Table 1.
Single fractional picosecond laser treatment
| Disease | Laser | Therapy parameters | Fitzpatrick scale | Number of cases | Clinical outcome | Adverse events | Reference |
|---|---|---|---|---|---|---|---|
| Facial rejuvenation | 755-nm picosecond laser with DLA | 8 mm spot, fluence of 0.4 J/cm2, 5 Hz pulse rate or 6 mm spot, fluence of 0.71 J/cm2, 10 Hz pulse for six treatments at 4-week intervals | III–IV | 18 | Skin texture and dyspigmentation scores improved significantly; however, in pore size or wrinkles, there was no significant improvements | Transient erythema and edema | [20] |
| 755-nm picosecond alexandrite lasers with DLA | 8-mm spot, fluence of 0.4 J/cm2, 750 ps pulse duration, 10 Hz pulse repetition for 3–5 treatment sessions at 4-week intervals | IV | 10 | Pores had improved at 12- and 20-week follow-up, while at 1-year follow-up, the score of pigmentation showed 38% improvement, and wrinkles improved significantly. | Mild erythema, itchiness, desquamation | [21] | |
| 755 nm picosecond alexandrite laser with a DLA | 8‐mm spot, 0.4 J/cm2, 10 Hz pulse repetition, and 750 ps pulse duration for 10 sessions at 2-week intervals |
III–IV III (n = 2); IV (n = 8) |
11 (10 patients completed) |
Pigmentation: compared with the control side, the improvement of the treated side reached statistical significance at follow‐up Wrinkles: the trend of improvement did not reach statistical significance at 6‐month follow‐ups |
Transient erythema and edema, slight PIH | [22] | |
| 755 nm picosecond laser with DLA | 8 mm spot, 10 Hz, 0.4 J/cm2 or 10 mm spot, 10 Hz, 0.25 J/cm2 in just one treatment session |
III–IV III (n = 29); IV (n = 17) |
46 | Wrinkles improved significantly, over half of patients showed improvement in pore size | Mild hyperpigmentation | [23] | |
| Combination of the 1064 and 532-nm picosecond laser with a fractional handpiece |
Total pulse energy: 350 mJ for the 1064-nm wavelength, 250 mJ for the 532-nm wavelength The 532-nm component followed the 1064-nm portion |
I–III I (n = 2); II (n = 12); III (n = 4) |
18 (10 subjects completed) | At 1-month follow-up, 79% of patients had mild‐to‐moderate wrinkle improvement. 93%, 78%, and 87% of patients showed mild to significant mottled pigmentation improvement at 1-month, 3-month, and 6-month follow-up | Trace erythema | [24] | |
| Wrinkles | 755 nm alexandrite picosecond laser with DLA | 6 mm spot, fluence of 0.57 J/cm2, 750 ps pulse duration, 10 Hz repetition rate for 5 treatments at 4-week intervals. Standard half face treatment: an average of 3301 + / − 155 pulses, the other half of face: an average of 5867 + / − 500 pulses | II–IV | 4 | Two treated sides had no significant difference. The standard pulse side had good to excellent improvement, and the high pulse side had very good to excellent improvement | Erythema and edema | [25] |
| 755 nm alexandrite picosecond laser with DLA | 6 mm spot, fluence of 0.71 J/ cm2, 750 ps pulse duration, 10 Hz pulse repetition for 4 treatments at 1 month intervals |
I–IV I (n = 4); II and III (n = 34); IV (n = 2) |
40 |
At the 6-month follow-up, the average Fitzpatrick wrinkle score was 3.47 (the baseline was 5.48). 31.6% of individuals were very much improved, 28.9% were much improved, and 28.9% were improved at 6-month follow-up. |
Transient erythema, edema, bruising | [26] | |
| Dyspigmentation (melasma) | 755 nm alexandrite picosecond laser with DLA | 8-mm spot size, fluence of 0.4 J/cm2, 750 ps for three treatment sessions at 4- to 6-week intervals | IV | 20 | The mean MASI score improved to 6.9 ± 3.7 after 3 sessions treatment with the baseline was 9.4 ± 4.7 | Erythema, pruritus, scaling, and only one developed mild PIH | [27] |
| Fractional 1064-nm picosecond laser | 450 ps pulses with a maximum microbeam energy per pulse of 3 mJ |
III–IV III (n = 2) IV (n = 8) |
10 | Compared with baseline, 7 patients showed moderate to marked improvement at 6 weeks post-treatment, and 5 patients showed sustained improvement | Erythema, edema, hyper/hypopigmentation | [28] | |
| Dyspigmentation (PIH) | 755-nm alexandrite picosecond laser with DLA | 8 mm spot, fluence of 0.4 J/cm2, 750 ps, 10 Hz pulse repetition for three treatments at 1- to 2‐month intervals | III | 1 | At the 3-year follow-up, the PIH lesions had 50–75% improvement | Deepening of local skin lesions | [4] |
| Facial pores | Picosecond 1064-nm laser with MLA | 8 mm spot, 0.8 J/cm2, 10 Hz for one session | III–IV | 59 | Compared to baseline, the number of enlarge pores decreased by 15.13%, while the diameter of face pores did not alter much | Mild erythema and folliculitis | [29] |
| 1064‐nm picosecond laser with MLA | 8 mm spot, fluence of 0.8 J/cm2, 5 Hz pulse repetition for three treatments at 4‐week intervals |
III–IV III (n = 19) IV (n = 6) |
25 | Pore volumes had a significant reduction, with average pore size had shrunk by 30% at 6-month follow-up | Moderate erythema,mild‐to‐moderate swelling, acneiform eruptions | [30] | |
| Atrophic acne scars | 755 nm alexandrite picosecond laser with DLA | fluence of 0.71 J/cm2, 6 mm spot, 750 ps pulse width, repetition rate of 5 Hz for 6 sessions at 4 to 8 weeks intervals |
I–V I (n = 1) II (n = 7); III (n = 6); IV (n = 3) |
20 (17 patients completed) |
Patients were satisfied with overall appearance and texture. scar volume improved 24.3% at the sixth treatment session | Transient erythema and edema | [15] |
| 755 nm alexandrite picosecond laser with DLA | 6 mm spot, fluence of 0.57 J/cm2, 750 ps pulse duration, 10 Hz repetition rate for 5 treatments at 4-week intervals. standard half face treatment: an average of 3301 + / − 155 pulses, the other half of face: an average of 5867 + / − 500 pulses | II-IV | 3 |
Two treated sides had no significant difference. The standard pulse side had good to excellent improvement, and the high pulse side had very good to excellent improvement |
Mild transient PIH, erythema, and edema | [25] | |
| 755-nm diffractive lens picosecond laser | Different sessions according to the patient’s condition | Not mentioned | 3 | Two cases improved > 75%, one improved 50–75% in skin texture | No | [31] | |
| 755 nm alexandrite picosecond laser with DLA | 6 mm spot, fluence of 0.71 J/cm2, 5‐Hz pulse repetition, and 750 ps pulse duration for 3 sessions at 4‐ to 6‐week intervals |
III–IV III (n = 5); IV (n = 15) |
20 | After three picosecond laser treatments, the texture of acne scars and post-inflammatory erythema greatly improved | Transient and mild erythema, edema, and scabbing | [32] | |
| 1064 nm picosecond laser with MLA | Fluence of 1.0 J/cm2, 8 mm spot, repetition rate of 10 Hz for 6 treatments at 1-month intervals | III–IV | 26 | Skin surface roughness and scar showed significant improvement | Mild‐to‐moderate erythema and swelling; transient PIH | [33] | |
| Picosecond 1064-nm laser with MLA | 8 mm spot, 0.8 J/cm2, 10 Hz for one treatment | III–IV | 59 | Compared to baseline, acne scar volume reduced significantly | Mild erythema and folliculitis | [29] | |
| Striae distensae | 1064 nm picosecond laser and MLA | Fluence of 0.6 J/cm2, 8 mm spot, 750 ps pulse width, repetition rate of 10 Hz for 4 sessions at 4-week intervals | IV–V | 20 | Significant improvement in the skin texture; 6 patients improved 51–75%, and 12 patients improved 25–50% in striae with the 6-month follow-up | Transient PIH in two patients | [34] |