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    The picosecond difference

    Next-generation devices mean derms can utilize this technology for treatment of a wider variety of conditions.

    Dr. BrauerThere are multiple picosecond pulse duration devices with multiple wavelengths. Indications for picosecond devices also are blossoming. While the technology was originally designed to treat tattoos and pigmented lesions, at least two systems now allow for non-ablative treatment of sun damage, scarring and overall rejuvenation, according to New York City-based dermatologist and Mohs surgeon Jeremy A. Brauer, M.D.

    To help dermatologists better understand picosecond technology and device choices, Dr. Brauer directed the March 3 presentation, “Take a Pico Under the Hood: Dissecting Picosecond Lasers and Indications,” at the 2017 American Academy of Dermatology (AAD) Annual Meeting in Orlando, Fla.

    “Most lasers used for treatment of tattoos and pigmented lesions are in the nanosecond range, and the picosecond pulse duration even better approximates the thermal relaxation time of these targets,” Dr. Brauer tells Dermatology Times. “More importantly, the former relies on photothermal effect, whereas with picosecond lasers, results are due to photomechanical in addition to photothermal effect.”

    In the realm of non-ablative fractional resurfacing, picosecond treatments also have a different mechanism of action and can be performed without anesthesia. Patients will likely have only a few hours of downtime, with some redness and swelling. These devices have been shown to be safe and effective in individuals of all skin types, Dr. Brauer says.

    FDA-clearances for picosecond pulse duration lasers include treatment of tattoos and pigmented lesions, acne scarring and wrinkles, according to Dr. Brauer.

    “Best candidates for treatment with picosecond lasers are the same candidates that would be best for treatment with the traditional gold standard devices for the specific indication,” Dr. Brauer says. “A major benefit of picosecond pulse duration lasers is the excellent safety/side effect profile in individuals of all skin types with minimal recovery.”

    For tattoos, 755nm or 785nm wavelength is an excellent choice for removal of blue, green and purple ink, while, 532nm is best for yellow, red and orange inks. For people with darker skin types, 1064nm is ideal.

    “For resurfacing, currently one company's device utilizes a diffractive lens array, while another utilizes a holographic fractionator,” Dr. Brauer says. “These treatments can often be performed without topical anesthesia, which is necessary when utilizing traditional non-ablative fractional devices for resurfacing treatments.”

    Disclosure: Dr. Brauer is a speaker, advisor or consultant for Cynosure, Miramar Labs and Merz.

    Lisette Hilton
    Lisette Hilton is president of Words Come Alive, based in Boca Raton, Florida.

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