CYNOSURE PICOSURE LASER
HOW IT WORKS: PICOSECOND VS NANOSECOND
Picosure is the earliest of a recent generation of aesthetic lasers that utilizes picosecond laser technology. This sophisticated technology has changed the paradigm for lasers that treat pigmentation and skin texture problems. The laser energy is delivered in short bursts, measured in picoseconds. This is in contrast to the previous generation of lasers that delivered their energy in longer pulses measured in nanoseconds. When laser energy is delivered in nanoseconds or longer, all the energy is translated into thermal (heat) energy. While this thermal energy is capable of breaking down pigmentation and producing collagen remodeling and stimulating effects, there are limits to what can be achieved. When these limits are reached, stubborn pigmentation does not improve further, and skin rejuvenation effects plateau and fall short of desires and expectations.
If we crank it up and go beyond these limits, too much heat is generated and the skin responds unfavorably, resulting in too much pain, damage to the skin, and the production of unwanted pigmentation (known as post inflammatory hyperpigmentation or PIH), which means that treated pigmentation could get worse instead of getting better.
On the other hand, picosecond energy delivery results in some of the energy being converted to photoacoustic energy. This energy is mechanical in nature, somewhat like tiny shockwaves and without a thermal component. So for a start, it means that we are delivering less heat, so there is a lower risk of doing harm and causing PIH. Deep, stubborn, and tiny islands of pigmentation that are resistant to nanosecond lasers respond more favorably to the photoacoustic energy, breaking down and disappearing more readily. The shockwaves generated by the picosecond delivery also travel down to the deep layer of the skin, stimulating collagen remodeling and production that does not occur when the laser energy is delivered in nanosecond pulses.
The bottom line is that we can treat pigmentation more effectively and safely without having to resort to large amounts of energy, and we can stimulate collagen remodeling and production more powerfully for the treatment of acne scars, wrinkles and for the purpose of skin tightening, again without large amounts of energy. Therefore, it is more the quality of the laser energy that matters than the quantity.
Picosure laser treatments are performed under topical anesthesia with numbing cream. During the treatment, a pinprick sensation is felt as the laser energy is delivered. It is stronger when used in collagen stimulating mode. After the treatment, a hot, prickly sensation persists for a few minutes to about fifteen minutes, depending on the intensity of the treatment. Redness is also a normal side effect. This ranges from mild to moderate, and lasts from a few hours to overnight, again depending on the intensity of the treatment.
If pigmentation has been treated, it typically turns darker as a consequence of having absorbed the laser energy.
A soothing cream is applied immediately upon completion of treatment. Treatments are ideally carried out once a month, and a typical course of treatments comprises six sessions.
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