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Evolution of the Picosecond Laser

A Review of Literature

Torbeck, Richard L., MD*; Schilling, Laura, MD; Khorasani, Hooman, MD*; Dover, Jeffrey S., MD, FRCPC; Arndt, Kenneth A., MD; Saedi, Nazanin, MD§

doi: 10.1097/DSS.0000000000001697
Review Article

BACKGROUND Picosecond pulse duration lasers (PS) have altered the field of dermatology. PS were initially used in tattoo removal, to optimize efficacy and reduce side effects with nanosecond domain lasers. More recently, they have been demonstrated to be effective in the treatment of pigmentary disorders, acne scarring, and photoaging.

OBJECTIVE In this article, we critically analyze the published data on the many uses of picosecond lasers in dermatology.

MATERIALS AND METHODS A systematic review of PubMed was conducted using the following search terms: “picosecond,” “picosecond laser,” “picosecond laser dermatology,” “picosecond laser pigment/pigmentation,” and “picosecond laser tattoo removal.” Articles ranged from 1988 until 2017.

RESULTS Forty-one articles were identified, and 27 met inclusion criteria for review. Indications for the PS included a variety of dermatologic applications include tattoo removal, benign pigmented lesions/pigmentary disorders, acne scarring, and photoaging. Most studies demonstrated safe and effective treatment.

CONCLUSION The development of the picosecond pulse duration is a breakthrough innovation in laser technology, changing the scope of laser treatment. Encouraging findings in tattoo pigment clearance spurred the use of PS in a wider array of dermatologic issues. The increasingly positive results and low incidence of adverse effects further substantiates PS efficacy for a variety of dermatologic uses.

*Department of Dermatology, Icahn School of Medicine Mount Sinai, New York, New York;

Maryland Dermatology Laser, Skin, and Vein Institute, Hunt Valley, Maryland;

SkinCare Physicians, Chestnut Hill, Massachusetts;

§Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Philadelphia, Pennsylvania

Address correspondence and reprint requests to: Richard L. Torbeck, MD, Department of Dermatology, Icahn School of Medicine at Mountt Sinai, 234 E. 85th St, 5th Floor, New York, NY 10028, or e-mail:

The authors have indicated no significant interest with commercial supporters.

© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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