Clinical focus: PicoWay® and skin of color

skin of color

Clinical focus — Treatment guidelines for the PicoWay laser system in skin of color

Today, 88.5% of the global population is composed of people with skin of color,1 demonstrating the need for dermatological interventions that can meet the unique treatment needs and considerations of this growing patient demographic.

The PicoWay system: A revolutionary laser treatment solution for skin of color

The introduction of picosecond lasers have revolutionized dermatological treatments, providing the ideal characteristics and parameters required for treating patients of all Fitzpatrick skin types-including patients with darker skin.

Additionally, picosecond lasers has raised the bar of treatment options for benign pigmented lesions and tattoos by achieving improved clearance of targeted lesions in fewer sessions when compared to Q-switched (QS) lasers,2-4 without compromising tolerability.2-4

Nanosecond lasers have restrictive use in skin of color due to the significant risk of Post Inflammatory hyperpigmentation (PIH). With QS lasers, skin of color has a 25% risk of developing PIH.5 Risk is reported to increase to 47% when the treatment is specific for lentigines, possibly due to the melanocytic hyperplasia noted histologically in a lentigo.5

Picosecond lasers can be used in a broader range of skin types than nanosecond lasers due to reduced risk of hyper- or hypopigmentation and scarring with picosecond photoacoustic versus photothermal effect. Shorter pulse durations and enhanced photoacoustic effect help avoid overheating of skin and decreases risk of PIH. In skin of color, a clinical study with the picosecond laser demonstrated a low rate of PIH, at only 4.65% of the lesions.6

Learn more about the treatment guidelines for the PicoWay laser system in Skin of Color along with case studies, video references and before and after photos at

Laser considerations include treating with7,8

  • A wavelength that is specific to and well absorbed by the chromophore being treated, good skin penetration and preferential absorption by the target 
  • A laser that doesn’t overheat surrounding tissues 
  • A laser with flexible treatment parameters (eg, adjustable power, spot size and fluence, no com - promise of spot size for fluence)
  • And ideally, a laser that offers excellent outcomes with a minimized number of treatment sessions
1 Colby SL, Ortman JM. Projections of the Size and Composition of the U.S. Population: 2014 to 2060. US Census Bureau. March 2015.
2 Ross V, Naseef G, Lin G, et al. Comparison of responses of tattoos to picosecond and nanosecond Q-switched neodymium:YAG lasers. Arch Dermatol. 1998;134(2):167-171.
3 Izikson L, Farinelli W, Sakamoto F, Tannous Z, Anderson RR. Safety and effectiveness of black tattoo clearance in a pig model after a single treatment with a novel 758nm 500 picosecond laser: a pilot study. Lasers Surg Med. 2010;42(7):640-646.
4 Herd RM, Alora MB, Smoller B, Arndt KA, Dover JS. A clinical and histologic prospective controlled comparative study of the picosecond titanium:sapphire (795nm) laser versus the Q-switched alexandrite (752nm) laser for removing tattoo pigment. J Am Acad Dermatol. 1999;40(4):603-606.
5 Wang CC, Sue YM, Yang CH, Chen CK. A comparison of Q-switched alexandrite laser and intense pulsed light for the treatment of freckles and lentigines in Asian persons: a randomized, physician-blinded, splitface comparative trial. J Am Acad Dermatol. 2006;54(5):804-810.
6 Negishi K, Akita H, Matsunaga Y. Prospective study of removing solar lentigines in Asians using a novel dual-wavelength and dual-pulse width picosecond laser. Lasers Surg Med. 2018;50(8):851-858.
7. Torjesen I. Cosmetic needs differ for skin of color patients. Dermatol Times. 2018;(39)6:1-2.
8 Alexis AF. Lasers and light-based therapies in ethnic skin: treatment options and recommendations for Fitzpatrick skin types V and VI. Br J Dermatol. 2013;169(suppl 3):91-97.