Plastic surgeon Japan Plastic Surgery Society Japan Laser Medical Association (Councilor) Japan Cosmetic Surgery Society Japan Society of Aesthetic Dermatology Japanese Breast Oncoplastic Surgery Society Japanese Society of Anti-Aging Medicine
Dr. Huang Seiko, the director of KO CLINIC. As a leading expert in "customized treatment" that performs appropriate treatment by analysis with a diagnostic imaging machine, he has participated in many academic conferences and lectures. Started clinical research on chloasma in 2007, and now teaches many doctors and medical professionals how to treat with multiple pico lasers. Established a treatment centered on skin care medical care aiming for healthy and beautiful bare skin. His major books include "Life changes when your bare skin is clean!" And many others.
A picosecond laser (hereinafter referred to as pico laser) is a laser that can crush melanin and tattoo ink pigments with the shock wave (photoacoustic effect) of the laser . Therefore, it is said that the Q-switched laser can crush pigment particles that are too small to be destroyed, and can improve skin problems while reducing the risk of scabs and pigmentation after treatment.
However, in rare cases, it is said that there are cases where the effect of pico laser treatment cannot be felt, such as "stains do not disappear" or "no change". Pico laser with many features such as crushing pigments, tone-up of dull skin, and improvement of skin quality . It is important to check the effects and risks before the procedure and receive appropriate treatment.
Table of contents
A pico laser (picosecond laser / picosecond laser) is a laser that can irradiate in picoseconds (1/1 trillion seconds) .
Since the irradiation time of the pico laser is extremely short, there is almost no heat generation, so it is said that the burden on the skin is small and the downtime is relatively short.
A laser is an artificial light created by extracting a specific wavelength from light containing multiple wavelengths and amplifying it. The wavelength of light or laser has the property of being absorbed by a specific substance, and heat energy is generated when the wavelength is absorbed by a specific substance. These are the same phenomena that make you feel warm when the sun hits your skin.
Laser treatment by aesthetic medicine uses a laser with a wavelength that is absorbed by the black pigment of melanin and the red pigment of hemoglobin, and improves by destroying the causes of various skin problems such as spots, freckles, bruises, and reddish faces. Lead to. The destroyed pigment is excreted by the metabolism (turnover) of the skin.
In the case of laser treatment, if the irradiation energy is low, the effect cannot be expected, and if it is too high, it will cause heat damage to healthy skin other than skin problems such as age spots. In order to perform appropriate treatment, it is important not only to select the wavelength for each symptom, but also the laser irradiation time and irradiation energy.
For example, if you continue to irradiate the spots with a laser, the heat will also affect the skin tissue around the spots. This is because the wavelength is absorbed by the stains and heat energy is generated, and the heat is transferred to the skin tissue around the irradiation by dissipating heat, and the temperature of the epidermis rises.
The stains that have absorbed the wavelength gradually dissipate heat, so the heat stays for a while. It is said that if the heat action is settled in the stain and does not spread to the surrounding skin tissue (heat relaxation time), the stain site can be destroyed while preventing damage to the surrounding skin tissue.
The laser irradiation method is not continuous irradiation, but pulse irradiation, which irradiates intermittently at regular intervals, and this laser irradiation time is called "pulse width" . If the pulse width is within the heat relaxation time, it can be said that damage to the surrounding skin can be suppressed and only the target area can be destroyed.
Lasers used in laser treatment have the following pulse widths, and lasers with pulse widths in picosecond units are called picosecond lasers (picosecond lasers and picosecond lasers).
|Picoseconds (ps)||1 / 1,000,000,000,000s (1/1 trillion seconds)|
|Nanoseconds (ns)||1 / 1,000,000,000s (1 billionth of a second)|
|Microseconds (μs)||1 / 1,000,000s (1 / 1,000,000 second)|
|Milliseconds (ms)||1 / 1,000s: Long pulse|
By shortening the pulse width of the laser, even if the irradiation energy (fluence) is low, the shock wave can destroy small substances. Although it is local, it has a large destructive power, and it can be crushed into pieces by suppressing the impact only on the spots and other parts . Since the pico laser with a short pulse width has low irradiation energy, it hardly damages normal cells around the irradiation site.
Pico lasers are good at crushing small substances. To destroy a large substance, it is necessary to increase the pulse width and apply thermal energy. Therefore, long pulse lasers with long pulse widths are used instead of pico lasers for treatments that irradiate large targets such as hair follicles (hair loss), which are organs that make hair, and blood vessels (treatment of red face and telangiectasia). I will.
Treatments to thin or remove pigments such as age spots, freckles, bruises, and tattoos were generally performed with a Q-switched nanosecond laser (hereinafter referred to as Q-switched laser).
In the treatment of spots and tattoo removal with a Q-switched laser, it is necessary to increase the irradiation energy of the laser as the pigment becomes thinner over time, which puts a strain on the skin tissue around the irradiation site. Therefore, it can be said that the risk of causing burns, blisters, and post-inflammatory hyperpigmentation tends to increase.
On the other hand, pico laser is said to be able to crush and remove melanin granules of stains and pigment particles of tattoos with shock waves due to low irradiation energy with almost no damage to the tissues around the irradiation site .
After laser treatment, it is not uncommon for spots to recur . This is caused by the inflammation caused by laser irradiation, which stimulates the cells that produce melanin (melanocytes). Post-inflammatory hyperpigmentation appears about 4 weeks after the procedure, so it looks like the spots that have been removed have recurred.
Post-inflammatory hyperpigmentation is not a stain. Post-inflammatory hyperpigmentation is said to be naturally eliminated in about 3 to 6 months by turnover, which is the metabolism of the skin, after the activity of melanocytes has subsided.
The risk of post-inflammatory hyperpigmentation with Q-switched laser treatment is 30% to 50%. Although it depends on the laser irradiation method, there are some reports that the risk of post-inflammatory hyperpigmentation with pico laser is less than half that of Q-switched laser .
Although there are differences depending on the wavelength, the pulse width of the pico laser is 15 to 100 times shorter than that of the Q-switched laser when compared in terms of pulse width. The shorter the pulse width, the lower the irradiation energy required, reducing the risk of damage to the surrounding normal skin tissue. From this, it can be said that post-inflammatory hyperpigmentation is less likely to occur with pico laser treatment.
Since the pico laser crushes spots with a shock wave of low irradiation energy, it is not good at treatments aiming at large substances such as hair loss and reddish face, but it is a low density pigment that is left behind by phototherapy (IPL treatment) and Q-switched laser. It is possible to approach particles.
With pico laser , even thin spots that could not be removed by phototherapy or Q-switched laser have less risk of post-inflammatory hyperpigmentation and can be made even thinner .
A major feature of the pico laser machine is that it can perform three types of irradiation: fractional irradiation, toning irradiation, and spot irradiation.
Fractional irradiation irradiates the skin with a laser in dots. It is said that the recovery of the skin will be accelerated by interspersing the non-irradiated area and the irradiated area. The skin is roughly divided into a two-layer structure from the outside, the epidermis layer and the dermis layer, and the second layer, the dermis layer, contains fibroblasts that produce fibers that supplement the elasticity of the skin, such as collagen and elastin. Fractional irradiation with a pico laser (pico fractional) produces collagen and other substances by applying appropriate stimulation to the fibroblasts in the dermis layer, promoting the reconstruction of the dermis.
Fractional irradiation with a pico laser is said to aim to improve the firmness of the skin, tighten pores, and improve fine wrinkles and acne scars.
The laser beam converges (aggregates) at each dot of the picofractional irradiation. Therefore, compared to treatments other than fractional irradiation, shock waves that are many times stronger act on the dermis layer and damage the capillaries in the dermis layer, which may cause petechiae . However, it is said that it will recover in a few days because it does not damage the epidermis layer, and it is said that downtime can be spent by covering it with a medical concealer. In addition, make-up is possible from the day.
If you are worried about the pain of laser irradiation, cream-type anesthesia can relieve the pain.
Toning is a treatment method that promotes epidermal turnover by eliminating melanin granules in the cells of the epidermal layer (keratinocytes) without stimulating the cells that produce melanin (melanocytes).
Toning irradiation with a pico laser (pico toning) can be performed efficiently even with lower irradiation energy than a Q-switched laser, so it does not stimulate the cells (melanocytes) that produce more melanin, and improves liver spots and causes light spots. You can expect it to be even thinner.
Pico toning causes little pain or downtime when using low radiation energy, but may be anesthetized when treated with high radiation energy. Petechiae may occur in redness or under the eyes, but most of the time, they will subside within a few hours or days after the procedure . Makeup is possible from the day of the event.
With spot irradiation with a pico laser (pico spot / pico shot), it is not necessary to increase the irradiation energy as with a Q-switched laser, even if the pigment becomes thinner over time. Therefore, it is said that pigment can be removed with a small number of treatments without causing scarring on healthy skin tissue.
Compared to Q-switched lasers, there is less inflammation, so the degree of scabs (scar formation) and bruises (purpura formation) is minor, and it may not be necessary to protect the irradiated area with tape as in Q-switched laser treatments. .. Makeup is supposed to start the next day.
If you are worried about pain, cream-type anesthesia can help.
Machines that can irradiate lasers in picosecond units have different wavelengths and pulse widths for each machine.
|Machine name||Company||wavelength||pulse width||Approved by the Ministry of Health|
|PicoSure||Cynosure (USA)|| 532nm|
|PicoWay||Syneron Candela (USA)|| 532nm|
|enLIGHTen||Cutera (USA)|| 532nm|
|Discovery Pico||Quanta (Italy)|| 532nm|
|SPECTRA PICO||Lutronic (Korea)|| 532nm|
|PICOCARE||WONTECH (Korea)|| 532nm|
Pico fractional is about 14,000 to 100,000 yen, pico toning is about 10,000 to 50,000 yen, and pico spots have different price settings depending on the medical institution. In many cases, it is set for one part, one shot, one ㎠, etc.
Some pico laser machines are unapproved. In addition, since it is a free medical treatment that is not covered by insurance, the full amount will be borne by you and the fee will vary depending on the medical institution.
We interviewed Dr. Huang Sei Amber, who supervised the article, about the pico laser.