GLASS LAB · Medical Aesthetics Evidence Index 303 cells · 19,226 papers · 5,969 top-tier evidence

Pigment · Melasma (epidermal)

Fractional picosecond resurfacing evidence for Melasma (epidermal)

B 60.8 / 100 Supported 7 RCT/meta · 2 clinical/observational · 0 case · 24 total
Good evidence · positive conclusion

There is a relatively good level of clinical evidence, and a majority of papers support its effectiveness.

Grade combines the quantity and quality of the research, while direction is a separate signal showing how the papers assess effectiveness.

Includes meta-analysis/SR Median year 2023 Last 5 years 71% Positive results 75% Negative results 2 Korea/Asia 8

Known in Korea as

피코프락셀

Procedure and brand names vary, but the evidence above applies to the same procedure mechanism.

Key papers

tier1 Comparison of 755-nm picosecond alexandrite laser versus 1064-nm Q-switched Nd:YAG laser for melasma: A randomized, split-face controlled, 2-year follow-up study. Lasers in surgery and medicine · 2024 · PMID 38282099

Abstract summary (English) OBJECTIVES: Pulsed laser treatment of melasma has shown some promising results. To compare the effectiveness and safety of 755-nm picosecond alexandrite laser (PSAL) fitted with diffractive lens array (DLA) versus 1064-nm Q-switched neodynimum:yttrium aluminum garnet laser (QSNYL) for the treatment of melasma. METHODS: We conducted a randomized, split face controlled, 2-year follow-up study.

Randomized Controlled Trial, Journal Article, Research Support, Non-U.S. Gov't

View on PubMed
tier1 Efficacy and safety of laser-related therapy for melasma: A systematic review and network meta-analysis. Journal of cosmetic dermatology · 2023 · PMID 37737021

Abstract summary (English) BACKGROUND: Melasma is a prevalent, persistent hyperpigmentation disorder that negatively affects the psychological health of patients. However, the treatment outcome remains unsatisfactory due to the complexity of pathogenesis, recurrence characteristics, and relatively high morbidity. OBJECTIVES: To compare the performance of laser-related therapies in improving the melasma area severity index (MASI) score of...

Journal Article, Systematic Review, Meta-Analysis, Comparative Study, Review

View on PubMed
tier1 Laser therapy in the treatment of melasma: a systematic review and meta-analysis. Lasers in medical science · 2022 · PMID 35122202

Abstract summary (English) Melasma is a highly prevalent and cosmetically disfiguring pigmented skin disease. The post-treatment results are often unsatisfactory. A large number of clinical trials have tried to prove the effectiveness of the combination therapy involving laser therapy, but the results have been indeterminate.

Journal Article, Meta-Analysis, Systematic Review

View on PubMed
tier1 Comparison of the Efficacy of Melasma Treatments: A Network Meta-Analysis of Randomized Controlled Trials. Frontiers in medicine · 2021 · PMID 34660626

Abstract summary (English) Background: Melasma is an acquired pigmentation disorder with challenges in treatment because of its refractory nature and high risk of recurrence. Objectives: This study aimed to compare the efficacy and side effects of 14 common therapies for melasma using a systematic review and network meta-analysis (NMA). Methods: The PubMed, Embase, and Cochrane Library databases were searched till...

Systematic Review, Journal Article

View on PubMed
tier1 A Prospective, Split-Face, Randomized Study Comparing a 755-nm Picosecond Laser With and Without Diffractive Lens Array in the Treatment of Melasma in Asians. Lasers in surgery and medicine · 2020 · PMID 32865858

Abstract summary (English) BACKGROUND AND OBJECTIVES: Treatment of melasma with lasers remains a challenge due to its limited clinical efficacy in addition to high rates of recurrence and side effects. Recently, picosecond lasers have shown favorable results in treatment of benign pigmented lesions. To compare the efficacy and safety of using a 755-nm picosecond laser for the treatment of melasma in a split-face manner, having one side...

Journal Article, Randomized Controlled Trial

View on PubMed
tier1 Prospective randomized controlled trial comparing treatment efficacy and tolerance of picosecond alexandrite laser with a diffractive lens array and triple combination cream in female asian patients with melasma. Journal of the European Academy of Dermatology and Venereology : JEADV · 2019 · PMID 31494973

Abstract summary (English) BACKGROUND: Recent evidence suggests melasma to be a photoaging disorder. Triple combination creams (TCC: fluocinolone acetonide 0.01%, hydroquinone 4% and tretinoin 0.05%) remain the gold standard treatment. Picosecond alexandrite laser treatment using a diffractive lens array (DLA) has been identified to be effective for improving photoaging conditions.

Comparative Study, Journal Article, Randomized Controlled Trial

View on PubMed
tier1 Effects of a fractional picosecond 1,064 nm laser for the treatment of dermal and mixed type melasma. Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology · 2017 · PMID 29020467

Abstract summary (English) BACKGROUND: Picosecond laser is a novel modality for pigmented skin disorders with extremely short pulse duration. Little is known about the effects of the picosecond laser in melasma. OBJECTIVE: This study aimed to investigate the efficacy of fractional picosecond 1,064 nm laser in melasma treatment.

Journal Article, Randomized Controlled Trial

View on PubMed
tier2 Photoaging Reversibility in Asian Patients With Melasma Treated Using Picosecond Lasers With a Diffractive Lens Array: A 1-Year Prospective Observational Cohort Study. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2021 · PMID 32271179

Abstract summary (English) BACKGROUND: Picosecond lasers appear to be effective and safe in treating pigmentation and photoaging disorders through laser-induced optical breakdown. OBJECTIVE: To analyze the feasibility of photorejuvenation using picosecond lasers with diffractive lens array (DLA) in patients with melasma. METHODS: Ten Asian (N = 10) women with melasma and Fitzpatrick skin Type IV were enrolled and treated using 755-nm...

Journal Article, Observational Study

View on PubMed
tier2 Treatment of Refractory Melasma in Asians With the Picosecond Alexandrite Laser. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2020 · PMID 32932271

Abstract summary (English) BACKGROUND/OBJECTIVES: The picosecond Alexandrite laser was studied in our practice with the diffractive lens array and the flat optic to treat melasma. METHODS AND MATERIALS: Sixty patients with melasma were treated in a prospective investigation with the picosecond Alexandrite laser. Nineteen patients were treated with the flat optic and 41 patients were treated with the diffractive lens array.

Clinical Trial, Journal Article

View on PubMed
tier0_review Efficacy and Safety of Laser-Based Therapies for Melasma: A Systematic Review and Meta-Analysis. Cureus · 2026 · PMID 42064496

Abstract summary (English) Melasma is a chronic acquired hyperpigmentation disorder that often exerts a psychosocial burden on affected individuals. Although laser- and light-based therapies are pivotal third-line interventions for recalcitrant cases, clinical consensus regarding their comparative efficacy and long-term safety remains inconsistent. This systematic review and meta-analysis aimed to evaluate and synthesize evidence from...

Journal Article, Review

View on PubMed

Suggested interpretation

Strong evidence base

Personalized evidence report

Tell us more about your concern
and the Glass Lab bot will build a personalized report for you.

Based on the Fractional picosecond resurfacing · Melasma (epidermal) information on this page, we'll email you an evidence summary tailored to your skin condition and treatment stage.

Concerns of interest (select multiple)
Decision stage
← Other indications for the same procedure group  |  Other procedures for the same indication →