Pico can be used to target tattoo pigments and break them down into extremely small particles.
In simple terms, Pico delivers the energy incredibly quickly, creating what we call a photoacoustic effect, tiny pressure waves or "air bursts" that shatter the pigment into incredibly fine particles, almost like dust. The finer we can break that pigment down, the easier it is for your body to gradually clear it.
That's the difference I see with Pico. It's not just about breaking the pigment, it's about how finely we can break it down. It gives me another very useful tool when I'm working with different types and depths of pigment.
Pico laser is one of the most versatile pieces of technology I have in the clinic. What makes it different is the incredibly short pulse duration: energy is delivered in picoseconds, or trillionths of a second, creating a predominantly photoacoustic or photomechanical effect rather than relying simply on heating the skin.
That means I can use different wavelengths and handpieces for different concerns. Pico was originally developed for tattoo removal, but the technology has expanded well beyond tattoos and is now used for a range of pigmentation, skin rejuvenation and softening the look of scars. The strength of the evidence varies between indications, so I always assess the skin and the specific concern before deciding whether Pico is the right treatment.
This is where Pico really made its name.
Different wavelengths are absorbed by different colours, which is why having access to different wavelengths and handpieces is so important when treating a multicoloured tattoo.
Depending on the technology available, Pico systems can be used for black, blue, green, red, orange, yellow and other tattoo colours. Black and darker blue pigments are commonly treated with longer wavelengths such as 1064 nm, while shorter wavelengths can be useful for other colours. No single wavelength treats every colour equally well, which is why I assess the actual pigment I am seeing rather than treating every tattoo the same way.
Anything new, changing, crusty or bleeding needs to be checked by your GP or dermatologist first.
Some Pico systems have specialised fractional or diffractive handpieces that allow the energy to be delivered into the skin in a different way.
These treatments are designed to create controlled microscopic effects below the surface, encouraging collagen and elastin remodelling.
This can be useful for softening the look of selected acne scars, particularly uneven texture and some shallow, indented scars.
With the appropriate fractional or specialised handpiece, Pico can also be used for skin rejuvenation.
The goal here isn't to remove the surface of the skin like an ablative resurfacing laser. Instead, the treatment uses controlled photomechanical effects beneath the surface to stimulate a wound-healing response and encourage new collagen and elastin.
This can improve the appearance of fine lines, texture and overall skin quality over a series of treatments.
Certain fractional Pico treatments can improve overall skin texture and the appearance of enlarged pores.
This is one of the treatments I consider when someone wants their skin to look smoother, fresher and more refined without undergoing a more aggressive resurfacing procedure.
Pico can also be used as a skin-revitalising treatment.
Depending on the handpiece and settings, the aim may be to improve:
Pico can be suitable for a very wide range of people, including people wanting to:
It can also be useful for people who want a treatment with minimal downtime, particularly when compared with more aggressive ablative resurfacing procedures. However, minimal downtime does not mean zero risk, and the downtime depends very much on what we are treating and how we treat it.
One of the things I like most about Pico is that it gives me options. I can choose the wavelength, spot size, handpiece and treatment approach according to what I am actually seeing in your skin.
I don't treat everyone with the same Pico treatment. I treat the skin in front of me.
There are times when I will say "not today" or ask you to wait before we treat. My priority is always making sure your skin is in the right condition and that the treatment is appropriate for you.
There isn't one universal list of contraindications for every Pico laser because different manufacturers, wavelengths and handpieces have different indications and safety requirements.
I would generally postpone or not treat if you have:
That includes certain medications and medical conditions, so I always want a complete medical history before treating.
I would not treat over an active bacterial, viral or fungal infection, or over significantly inflamed or compromised skin.
Some device manufacturers list certain autoimmune diseases as contraindications or precautions.
Laser treatment is designed to create a controlled response in the skin, so I need to understand how your skin has healed from previous injuries, surgery, tattoos or other procedures.
I always want to know about your medications and supplements before treatment rather than finding out afterwards.
I would never want you to stop prescribed medication simply for a cosmetic treatment without discussing it with the doctor who prescribed it.
And sometimes the answer isn't "no", it's simply "let's wait."
If your skin is sun-exposed, irritated, inflamed or not quite where I want it to be, I'd rather postpone your treatment than treat skin that isn't ready.
Recently tanned or sun-exposed skin can have an increased risk of pigmentary complications.
I also won't laser a spot just because it looks like pigmentation. If I don't know what I'm looking at, I want it assessed first.
If a lesion is changing, irregular, suspicious or has not been appropriately diagnosed, it needs medical assessment before cosmetic laser treatment. A suspicious lesion should not be laser-treated simply to make it disappear.
This is one of the reasons I assess the actual pigment before deciding how to treat it. Some pigments require a test spot or may be unsuitable for laser treatment altogether.
That's part of my job too, knowing when to treat, knowing how to treat, and knowing when to leave the skin alone.
I use picosecond laser technology, together with Fotona laser technology.
I have both available because different tattoos, pigments and skin types can respond differently. Having access to both technologies means I can choose the wavelength and treatment approach that is most appropriate for the tattoo and the result we're trying to achieve.
Pico was something I couldn't afford 12 years ago when I bought my Fotona ND YAG 1064. It was simply out of reach.
When we had the opportunity to bring Pico into the clinic, I was able to see just how different that ultra-fast pulse delivery can be.
Pico is not a hair-removal laser.
It is primarily a pigment-targeting and skin-rejuvenation technology, depending on the specific system and handpiece.
And not every Pico machine can do everything.
A 1064 nm Pico, a 755 nm Pico and a system with 532 nm or fractional handpieces are not interchangeable. The wavelength, pulse duration, energy, spot size and delivery system all change what the treatment can effectively target.
That's why the machine is only part of the treatment.
The other part is knowing what you're looking at, understanding the pigment or tissue you're treating, choosing the correct wavelength and knowing when to treat, and when not to.
It's incredibly fast, often just a few minutes.
There's no one number I can give you because every tattoo is different, and it also depends on whether you want to simply fade it or remove it as completely as possible.
Sometimes you may need 6 to 8 treatments, sometimes fewer, sometimes more.
For example, eyebrow tattooing can take up to 8 to 12 treatments.
It also depends on what colours were used. Brown isn't just brown: tattoo artists often use several pigments to create it. As we remove one colour, another can become more visible underneath, so I may need to change handpieces or wavelengths as we work through the different pigments.
Body tattoos are much the same. I can move between handpieces to target different colours. Black and deep navy/blue pigments generally respond very well to 1064 nm, while lighter colours can require more time and a little more patience.
Whether I use 1064 nm or Pico, I'll choose the technology according to the tattoo and the colours I'm seeing.
My aim is always the same: the best possible result, with minimal downtime and without unnecessary trauma to the skin.
Eight weeks is a good minimum. Longer is absolutely fine, and I often continue to see the tattoo fading between treatments.
The Pico laser breaks the tattoo pigment down into incredibly fine particles, almost like dust, and your body then gradually clears those particles through its own waste-disposal processes. I also limit how much tattoo we treat at one time, because your body needs time to process what we have broken down.
There's no advantage in coming back sooner. If we treat too early, we can end up targeting pigment we have already broken down rather than allowing your body to finish clearing it.
Be patient. Let your body do the work. It's part of the treatment.
The heat and redness usually settle within a few hours. It is not uncommon to see bruising or purpura as we turn the fluence up to go deeper. This usually subsides in under 5 to 9 days.
Every treatment carries some risk. I go through the risks and the recovery with you at your consultation before we begin.
I also use techniques to help minimise downtime. Depending on the size of the tattoo and the colour of the ink, I may perforate the skin beforehand with CO2 or fractionated radio frequency to allow the heat and gas to escape more easily.
The first night: keep the area covered.
The next day: gently wash it, let it breathe and keep it protected from the sun.
Then let your skin do what it does best, heal.
Pico treatments generally range from $250 to $1,000, depending on the size of the area and what we're treating.
For example:
Your treatment includes the appropriate Pico technology, wavelength and settings selected for your skin and the pigment we're treating.
Because every tattoo and pigment concern is different, I'll give you an exact price before we begin, so there are no surprises.
And just because it's Pico doesn't mean it has to break the bank. I'm very flexible with pricing.
Call me for a clear picture of current pricing.
Sun exposure, and that tattoo removal can feel like a hot rubber-band snapping against the skin.
But the other thing I find myself repeating is that Pico tattoo removal is usually a series, not a one-treatment fix. It's very difficult to put an exact number on it before I see the tattoo because so much depends on the ink, colours, depth, age of the tattoo and, most importantly, what you want to achieve.
Are you wanting to fade it? Remove it as completely as possible? Or simply get it to a point where you're happy with it?
This is why I put so much importance on the consultation. We need to be on the same page from the beginning. I want to be completely transparent with you about what I think you're looking at, what it may cost, how often you'll need to come in and how the treatment will fit into your lifestyle.
Then you have all the information you need to make your own decision.
I'd much rather tell you everything upfront than have you come back six months later wishing I had explained something at the beginning.
You'll feel a hot, rubber-band snapping sensation, but I use Cryo ice-cold air during treatment, which makes a real difference to comfort.
Results vary from person to person.
| Activity | When |
|---|---|
| Makeup | After 48 hours |
| Gym | After 48 hours |
| Swimming | Day 5 |
| Sauna | After a week |
| Sun | Ask me first |
| Alcohol | After 48 hours |