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Picosure treats blemishes and improves skin quality




謙太郎 奥
Dr. 謙太郎 奥


American society for laser medicine and surgery (ASLMS) Advisory Board Member of CynoSure, Scientis, L'Oreal Japan Japan Society of Cosmetic Dermatology Japanese Dermatological Association Japanese Society of Anti-Aging Medicine

Medical institution with Dr. Kentaro Oku

Azamino Hills Skin Clinic Azamino Hills Skin Clinic
Contact: 045-507-7420

Picosure treats blemishes and improves skin quality

Laser treatment has the effects of improving spots, freckles, fine lines, acne, acne scars, removing tattoos, and removing hair, but the Q-switched laser, which was mainly used in the past, breaks the skin with heat. , Redness and freckles are generally considered to be treatments with downtime. However, pico lasers (picosecond lasers, picosecond lasers) with short irradiation times tend to have relatively short downtime.

Let's know the effect of Picosure before receiving the treatment so that you can think "I'm glad I chose Picosure".

The effect of Picosure that can deal with various skin problems

Picosure_Cynosure Inc. There are various types of lasers used in aesthetic medicine, but the pico laser has a shorter irradiation time, called the pulse width, than the conventional Q-switched laser. And, among the pico lasers, "Picosure" was developed by Cynosure of the United States. Picosure has been recognized by the Ministry of Health, Labor and Welfare for its effectiveness in treating benign pigmented lesions (such as age spots) and removing tattoos. (Approval number: 30200BZX00153000)

Picosure can perform three types of irradiation: pico spot, pico toning, and pico fractional, so one picosure can improve a wide range of skin problems.

Three irradiation methods that can be picosure

Pico spot for spots and freckles

The cause of spots and freckles is lumpy melanin. Spot irradiation is a method of strongly irradiating the mass. Since pinpoint irradiation can be performed by changing the irradiation size in 0.1 mm increments regardless of whether the stain is dark or light, it can be expected to improve light stains that are difficult with light (IPL) treatment with weak irradiation power or Q-switched laser.

With conventional laser treatment, when melanin pigment is irradiated, the surrounding skin may be damaged and redness or scabs may appear, but it is said that pico spots are less likely to become scabs.

There are two reasons. As shown in the figure on the right side of the figure below, Picosure traps the shock wave of irradiation in the melanin pigment and breaks the melanin pigment into small pieces, so it does not easily damage the skin.

Pico spot _Cynosure for spots and freckles
Comparison of the action of Q-switched lasers and nanosecond lasers on dyes (left figure) and the action of pico lasers on dyes (right figure). As shown in the figure on the right, Picosure, a piloter, traps a shock wave in a melanin pigment and breaks it into small pieces.

And the laser wavelength of Picosure should be 755nm, which is suitable for aiming at melanin pigments.

At other wavelengths, the red hemoglobin in the blood absorbs a lot of laser as well as the melanin pigment, so it is highly likely that it will become a scab.

Pico toning for chloasma, dull skin, and uneven color

"Toning", which is one of the laser irradiation methods, is a treatment that helps to decompose and discharge melanin pigment by irradiating the entire face with a weak laser to reduce dark spots and dullness on the entire skin.

Pico toning shatters fine spots and melanin pigments from the reserve army of spots on the entire face.

Pico fractional for pores, acne scars, wrinkles and skin texture

"Fractional", which is one of the laser irradiation methods, is a method of irradiating laser light in fine dots (fractional) .

The skin has a two-layer structure consisting of the epidermis layer and the dermis layer from the outside, but when irradiated with picofractional, fine irritation is applied to the epidermis layer of the skin. Then, as the turnover cycle of the epidermis is adjusted, the production of collagen, hyaluronic acid, and elastin increases in the dermis layer below the epidermis layer, and the self-renewal function that the skin regenerates is switched on. Therefore, you can expect the effect of youthful skin, tightening of pores, and improvement of fine wrinkles and acne scars.

The feature of Picosure is that it can activate the dermis layer by stimulating the epidermis layer of the skin.

In the carbon dioxide treatment, which is common as fractional irradiation, when the skin is irradiated in dots, the skin tissue is instantly vaporized and blown away, resulting in many small holes in the skin. Perforated skin areas require downtime because they become scabs, but picofractional has the advantage of being less scabbing because it puts less strain on the skin surface.

Treatment by combining three irradiation methods

A combination of pico spot, pico toning, and pico fractional is a way to maximize the effect of picosure.

Picosure can be used according to the condition of the skin, such as removing conspicuous spots with spot irradiation and regaining firmness with fractional irradiation in order to improve the skin quality of the entire face.

The size of the target that can be aimed at changes depending on the irradiation method

The size of the target that can be targeted by irradiation also changes depending on the irradiation method.

Target size that can be aimed at by irradiation
Pico spot 2.0 to 6.0 mm (possible in 0.1 mm increments)
Pico toning 4.0 to 6.0 mm (possible in 0.1 mm increments), 8.0 mm, 10.0 mm
Pico fractional 6.0mm, 8.0mm, 10.0mm

By carefully changing the irradiation method and irradiation size according to the size of spots and pores and the condition of the skin, multiple effects such as improvement of spots, dullness, firmness, and tightening of pores can be obtained. You can expect it.

Those who are suitable for picosure

  • Conspicuous stains on the face
  • Uneven skin tone and dullness have become noticeable
  • I'm worried about chloasma
  • I want to get rid of freckles
  • As I get older, I'm worried about sagging skin
  • I want to regain the firmness of my skin
  • I want to tighten the pores
  • I want to cure acne
  • I want to smooth out the bumpy acne scars
  • I have a bad skin
  • I want to get rid of fine wrinkles and escape my old face
  • I want to remove the bruise-like stains (ADM) that I have been worried about for many years
  • I want to remove tattoos
  • I want to eliminate atopy marks
  • I want to get rid of age-related warts (seborrheic keratosis)

Why Picosure is chosen

Expected to improve light spots

The Q-switched laser responds better to dark spots with a lot of melanin pigment, so it has the disadvantage that light spots are less likely to react than dark spots.

Picosure responds to light spots because the pulse width, which is the laser irradiation time, is short and the instantaneous power is strong.

Low risk of post-inflammatory hyperpigmentation

Q-switched lasers use heat to destroy the melanin pigment that causes age spots, and the heat also damages the skin around the melanin pigment, creating a scab.

On the other hand, the pico laser, Picosure, can confine energy in the melanin pigment and crush the melanin that has been agglomerated by the shock wave like sand.

Because the impact can be trapped within the melanin pigment, it tends to reduce the risk of post-inflammatory hyperpigmentation without damaging the surrounding skin.

Less downtime

Generally, after Q-switched laser irradiation, the irradiated area becomes a scab, so tape protection is required for a while. However, Picosure does not require tape protection.

Picosure does not damage the surrounding skin while shattering the melanin pigment with a shock wave, so it does not become a scab. In addition, make-up is possible from the same day or the next day, shower is possible from the day, and drinking and smoking are possible from the next day.

Exercise is possible from the day of the event, but it is important to deal with sweating. Be careful not to rub it or wipe it with a towel as it will be irritating.

The effect can be expected with a small number of treatments

Picosure breaks the pigment into small pieces with a shock wave, so the pigment is removed quickly. Therefore, it can be expected to be effective in treating spots and removing tattoos even with a smaller number of treatments than a Q-switched laser.

Compare picosure with other pico lasers

In addition to Pico Sure, Pico Laser machines include Pico Way (Cineron Candela) and Enlighton (Kyutera).

Picosure is FDA certified and safe

Picosure has been approved by the FDA, which is the Ministry of Health, Labor and Welfare of the United States, to improve the symptoms of "pigmented lesions (stains, etc.)", "wrinkles", "acne scars", and "removal of tattoos".

Other than Picosure, there are Picoway and Enlighton, which have obtained FDA certification for "removal of tattoos", etc., but improvements have been officially recognized in four fields: spots, wrinkles, acne scars, and tattoos. Only Picosure is a tattoo laser.

Picosure is highly responsive to melanin pigments but does not hurt the skin

There are multiple machines that irradiate pico lasers, but the characteristic of picosure is the wavelength of the laser.

It is the wavelength band around 650nm to 800nm that does not damage the skin while acting on the melanin pigment that causes spots and freckles. Picosure has a high degree of laser absorption for melanin pigments and can irradiate with a wavelength of 755 nm, which causes less damage to the skin, so it can be expected to be extremely effective in treating spots and freckles.

The 532nm wavelength used by other pico lasers to treat age spots is absorbed not only by melanin pigments but also by the red hemoglobin in the blood. Absorption by hemoglobin has the effect of laser irradiation around the blood vessels, which tends to cause scabs.

Picosure removes tattoos of various colors

With Q-switched lasers, it was difficult to remove colorful blue and red tattoos. Therefore, I had to consider surgical treatment (excision) when trying to remove the tattoo.

However, Picosure uses three wavelengths, 1064nm, 532nm, and 755nm, so it can remove tattoos of most colors.

Risks and precautions you should know before receiving Picosure

Picosure downtime and risk

  • Post-inflammatory hyperpigmentation
  • Blisters
  • Depigmentation
  • Petechiae in the skin (no blood comes out of the skin)
  • Redness (a few hours to a few days after the treatment with pico spot and pico fractional)
  • Chloasma may worsen (in that case, oral medication)

Post-inflammatory hyperpigmentation

Post-inflammatory hyperpigmentation is a phenomenon in which spots that have once become lighter after laser irradiation become darker again about 2 to 4 weeks after irradiation. This is a phenomenon that can occur with any laser treatment and is more likely to occur with procedures that cause significant damage to the skin.

The incidence depends on the irradiation method and technique, but it can be said that Picosure, which uses a laser wavelength that causes less damage to the skin, is less likely to have post-inflammatory hyperpigmentation than a Q-switched laser.

Improvement in about 2 to 6 months

Post-inflammatory hyperpigmentation is a collection of melanin about the size of pebbles, unlike spots, which are lumps of melanin. The lumps cannot be removed by skin turnover, but the pebbles are expelled by turnover. Therefore, post-inflammatory hyperpigmentation improves in 2 to 6 months, depending on the turnover cycle, although there are individual differences.

The stain looks dark

After the pico spot, the stains will appear darker at the peak about 3 days after irradiation. This is because the melanin that was a lump in the pico spot is crushed into small pieces and moves to the upper layer of the skin . After that, the melanin that floats in the upper layer in about 7 to 10 days will be peeled off together with the keratin by turnover.

Tingling pain caused by picosure irradiation

There is pain that is described as tingling due to the heat of laser irradiation, but since it can be avoided by applying a local anesthetic in advance, those who are "vulnerable to pain" and "I absolutely hate pain" Please consult with a doctor at a medical institution in advance.

Aftercare and precautions after picosure treatment

Please follow the instructions of the medical institution for how to spend after the treatment.

After picosure, moisturize well and take measures against UV rays. Be careful of the sunlight on your way home.

Pico toning and pico fractional can be made from the same day, so you can go home after applying sunscreen and makeup after the treatment. Pico spot can be made from the next day.

You can take a bath or shower from the same day, but please avoid sweating activities such as sports and sauna during the day. Exercise, drinking and smoking are possible from the next day.

When picosure treatment is not possible

  • Pregnant
  • Those who have gold thread
  • Photosensitivity
  • Keloid constitution
  • Those who are receiving some oral treatment (isotretinoin)

In addition, if you receive sunburn within 4 weeks before the procedure, laser treatment or phototherapy within 4 weeks, or receive botulinum injection within 1 week, it is highly likely that the picosure procedure will be judged to be NG. Please consult with a medical institution in advance.

Flow until the end of Picosure treatment and treatment period / number of times

(1) Fill out the questionnaire

Enter what you would like to discuss, the part you are interested in, and the symptoms.

(2) Face washing / cleansing

Wash your face and remove makeup.

(3) Shooting

The state before laser irradiation is taken with a camera with a special light source that shows the state of the melanin pigment on the skin.

(4) Counseling

Talk to your doctor about your skin problems. We will decide which irradiation is better according to your worries. If you have any concerns or doubts, please ask at this time.

(5) Treatment

There are individual differences in how pain is felt, but if you are concerned, give a creamy anesthesia and then irradiate the laser. After the irradiation is finished, cool the laser-irradiated area.

(6) Make up and finish

In the case of pico spot, make-up will start the next day, but in the case of pico toning and pico fractional, make-up after treatment is possible.

Picosure treatment period and number of treatments

The duration and frequency of treatment will vary greatly depending on the type of skin problem.

Treatment period / frequency example
  • For sun-induced pigmented spots, 1 to 3 times, and the frequency of treatment is 4 to 6 weeks.
  • With ADM, it is about 2 to 5 times, and the frequency of treatment is every 12 weeks.

Each person's skin condition is different, and even for the same person, the skin condition changes before and after the treatment, so it is necessary to receive thorough skin counseling from a doctor at the medical institution that receives the treatment.

If you want to receive picosure that alleviates the problem of laser treatment

Since pico laser is a free medical treatment, the fee varies depending on the medical institution. Also, compared to other laser treatments such as Q-switched lasers, it may be said that the high price setting per treatment is a disadvantage.

Although the treatment fee is high, the problems such as pain, post-inflammatory hyperpigmentation and scabs, which are said to be disadvantages of laser treatment, are alleviated.

Among the pico lasers, Pico Sure has been recognized by the FDA for its effects of improving spots, wrinkles, and acne scars and removing tattoos.

The effect of irradiation varies greatly depending on the doctor who handles Picosure.

Customized treatment can be performed by carefully adjusting the irradiation method and irradiation size according to the skin condition, but in order to customize, it is essential to know the characteristics of the machine and to carefully assess the skin condition. is. You may want to check the Picosure cases and the number of cases on the medical institution's site and select a reliable medical institution.

In addition, there are some symptoms that are more effective when used in combination with chemical peels, hydra facials, and carbon dioxide lasers. There are machines that can be used with Picosure, so choose a medical institution that will suggest the most effective method.

Azamino Hills Skin Clinic Picosure

We asked Mr. Oku, who supervised the article, about Picosure.

How long does it take to combine the medical examination (counseling) and the treatment?
Mr. Kentaro Oku
Irradiation itself takes about 20 to 40 minutes, and counseling takes about 30 to 45 minutes. With anesthesia, it takes about an hour and a half to return.
How much pain is it? Do you anesthetize?
Mr. Kentaro Oku
Depending on the irradiation method, there is a feeling of tingling in pico toning, a feeling of tingling in pico fractional, and a feeling of being repelled by a rubber band in pico spot. If the pain is strong, we will give you anesthesia (5,500 yen / whole face), so please let us know.
How often do you recommend the treatment?
Mr. Kentaro Oku
It depends on the condition of your skin. Irradiation can be done after 4 weeks at the earliest if it is a stain treatment, but it will change if there is liver spots. It's a good idea to give thorough skin counseling before deciding on the frequency.
Please tell me about downtime and precautions.
Mr. Kentaro Oku
Picosure will not become a thick scab if properly irradiated. After irradiation, the color of the stains will appear, but it will come off in about a week, and the redness will almost always disappear in a few hours. After the treatment, your skin will become sensitive, so please take sufficient measures against UV rays and moisturize.
I heard that Mr. Oku is good at performing three irradiation methods (pico spot, pico toning, pico fractional) at the same time. What is the difficulty of this irradiation method?
Mr. Kentaro Oku
Just because you use the same picosure does not mean that every doctor will have the same effect. Of these, the method of performing the three irradiation methods at the same time is extremely difficult unless you are a doctor who is familiar with the skin condition and the characteristics of the machine, and if you irradiate with the wrong diagnosis, your skin problems may worsen. There is.
Please give a message to those who are wondering whether to receive Picosure from now on.
Mr. Kentaro Oku
Picosure is a strong ally for those who have not been able to take a step toward treatment, and for those who have not been able to obtain satisfactory results with conventional treatments. We can treat each person's skin problems according to their skin problems, so please feel free to contact us.
Thank you, Mr. Oku!

Azamino Hills Skin Clinic Picosure Treatment Fee

It is a device approved by the Ministry of Health, Labor and Welfare. It will be a free medical treatment and you will have to pay the full amount.

Irradiation method Price (tax included)
Pico spot (no upper limit on the number of irradiations) 55,000 yen
Pico toning 27,500 yen
Pico fractional 38,500 yen
Hills Facial * 110,000 yen

* Hills Facial is a treatment course uniquely combined by Azamino Hills Skin Clinic. After performing treatment with three types of irradiation methods, pico spot, pico toning, and pico fractional, depending on the condition of the skin, we perform introductory treatment and pack to introduce high-concentration skin active ingredients.

Introduction of supervising doctor

Dr. Kentaro Oku, director of the Azamino Hills Skin Clinic and an Advisory Board Member at CynoSure, the largest medical laser manufacturer in the United States that developed Picosure. We have abundant experience in picosure treatment, and clinical results by picosure amount to 5,000 cases. Many foreign doctors come to Japan just to attend the seminars of Oku-ishi, and their knowledge and high technical capabilities are highly trusted not only in Japan but also overseas.

Medical institution with Dr. Kentaro Oku

Azamino Hills Skin Clinic Azamino Hills Skin Clinic
Contact: 045-507-7420

Information on safety in other countries: We have obtained approval from the US FDA (US Food and Drug Administration) for "dye spot removal" and "tattoo removal" at all wavelengths of 532nm, 755nm, and 1064nm. The approval dates for each wavelength and disease are as follows.
Approval date Approved indications
2012.11.27 755nm: Removal of benign pigment spots and tattoos
2014.07.22 755nm: Acne scar treatment
2014.09.22 755nm: Fine wrinkle treatment
2015.02.23 532nm: Tattoo removal
2016.05.17 1064nm: Removal of benign pigment spots and tattoos
2018.02.07 532nm: Removal of benign pigment spots
Side effects in the approval: Transient redness, scabs, pain, itchiness, blisters that disappear in 2 to 11 days