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Picosure treats spots that are less likely to scab 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

Hills Grace Clinic Hills Grace Clinic
Contact: 045-507-7420

Laser treatment has the effect of improving blemishes , freckles, fine wrinkles, acne, acne scars, removing tattoos, and removing hair. , It is generally considered a treatment with downtime, such as redness and scabs . 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 undergoing the treatment so that you can think that you are glad you chose picosure.

Picosure treats spots that are less likely to scab and improves skin quality 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 pico lasers have a shorter laser irradiation time, called the pulse width, than conventional Q-switched lasers . And among the pico lasers, "Picosure" was developed by Cynosure in the United States. Picosure has been recognized by the Ministry of Health, Labor and Welfare as effective in treating benign pigmented lesions (such as 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 Picosure can do

Pico spot for blemishes and freckles

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

In previous laser treatments, when the melanin pigment was irradiated, the surrounding skin was damaged, causing redness and scabs, but it is said that picospots are less likely to scab.

There are two reasons. As shown on the right side of the figure below, picosure confines the shock wave of irradiation in the melanin pigment and crushes the melanin pigment into small pieces, so it is difficult to damage the skin.

Pico spot for blemishes and freckles_Cynosure
Comparison of the action of Q-switched laser and nanosecond laser on pigment (left figure) and the action of pico laser on pigment (right figure). As shown in the figure on the right, picosure, which is a piller, confines the shock wave in the melanin pigment and crushes it finely.

And the picosure laser wavelength is 755 nm, which is suitable for targeting melanin pigments.

At other wavelengths, the red hemoglobin in the blood absorbs a lot of the laser in the same way as the melanin pigment, so it can be said that there is a high possibility that scabs will form.

Pico toning for melasma, dull skin and uneven color

"Toning", one of the laser irradiation methods, is a treatment that applies a weak laser to the entire face to help break down and excrete the melanin pigment, and to lighten the spots and dullness of the entire skin .

Pico Toning pulverizes and discharges the melanin pigment of fine spots and potential 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 of the epidermis layer and the dermis layer from the outside, but when irradiated with picofractional, the epidermis layer of the skin is slightly stimulated. As a result, the turnover cycle of the epidermis is adjusted, and the production of collagen, hyaluronic acid, and elastin increases in the dermis layer below the epidermis layer, and the self-regeneration function that regenerates the skin is switched on. Therefore, you can expect the effect of tightening pores, improving fine wrinkles and acne scars, making your skin look younger.

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

In the procedure using carbon dioxide gas, which is commonly used as fractional irradiation, when the skin is irradiated in a point-like manner, the skin tissue is instantly vaporized and blown away, so many small holes are made in the skin. The perforated skin becomes a scab, which requires downtime, but Pico Fractional has the advantage of being less likely to scab because it puts less strain on the skin surface .

Treatment by combining three irradiation methods

A treatment that combines pico spot, pico toning, and pico fractional is the method to maximize the effect of picosure.

Picosure allows you to use irradiation according to your skin condition, such as removing conspicuous spots with spot irradiation and restoring firmness with fractional irradiation to improve the skin quality of the entire face.

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

The size of the target that can be aimed at by irradiation also changes for each irradiation method.

Size of target that can be aimed at by irradiation
pico spot 2.0 to 6.0mm (possible in 0.1mm increments)
pico toning 4.0 to 6.0mm (possible in 0.1mm increments), 8.0mm, 10.0mm
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 quality, it is possible to obtain multiple effects such as improving spots, dullness, firmness, and tightening pores. You can expect it.

Those for whom picosure is suitable

  • conspicuous blemishes on the face
  • Uneven skin tone and dullness became noticeable
  • I'm worried about melasma
  • I want to erase freckles
  • With age, skin sagging becomes a concern
  • I want to restore the firmness and luster of my skin
  • I want to tighten my pores
  • I want to cure acne
  • I want to smooth out bumpy acne scars
  • bad skin
  • I want to get rid of fine wrinkles and get rid of my old face
  • I want to get rid of bruise-like spots (ADM) that have bothered me for many years
  • I want to remove a tattoo
  • I want to get rid of atopic scars
  • I want to remove age-related warts (seborrheic keratosis)

Why choose picosure

Improvement of light spots can be expected

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

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

Low risk of post-inflammatory hyperpigmentation

The Q-switched laser destroys the melanin pigment that causes spots by heat action, but the heat also damages the skin around the melanin pigment and creates a scab.

On the other hand, picosure, which is a pico laser, can trap energy in melanin pigments and crush the melanin that has clumped together with shock waves like sand.

Because the impact can be trapped within the melanin pigment, the surrounding skin is not damaged and the risk of post-inflammatory hyperpigmentation tends to be low .

less downtime

In general, after irradiation with a Q-switched laser, the irradiated area becomes a scab, so it is necessary to protect it with tape for a while. However, picosure does not require tape protection.

Picosure does not cause scabs because it does not damage the surrounding skin while shattering the melanin pigment with a shock wave. Also, make-up can be applied from the same day or the next day, showers can be taken from the same day, and drinking and smoking can be done from the next day.

Exercise is possible from the same day, but it is important to treat when you sweat. Be careful not to rub it or wipe it off with a towel as it will irritate it.

Results can be expected with a small number of treatments

Picosure crushes the pigment finely with a shock wave, so the pigment is removed quickly. Therefore, it can be expected to be effective in treating spots and removing tattoos with fewer treatments than Q-switched lasers.

Compare picosure with other pico lasers

In addition to Picosure, pico laser machines include Picoway (Sineron Candela) and Enlighton (Cutera).

Picosure is FDA-approved and recognized for its safety

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

Other than Picosure, there are Picoway and Enlighton, which have received FDA certification for "removal of tattoos", etc., but improvements have been officially recognized in four areas: spots, wrinkles, acne scars, and tattoos. Among the pico lasers, only picosure is available.

Picosure does not damage the skin even though it has a high reaction to melanin pigment

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

The wavelength range from 650nm to 800nm works on the melanin pigment that causes spots and freckles without damaging the skin. Picosure has a high degree of laser absorption for melanin pigments and can irradiate with a wavelength of 755 nm, which causes little damage to the skin, so it can be expected to be very effective in treating spots and freckles.

The 532 nm wavelength that other pico lasers use for spot treatment is absorbed not only by melanin pigments but also by red hemoglobin in the blood. Being absorbed by hemoglobin means that the surrounding blood vessels are affected by the laser irradiation, so scabs tend to form more easily.

Picosure removes tattoos of various colors

With a Q-switched laser, it was difficult to remove colorful tattoos such as blue and red. Therefore, I had to consider surgical treatment (excision) to remove the tattoo.

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

Risks and precautions to know before receiving Picosure

Picosure Downtime and Risk

  • Post-inflammatory hyperpigmentation
  • blisters (blister)
  • depigmentation
  • Intracutaneous petechiae (blood does not appear outside the skin)
  • Redness (A few hours to a few days after treatment with pico spot and pico fractional)
  • Melasma may worsen (in that case, oral drug treatment)

Post-inflammatory hyperpigmentation

Post-inflammatory hyperpigmentation is a phenomenon in which the spots that have 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 the incidence is higher in treatments that cause more damage to the skin.

The incidence depends on the irradiation method and irradiation technique, but it can be said that picosure, which uses a laser wavelength that causes less damage to the skin, has a lower possibility of post-inflammatory hyperpigmentation than a Q-switched laser.

Improvement in approximately 2 to 6 months

Post-inflammatory hyperpigmentation is a collection of pebbles of melanin, which is different from blemishes, which are masses 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 according to the turnover cycle, although there are individual differences .

Blemishes look darker

After the pico spot, the spots will appear darker, peaking about 3 days after irradiation. This is because melanin, which was clumped in pico spots, is broken into pieces and moves to the upper layers of the skin . After that, in about 7 to 10 days, the melanin that floats to the upper layer will peel off along with the keratin due to turnover.

Pricking pain caused by picosure irradiation

There is a tingling pain due to the heat of the laser irradiation, but it can be avoided by applying a local anesthetic beforehand, so those who are "vulnerable to pain" and "absolutely dislike pain". Please consult a doctor at a medical institution in advance.

Aftercare and precautions after picosure treatment

Please follow the instructions of the medical institution on how to spend your time after the treatment.

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

Pico Toning and Pico Fractional can be applied on the same day, so you can apply sunscreen and make-up before going home. Picospot can be applied from the next day.

You can take a bath or shower on the day of your appointment, but please avoid activities that cause sweating, such as sports and saunas. Exercise, drinking and smoking are allowed from the next day.

When picosure treatment cannot be performed

  • pregnant
  • Those with gold threads
  • photosensitivity
  • keloid constitution
  • Those who are receiving some oral treatment (isotretinoin)

Also, if you have received sunburn within 4 weeks before the treatment, laser treatment, phototherapy within 4 weeks, or botulinum injection within 1 week, there is a high possibility that picosure treatment will be judged as NG. Please consult a medical institution in advance.

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

(1) Fill out the medical questionnaire

Write down what you want to consult, areas of concern, symptoms, etc.

(2) Face wash/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 in the skin.

(4) Counseling

Talk to your doctor about your skin concerns. We will decide which irradiation is best according to your concerns. If you have any concerns or questions, please ask them at this time.

(5) Treatment

There are individual differences in how pain is felt, but if you are concerned, apply a cream-like anesthesia and then irradiate the laser. When the irradiation is over, cool the part irradiated with the laser.

(6) Finish with makeup

In the case of pico spot, makeup will be applied from the next day, but with pico toning and pico fractional, makeup can be applied after treatment.

Picosure treatment period and number of treatments

The duration and number of treatments will vary depending on the type of skin problem.

Example of treatment period and number of times
  • For solar pigmented spots, once to three times, treatment frequency is every 4 to 6 weeks
  • 2 to 5 times for ADM, treatment frequency is every 12 weeks

Each person's skin condition is different, and even for the same person, the skin condition will change before and after the treatment, so it is necessary to receive thorough skin counseling from a doctor at the medical institution where the treatment will be performed.

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

Picosure treats spots that are less likely to scab and improves skin quality

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-switch laser, it may be said that the disadvantage is that the price per treatment is higher.

Although the treatment fee is high, the disadvantages of laser treatment such as pain, post-inflammatory pigmentation and scab formation are reduced.

Among the pico lasers, picosure has been recognized by the FDA for its effectiveness in improving spots, wrinkles, acne scars, and removing tattoos.

The effect of irradiation varies greatly depending on the doctor who treats picosure.

Customized treatment is possible by carefully adjusting the irradiation method and irradiation size according to the skin condition, but in order to customize it, it is necessary to know the characteristics of the machine and the skill to carefully assess the condition of the skin. is. It may be a good idea to check the Picosure cases and number of cases on the medical institution's site and select a reliable medical institution .

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

Hills Grace Clinic picosure

We asked Dr. Oku, who supervised the article, about picosure.

How long does the consultation (counseling) and treatment take?
Mr. Kentaro Oku
The irradiation itself takes about 20 to 40 minutes, and the counseling takes about 30 to 45 minutes. It takes about an hour and a half to go home, including anesthesia.
How much pain? Will you give me anesthesia?
Mr. Kentaro Oku
Depending on the irradiation method, pico toning gives a crisp feeling, pico fractional gives a tingling feeling, and pico spot gives a feeling like being repelled by a rubber band. If the pain is strong, we will apply a topical anesthesia (5,500 yen/whole face), so please let us know.
How often do you recommend treatments?
Mr. Kentaro Oku
It depends on your skin condition. For spot treatment, irradiation can be done after a minimum of 4 weeks, but it will change if you have melasma. It is a good idea to do a thorough skin counseling before deciding on the frequency.
What about downtime and precautions?
Mr. Kentaro Oku
Picosure will not become a thick scab if it is irradiated well. After irradiation, the color of the stain will float, but it will peel off in about a week, and in most cases, the redness will subside in a few hours. After the treatment, the skin becomes sensitive, so please take sufficient measures against UV rays and moisturizing.
I heard that the method of simultaneously performing three irradiation methods (pico-spot, pico-toning, and pico-fractional) is Professor Oku's specialty. What is the difficulty of this irradiation method?
Mr. Kentaro Oku
Using the same picosure does not mean that every doctor will have the same effect. Among them, the method of performing 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. To some extent.
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 been unable to take the first step toward treatment, and for those who have not obtained satisfactory results with conventional treatments. Treatment can be tailored to each individual's skin concerns, so please consult us.
Thank you very much, Mr. Oku!

Picosure treatment fee at Hills Grace Clinic

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

Irradiation method Fee (tax included)
Pico spot (no upper limit on 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 Hills Grace Clinic. After treatment with three types of irradiation methods, pico-spot, pico-toning, and pico-fractional, according to the skin condition, we will perform an introductory treatment and a pack that introduces highly concentrated skin active ingredients.

Introduction of supervising doctor

Dr. Kentaro Oku, director of the Hills Grace Clinic and Advisory Board Member at CynoSure, the largest medical laser manufacturer in the United States that developed PicoSure. We have a wealth of experience in picosure treatment, and the clinical results of picosure have reached 5,000 cases. There are many foreign doctors who come to Japan just to attend Dr. Oku's seminars, and their knowledge and high technical skills are highly trusted not only in Japan but also overseas.

Medical institution with Dr. Kentaro Oku

Hills Grace Clinic Hills Grace 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 "pigment spot removal" and "tattoo removal" at all wavelengths of 532 nm, 755 nm, and 1064 nm. The approval dates for each wavelength and disease are as follows.
Date of approval Approved Indications
2012.11.27 755nm: Removal of benign pigment spots and tattoo removal
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 tattoo removal
2018.02.07 532nm: Removal of benign pigment spots
Side effects in this approval: Transient redness, scabs, pain, itching, and blisters that resolve within 2 to 11 days