Evolution of the Picosecond Laser: A Review of Literature

Abstract

BACKGROUND Picosecond pulse duration lasers (PS) have altered the field of dermatology. PS were initially used in tattoo removal, to optimize efficacy and reduce side effects with nanosecond domain lasers. More recently, they have been demonstrated to be effective in the treatment of pigmentary disorders, acne scarring, and photoaging. OBJECTIVE In this article, we critically analyze the published data on the many uses of picosecond lasers in dermatology. MATERIALS AND METHODS A systematic review of PubMed was conducted using the following search terms: “picosecond,” “picosecond laser,” “picosecond laser dermatology,” “picosecond laser pigment/pigmentation,” and “picosecond laser tattoo removal.” Articles ranged from 1988 until 2017. RESULTS Forty-one articles were identified, and 27 met inclusion criteria for review. Indications for the PS included a variety of dermatologic applications include tattoo removal, benign pigmented lesions/pigmentary disorders, acne scarring, and photoaging. Most studies demonstrated safe and effective treatment. CONCLUSION The development of the picosecond pulse duration is a breakthrough innovation in laser technology, changing the scope of laser treatment. Encouraging findings in tattoo pigment clearance spurred the use of PS in a wider array of dermatologic issues. The increasingly positive results and low incidence of adverse effects further substantiates PS efficacy for a variety of dermatologic uses.

Comparison of a 1064‐nm neodymium‐doped yttrium aluminum garnet picosecond laser using a diffractive optical element vs. a nonablative 1550‐nm erbium‐glass laser for the treatment of facial acne scarring in Asian patients: a 17‐week prospective, randomized, split‐face, controlled trial

“…2,5,6 Picosecond lasers represent a novel group of laser devices characterized by ultrashort, picosecond pulse duration. 7 They exert potent photomechanical effects, leading to an enhanced disintegration of tiny pigment particles. 8 Furthermore, an innovative incorporation of a diffractive optical element (DOE) redistributes the beam into spots of high fluence surrounded by a low fluence background, thereby creating a grid of focused, microinjury zones present as dermal vacuoles through the electron avalanche breakdown called 'laser-induced optical breakdown' (LIOB).…”

“…Picosecond lasers represent a novel group of laser devices characterized by ultrashort, picosecond pulse duration 7 . They exert potent photomechanical effects, leading to an enhanced disintegration of tiny pigment particles 8 .…”

Usefulness of a 1,064 nm Microlens Array-type, Picosecond-dominant Laser for Pigmented Scars with Improvement of Vancouver Scar Scale

“…11 Since 2012 when the FDA approved use of 755-nm picosecond alexandrite laser in removing tattoos, the picosecond laser has been used to treat various pigmented scars and showed their effectiveness in pigmented scars. Torbeck et al 4 conducted systemic review of 41 articles about the effectiveness of picosecond laser in pigmented scars, removing tattoos and acne scarring. In most studies, the result was effective and safe.…”

Treatment of pigmentary disorders using picosecond laser in Asian patients: A meta‐analysis and systematic review

“…[5][6][7][8] Picosecond (PS) lasers represent significant technical advances from their nanosecond (Q-switched, QS) predecessors. [9][10][11] By delivering short pulses of energy in the range of 500-750 ps, they can induce a greater degree of photomechanical damages and reduce the degree of nonspecific photothermal effects, thereby enhancing the specificity of energy delivered to target cells within the lesions. [11][12][13][14] PS laser devices have been commercially available since 2013.…”