears the fragments through its normal pathways. Less heat means less collateral irritation than older laser approaches gave.
What it does well
Sun damage, age spots, freckles, and certain tattoo inks respond well. Melasma can also be approached with PicoSure, though melasma is a careful diagnosis and not every pigmentation problem is melasma. PicoSure is also used for general tone evening, where the pigment burden across an area is making the skin look duller than it needs to.
What it does not do
PicoSure does not treat redness, vessels, scarring, or laxity. Those each have their own appropriate tools. Treating melasma with PicoSure also requires patient selection and a measured approach. Aggressive laser on the wrong melasma case can make it worse, which is one of the reasons we are conservative with it.
Our view
Pigmentation is the area in aesthetic medicine where the wrong tool causes the most avoidable harm. Dr Ong assesses pigment type and depth before recommending the laser, and is comfortable telling a patient to wait, change topical regime, or use a different modality if PicoSure is not the right answer.
Practical notes
A session takes around twenty to thirty minutes. There is minimal downtime, with sometimes a few hours of redness afterwards. Sun protection between sessions is part of the protocol, not an extra.
