PICOSURE LASER FOR PIGMENT REDUCTION

Picosecond Laser Treatment for Uneven Pigmentation & Sun-Related Pigment

PicoSure is a non-ablative picosecond laser treatment that may be used to reduce unwanted pigmentation at different depths within the skin while preserving the skin surface.

PicoSure treatment can be performed using different energy-delivery approaches. Flat optics may be used for more selective treatment of discrete areas of pigmentation, while the Focus™ Lens Array provides fractional energy delivery for broader or deeper pigmentary changes and skin remodeling. These approaches may be used individually or combined as part of a series of treatments.

At International Vein & Skin Institute (IVSI), PicoSure pigment treatments are personally performed by Jozef Tryzno, MD, with treatment parameters and delivery method selected according to the type, depth, and distribution of pigmentation, skin characteristics, treatment area, and clinical response.

UNDERSTANDING SKIN PIGMENTATION

Pigmentation develops when melanin becomes unevenly distributed or concentrated within the skin. It may appear as isolated spots, freckles, broader areas of sun-related pigmentation, or more diffuse patches of discoloration.

Pigment may occur at different depths within the skin rather than existing only at the surface. Similar to a stain that penetrates through several layers, visible pigmentation may represent pigment located at more than one level. This is one reason superficial pigment may respond relatively quickly, while deeper or more complex pigmentation may require a series of treatments and treatment at different depths.

PicoSure treatment can be adapted to these differences. Flat optics can selectively target more discrete pigmentation, while Focus™ fractional delivery can be incorporated when pigmentary changes extend more broadly or at different depths within the skin. The two approaches are not mutually exclusive and may be used during different stages of treatment.

The depth and behavior of pigment also vary according to the underlying condition. Sun spots behave differently from chronic or recurrent pigmentary conditions such as melasma, and treatment must reflect those differences.

Medical evaluation helps determine the cause, depth, and distribution of pigmentation and which treatment approach—or combination of approaches—is appropriate.

CONDITIONS COMMONLY TREATED

PicoSure pigment treatment may be considered for:

Sun spots (solar lentigines)
Age spots
Freckles
Uneven pigmentation related to sun damage
Selected residual or persistent pigmentation associated with melasma
Pigmentation within selected, diagnostically established benign nevi

Common treatment areas include:

Face
Neck
Upper chest (V-neck area)
Dorsum of the hands
Other sun-exposed areas with appropriate pigmentation

Not every area of unwanted pigmentation should be treated with a laser. Initial evaluation is important to determine the cause of the pigmentation, whether the skin should first be allowed to stabilize, and whether laser treatment is appropriate. Treatment selection depends on the cause, depth and distribution of pigment, skin type, stability of the condition, and previous treatment response.

SUN SPOTS & PIGMENTATION ON THE DORSUM OF THE HANDS

The dorsum of the hands commonly develops a combination of solar lentigines, freckles, and more diffuse uneven pigmentation from cumulative sun exposure.

PicoSure treatment can be adapted according to the pattern of pigmentation:

PicoSure flat optics may be used to selectively target individual sun spots, age spots, and freckles
PicoSure Focus™ may be used when treatment is directed toward broader areas of uneven pigmentation and sun-damaged skin
The two approaches may be used selectively or in combination according to the distribution and depth of pigmentation

Treatment of the hands is planned with attention to the individual areas of pigmentation as well as the surrounding skin, with the goal of improving pigmentation while maintaining a natural, blended appearance.

MELASMA REQUIRES A DIFFERENT APPROACH

Melasma is a chronic pigmentary condition with a tendency to recur and is not treated like an isolated sun spot or freckle.

Initial management focuses on controlling pigment activity and addressing contributing factors. Laser treatment is not considered first-line treatment for active or unstable melasma.

Once melasma is adequately controlled, PicoSure treatment may be considered selectively for residual pigmentation as part of a broader management plan. Treatment parameters are conservative and individualized because excessive inflammation may contribute to recurrent or worsening pigmentation.

Learn more about Melasma Evaluation & Treatment.

PIGMENT REDUCTION IN SELECTED BENIGN NEVI

PicoSure may also be considered for pigment reduction in selected benign melanocytic nevi when the diagnosis is established and the treatment goal is to lighten visible pigmentation rather than remove the lesion itself.

Pigment-targeting laser treatment:

Targets melanin within the lesion
May lighten or reduce visible pigmentation
Affects color rather than lesion size or depth
Does not remove the tissue or reduce the bulk of a raised or thick nevus
May require multiple treatment sessions
Does not guarantee complete elimination of pigmentation

For raised or bulky nevi, pigment treatment alone does not address the elevated tissue. Reduction or removal of the raised component may be performed first using an appropriate technique. After healing, pigment-targeting laser treatment may be considered for residual or persistent pigmentation when clinically appropriate.

Because laser treatment alters the visible pigmentation of a melanocytic lesion, diagnostic certainty is particularly important before treatment. Clinical and dermoscopic evaluation is performed first, and lesions that are atypical, changing, or diagnostically uncertain may require biopsy or other diagnostic management rather than cosmetic pigment treatment.

HOW PICOSURE TARGETS PIGMENT

PicoSure delivers ultra-short picosecond laser pulses, measured in trillionths of a second, to target melanin with a predominantly photomechanical effect rather than relying primarily on heat.

Different PicoSure delivery methods allow treatment to be adapted to the depth, distribution, and pattern of pigmentation.

FLAT OPTICS

Flat optics deliver laser energy directly and evenly across the selected treatment area and are particularly useful for discrete, well-defined areas of pigmentation.

This approach may:

Target concentrated melanin within sun spots, freckles, and other localized areas of pigmentation
Fragment pigment into smaller particles that are gradually cleared through natural processes
Limit thermal effect on surrounding tissue
Preserve the skin surface

FOCUS™ LENS ARRAY

The Focus™ Lens Array delivers concentrated energy through microscopic treatment zones while preserving surrounding tissue.

For pigment treatment, Focus™ may be incorporated when pigmentation is broader, more diffuse, or present at different depths within the skin. A series of treatments can progressively address pigmentary changes while also stimulating collagen and elastin remodeling.

Focus™ may therefore be useful when pigmentation occurs together with uneven texture or broader sun-related skin changes.

COMBINING TREATMENT APPROACHES

Flat optics and Focus™ are not mutually exclusive. Depending on the pigmentation pattern, one approach may be used alone or both may be incorporated during a treatment series.

For example, flat optics may target more discrete areas of concentrated pigment, while Focus™ treatment addresses broader or deeper pigmentary changes and surrounding skin quality.

Treatment parameters and sequence are adjusted according to the pigment depth and distribution, skin response, and treatment goals.

TREATMENT EXPERIENCE

PicoSure pigment treatments are performed in-office. Patients commonly describe the laser sensation as brief snapping or prickling, with sensitivity varying according to the treatment area, treatment settings, and individual tolerance.

Topical Anesthetic

Not routinely required
May be applied in-office approximately one hour before treatment when appropriate for patient comfort

EXPECTED RESPONSE AND ACTIVITY

The response after PicoSure treatment varies according to the type and depth of pigmentation, treatment method, and treatment intensity.

Following treatment:

Discrete pigmented spots treated with flat optics may temporarily darken before gradually flaking or fading
Mild redness or sensitivity may occur
Following Focus™ treatment, temporary redness or tenderness is generally mild and short-lived
Most patients return to normal daily activities the same day
Pigment reduction develops progressively as treated pigment is cleared and the skin responds over time

Deeper or more diffuse pigmentation may improve gradually over a series of treatments rather than after a single session.

NUMBER OF TREATMENTS

The number of treatments depends on the type, depth, and distribution of pigmentation.

Discrete superficial pigment may respond with fewer treatments, while deeper, diffuse, or layered pigmentation commonly requires a series of treatment sessions. Treatments are generally spaced several weeks apart and adjusted according to clinical response and healing.

IMPORTANT CONSIDERATIONS

PicoSure treatment does not prevent new pigmentation from developing
Not all pigmentation can or should be completely removed
Deeper or chronic pigmentation may require multiple treatments or combination treatment
Melasma requires careful management because pigmentation may recur or worsen with inflammation
Atypical, changing, or diagnostically uncertain pigmented lesions require appropriate evaluation before cosmetic laser treatment

Treatment is directed toward meaningful pigment reduction while preserving healthy surrounding skin.

PHYSICIAN-PERFORMED LASER TREATMENTS

At IVSI, PicoSure treatments are personally performed by Jozef Tryzno, MD, with more than 25 years of hands-on experience using laser and light-based technologies.

The treatment approach, laser settings, and use of flat optics, Focus™ Lens Array, or a combination of both are selected and adjusted according to the pigmentation, skin characteristics, treatment area, and individual response.

This treatment is one of several Cosmetic Laser Treatments available at IVSI.

Schedule a Cosmetic Laser Consultation

An evaluation can help determine the type and depth of pigmentation and whether PicoSure or another treatment approach is appropriate.

📞 Call (847) 518-9999 to schedule a cosmetic laser consultation.

Medical Disclaimer
This information is provided for educational purposes only and does not replace individualized medical evaluation. Treatment recommendations and outcomes depend on clinical findings, individual skin characteristics, treatment response, and patient-specific factors. Multiple treatments may be needed to achieve treatment goals, and periodic maintenance treatments may be recommended to help maintain results. Cosmetic results vary between patients, and no specific cosmetic result can be guaranteed.

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