A pico laser fires in pulses measured in trillionths of a second. The pulse is so short that pigment is shattered by a pressure wave rather than heated, and the surrounding skin absorbs less heat, which matters in Asian skin because heat and inflammation provoke new pigment. That lower heat load is the real advantage of the technology. The benefit is also narrower than advertising suggests, and this page sets out where a pico laser helps, where it does not, and what pico laser treatment costs at my practice.
I run three pico laser platforms, Picocare, Picoplus and Helios 785, all fitted with Pico MLA, and the platform is chosen after the pigment is diagnosed, never before. The wider plan for pigmentation, including the creams and the steps that come before any laser, is on my pigmentation treatment page.
Pico laser in Singapore, key points
- Pico laser treatment at my practice costs $350 a session, $320 a session in a course of 5 and $280 a session in a course of 10, before GST.
- A pico laser clears freckles, sun spots and brown acne marks reliably, treats deeper pigment such as Hori’s naevus over a longer course, and is used at low energy as only one part of a melasma plan.
- Three platforms, Picocare, Picoplus and Helios 785, offer different wavelengths, so the machine is matched to the pigment rather than every patient being fitted to one machine.
- Every pigmented spot is examined under the dermatoscope, a magnifying lens with polarised light that shows the pigment pattern beneath the surface, before any treatment. A new, changing or irregular spot is diagnosed before anything cosmetic is done to it.
Pico laser price Singapore, per session and packages
| Pico laser at my practice | Price before GST | Per session |
|---|---|---|
| Single session, full face | $350 | $350 |
| Course of 5 sessions | $1,600 | $320 |
| Course of 10 sessions | $2,800 | $280 |
The price covers the full face, the consultation and examination under the dermatoscope, the treatment itself and the review afterwards. A package is the sensible choice when the diagnosis needs several sessions, which applies to most diagnoses other than a few freckles or sun spots. The number of sessions is set by the type and depth of the pigment, as the session table below shows, and every patient leaves the consultation knowing the expected course and its total cost rather than the price of one visit.
How to read an $88 pico laser promotion
Advertised pico laser prices in Singapore range from about $48 to $800 a session, and the spread reflects what each price includes more than the machine used. A very low trial price usually buys one short pass at gentle settings over a small area. For a few freckles that may be enough. What such a price leaves unstated is how many sessions the diagnosis needs, whether the price holds after the first visit, and who decides the settings.
Six questions make two quotes comparable. The first is which exact machine and wavelength will be used. The others are which areas are included, how many sessions the diagnosis usually needs, who examines the pigment and who holds the handpiece, and whether consultation, review and aftercare are included. The sixth is what happens if the skin darkens afterwards and does not settle.
What a pico laser does to pigment
Melanin absorbs the laser light, and because the pulse ends before heat can spread out of the pigment particle, the energy builds as pressure and breaks the particle into fragments small enough for the body to clear. Scavenger cells in the skin carry these fragments away over the following weeks. An older nanosecond laser does the same job with a pulse ten to a hundred times longer, which lets more heat escape into the skin around the spot. Skin that responds to heat and inflammation by making more pigment is therefore better served by the shorter pulse.
A pico laser is a faster laser rather than a stronger one, and its benefit appears mainly as fewer side effects rather than more pigment cleared.
The depth of the pigment determines most treatment decisions. Freckles and sun spots sit in the epidermis, the top layer of the skin, and clear quickly. Hori’s naevus sits in the dermis beneath it and needs a longer wavelength, which scatters less and so reaches deeper, over a longer course. Melasma can involve both layers and is driven by pigment cells that stay overactive, so it behaves like neither a surface nor a deep deposit. The same brown patch on two faces can therefore need two different machines.
Pigmentation removal with pico laser, pigment by pigment
Freckles and sun spots
Freckles and sun spots respond fastest of all pigment types, because the pigment lies in the top layer within easy reach of the shorter wavelengths. Treated spots darken for a few days and flake off, leaving clearer skin underneath. Most patients need 1 to 3 sessions, and new spots form with new sun exposure, so daily sunscreen determines how long the result lasts. In Asian skin the 532 nm green and 785 nm wavelengths both clear freckles well, with the picosecond pulse causing less darkening afterwards than the older nanosecond laser [1, 2, 3].
Brown acne marks
The flat brown marks left after acne, a form of post-inflammatory hyperpigmentation, respond well once the acne itself is controlled. Each new inflamed spot leaves a fresh mark, so the acne is settled first and the marks are treated afterwards. The usual course is 3 to 6 sessions. Red marks are a different problem, because they are dilated blood vessels rather than pigment and need a vascular laser, covered on my red acne marks page. My brown acne marks page explains why these marks are so common in Asian skin.
Hori’s naevus and deeper pigment
Grey-brown patches on both cheekbones that do not fade with creams are usually Hori’s naevus, in which the pigment cells sit deep in the dermis. The longer 1064 nm wavelength is suited to this depth, over 6 to 10 sessions or more, spaced 6 to 8 weeks apart. Picosecond lasers clear this type of pigment reliably in Asian patients, with a low rate of complications when the energy is kept conservative [4, 5].
Melasma
Melasma is the pigment condition in which lasers cause the most harm when used aggressively. It is an active process rather than a fixed deposit, driven by overactive pigment cells that hormones, sunlight and heat all stimulate further. I use the pico laser for melasma only at low energy, only after sun protection and topical treatment have had 2 to 3 months to work, and only as one part of a plan, set out in the melasma section below.
Pores, texture and shallow acne scars
With the Pico MLA handpiece the same laser becomes a fractional treatment, which stimulates collagen beneath the skin without breaking the surface. The treatment improves enlarged pores, shallow texture and mild acne scars, with a day or two of redness rather than the week of downtime of an ablative laser, which removes the surface layer of skin. In Asian patients the improvement in acne scars after fractional picosecond treatment was still present at 6 months [6, 7]. Deep indented scars still need subcision or fractional resurfacing with the Fraxel or CO2 laser, described in my acne scar treatment guide.
What a pico laser does not treat
A pico laser does not treat red acne marks or other redness, which need a vascular laser. Raised growths such as seborrhoeic keratoses are removed by a different method after examination. Deep indented acne scars need subcision or resurfacing. A new, changing or undiagnosed pigmented spot is a diagnostic question before it is a cosmetic one. Laser treatment destroys the pigment that a diagnosis would rely on, so I examine every spot under the dermatoscope before treating it, and a spot that looks abnormal is managed as a mole, as described on my mole removal page.
Pico laser platforms at my practice, Picocare, Picoplus and Helios 785 with Pico MLA
Most clinics in Singapore run a single pico laser and treat every patient on it. I run three, and they are not interchangeable. Each wavelength is absorbed by melanin to a different degree and reaches a different depth, so the platform is chosen after the pigment is diagnosed.
Picocare
The Picocare is the platform I use most. It is a 1064 nm and 532 nm picosecond laser, with the 532 nm wavelength used for surface pigment such as freckles and sun spots and the 1064 nm wavelength for deeper pigment and low-energy melasma toning. Most first treatments for surface pigment are performed on the Picocare.
Picoplus
The Picoplus carries the full set of handpieces, 1064 nm and 532 nm plus 595 nm and 660 nm, wavelengths that melanin absorbs strongly, the 660 nm close to that of a ruby laser. I use it when pigment has not responded to other settings, for sun spots that persist after earlier treatment, and when a wavelength between the usual two is the safer choice.
Helios 785
The Helios 785 uses a middle wavelength of 785 nm, which melanin absorbs well and the haemoglobin in blood vessels absorbs little, so the pigment is targeted while the vessels are spared. It suits mixed pigmentation, freckles in darker skin and cases where a gentler approach is safer. In Asian skin the 785 nm wavelength clears freckles and sun spots with little darkening afterwards [2, 8].
Pico MLA, what it adds
All three platforms carry Pico MLA, a micro lens array handpiece that splits the beam into many tiny high-energy columns. Beneath the skin each column creates a microscopic zone of controlled injury, and the repair of these zones lays down new collagen while the surface is left intact. The handpiece allows one machine to treat pigment at one visit and pores, texture and shallow scars at the next. I also use it for the gentlest melasma toning, because in a split-face trial a micro lens pass gave lower recurrence than a plain pass at the same low energy [9].
Alongside the three pico lasers I run a Fraxel Dual, with a 1550 nm wavelength and a 1927 nm thulium wavelength that some call the BB laser. The Fraxel is a resurfacing laser rather than a pigment laser, and it replaces the pico laser when the problem is diffuse surface pigmentation with rough texture, or scars too deep for Pico MLA. The resurfacing options are covered on my Fraxel laser page.
When comparing clinics, the most useful question is which machine would be used on the face and why. A clinic that cannot answer it is treating the machine it owns rather than the pigment in front of it.
Pigmentation laser treatment in Singapore, pico laser or Q-switch
Patients ask this more than any other question, and the published evidence does not support the usual marketing. Pooled across the published trials, picosecond and nanosecond lasers clear skin pigment to a similar degree. The picosecond laser, however, causes less pain and less darkening and pale patching afterwards, and those side effects are more common and slower to fade in Asian skin than in European skin [10]. The case for pico is therefore a safety case rather than a strength case, and it is strongest in a Singapore practice, where most patients have skin that darkens easily after injury. The full comparison, wavelength by wavelength, is on my pico laser vs Q-switch laser page, and the older laser itself is on my Q-switch laser page.
Pico laser for melasma, and why I keep the energy low
My sequence is sun protection and topical treatment first for 2 to 3 months, then low-energy toning added monthly only if the response has plateaued, then maintenance. I do not tone skin that is tanned, inflamed or untreated, because in each of those states the pigment cells are primed to overreact to heat.
This caution follows the evidence. Low-energy laser toning improves melasma in many patients, but it can leave mottled pale patches as the energy accumulates over sessions, can darken melasma in darker skin when used aggressively, and is often followed by recurrence within a few months [11, 12]. Trials of the picosecond laser in Asian women with melasma found it equivalent to a good prescription cream rather than superior to it [13, 14]. A laser is a component of melasma treatment rather than the treatment itself. Cyspera, a cysteamine cream, and daily sun protection contribute more to the result than the machine does, and for melasma that has stalled I combine the laser with microneedle fractional radiofrequency rather than raising the energy.
How many pico laser sessions you need
| Pigment | Usual course | Interval |
|---|---|---|
| Freckles and sun spots | 1 to 3 sessions | 3 to 4 weeks |
| Brown acne marks | 3 to 6 sessions | 3 to 4 weeks |
| Melasma toning | 5 to 10, then maintenance | Monthly, then spaced |
| Hori’s naevus and deeper pigment | 6 to 10 or more | 6 to 8 weeks |
| Pores and texture with Pico MLA | 3 to 5 sessions | 4 weeks |
Sessions are spaced because the scavenger cells that remove the fragmented pigment need several weeks to clear it, and because treating again before the skin has settled is one of the ways rebound pigmentation is produced. Improvement after a session does not mean clearance. In a trial of a single session for freckles almost every patient improved, but only about 1 in 8 cleared completely, which is why I quote a course rather than a session [3].
Pico laser treatment in Singapore, what happens during a session
Every spot is first examined under the dermatoscope, a step that takes a minute and distinguishes a freckle from a mole. Numbing cream is applied for 20 minutes before the pigment settings and is usually not needed for toning. The laser itself takes 10 to 15 minutes for the full face and feels like a series of small hot flicks against the skin. A cooling mask follows to settle the heat, and sunscreen is applied before the patient leaves.
Treated spots darken and crust lightly for 3 to 7 days, then flake, as the fragmented pigment rises to the surface and is shed. Pigment that keeps spreading and darkening beyond a week is a different process, usually early post-inflammatory hyperpigmentation, and should be reviewed. Toning and Pico MLA passes give a few hours of redness and no crusting. Makeup can be applied the next day. Applying sunscreen every morning, before and throughout the course, determines how long the result lasts.
Laser pigmentation removal on Asian and darker skin
Skin that tans easily also darkens easily after a laser, and most of my patients have this skin type. The greater amount of melanin in the surface layer absorbs part of the laser energy on its way to the target, and the resulting heat and inflammation stimulate the pigment cells to produce more pigment. The safeguards are lower energy across more sessions, the longer wavelengths for deeper pigment, a test spot where the skin type or the diagnosis is uncertain, and sunscreen for weeks before and after treatment rather than only afterwards. Darkening after treatment is the complication I guard against throughout, so I would rather treat a patient 6 times at gentle settings than twice at aggressive ones. The published series in Asian skin support that approach across the 755, 785 and 1064 nm wavelengths [4, 8, 15].
How I assess and treat pigmentation
I have practised aesthetic medicine in Singapore since 2012, trained in surgery before that and hold the MRCS from the Royal College of Surgeons of Edinburgh and a Postgraduate Diploma in Practical Dermatology. Pigment is the commonest complaint in my clinic, and the first visit is an examination rather than a laser treatment. Every spot is examined under the dermatoscope, the type and depth of the pigment are identified, previous treatments are reviewed, and only then is a platform chosen from the three I run. Each patient leaves with the expected number of sessions and the total cost. My training and practice are set out on the about page.
Book a pico laser consultation in Singapore
Dr Gerard Ee consults and performs pico laser treatment at The Clifford Clinic, 50 Raffles Place, Singapore. Consultations are by appointment. Message the clinic on WhatsApp, or call 6532 2048.
A consultation establishes the diagnosis before any laser is chosen. The assessment covers the type and depth of the pigment, the skin type, previous treatments, and the platform and wavelength that suit the finding.
