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

Pigment · PIH

Picosecond laser pigment evidence for PIH

A 72.5 / 100 Supported 48 RCT/meta · 12 clinical/observational · 25 case · 126 total
Strong evidence · positive conclusion

This procedure group has the highest level of PubMed evidence for this indication, and the papers broadly 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 2022 Last 5 years 67% Positive results 76% Negative results 9 Korea/Asia 60

Known in Korea as

피코슈어피코웨이피코토닝피코플러스피코슈어 프로피코 색소레이저

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

Key papers

tier1 Efficacy of Alexandrite picosecond laser therapy with and without dermal polyrevitalisation (NCTF® 135 HA) in patients with melasma: A Randomised Controlled Trial. La Clinica terapeutica · 2026 · PMID 42047123

Abstract summary (English) OBJECTIVES: This randomised controlled trial aimed to compare the efficacy of Alexandrite picosecond laser therapy combined with dermal polyrevitalisation (NCTF® 135 HA) with laser therapy alone for reducing the severity of melasma. The outcomes were assessed using 3D imaging and the Dermatology Life Quality Index (DLQI). The secondary objectives were to evaluate the safety and tolerability of the combined...

Comparative Study, Journal Article, Randomized Controlled Trial

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tier1 Assessing the Safety and Efficacy of Picosecond Alexandrite Lasers in the Management of Melasma: A Systematic Review and Meta-Analysis of Randomised Control Trials. The Australasian journal of dermatology · 2026 · PMID 41589005

Abstract summary (English) Melasma is a chronic hyperpigmentation disorder that disproportionately affects women and individuals with darker skin types, leading to a significant psychosocial burden. This meta-analysis aims to evaluate the safety and efficacy of the 755-nm picosecond alexandrite laser (PSAL) compared with conventional therapies in the management of melasma. PubMed, Ovid Medline, Embase, Cochrane Library, and Google Scholar...

Journal Article, Systematic Review, Meta-Analysis, Review

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tier1 Efficacy of 1064-nm Picosecond Laser in the Treatment of Lichen Planus Pigmentosus: A Split-Face Randomized Controlled Trial. Journal of cosmetic dermatology · 2026 · PMID 41947502

Abstract summary (English) BACKGROUND: Lichen planus pigmentosus (LPP) is an uncommon variant of lichen planus that causes visible pigmentation and significantly impacts quality of life. Current treatments for LPP are limited, with inconsistent outcomes from topical, oral, and laser therapies. The 1064-nm picosecond laser has shown potential in managing pigmented skin disorders; however, evidence regarding its effect on LPP remains scarce.

Journal Article, Randomized Controlled Trial

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tier1 Investigating the efficacy and safety of the 755-nm picosecond alexandrite laser in treating nevus of Ota: A systematic review and meta-analysis. Medicine · 2026 · PMID 41731817

Abstract summary (English) BACKGROUND: The nevus of Ota is an uncommon pigmentary skin condition that causes bluish-gray pigmentation and is traditionally treated with a Q-switched laser. Emerging evidence suggests that the 755-nanometer picosecond alexandrite laser is a safe and effective therapeutic option. We sought to determine the overall effectiveness and safety profile of the 755-nanometer (nm) picosecond alexandrite laser for managing...

Journal Article, Systematic Review, Meta-Analysis

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tier1 Laser Therapy for Lichen Planus Pigmentosus and Erythema Dyschromicum Perstans: A Systematic Review. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2025 · PMID 40965050

Abstract summary (English) BACKGROUND: Lichen planus pigmentosus (LPP) and erythema dyschromicum perstans (EDP) are dermal hyperpigmentation disorders that disproportionately affect individuals with darker skin and are often resistant to standard therapies. Laser treatment is emerging as a therapeutic option, although optimal parameters and safety remain unclear. OBJECTIVE: To evaluate the efficacy, laser parameters, and safety of laser...

Journal Article, Systematic Review

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tier1 The efficacy and adverse reactions of 755 nm picosecond alexandrite laser on the treatment of nevus of Ota at different endpoints: A split-lesion, single-blinded, randomized controlled comparison study. Journal of the American Academy of Dermatology · 2025 · PMID 40846236

Abstract summary (English) BACKGROUND: The picosecond alexandrite laser (PSAL) is a first-line treatment for nevus of Ota. However, low-fluence PSAL (LF-PSAL) that does not produce immediate whitening as treatment endpoint, remains unexplored. OBJECTIVE: To compare the efficacy and safety of LF-PSAL versus conventional high fluence PSAL (HF-PSAL) for treating nevus of Ota.

Journal Article, Randomized Controlled Trial, Comparative Study

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tier1 Efficacy and safety of low-fluence 1064 nm picosecond laser with/without micro-lens arrays for melasma treatment: a randomized, split-face controlled study. Lasers in medical science · 2025 · PMID 41003821

Abstract summary (English) Low-fluence picosecond (LFPS) neodymium-doped yttrium aluminum garnet (Nd: YAG) 1064 nm laser has emerged as a promising treatment for melasma; however, its optimal strategy remains unclear. To evaluate the efficacy and safety of LFPS combined with microlens arrays (MLA) compared with LFPS alone in treating melasma. Thirty patients with melasma received LFPS alone on one side of the face (control [C] side) and LFPS...

Journal Article, Randomized Controlled Trial

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tier1 730-nm, 532-nm and 694-nm laser in the treatment of freckles and solar lentigines (A randomized clinical trial). Lasers in medical science · 2025 · PMID 40616673

Abstract summary (English) OBJECTIVE: This study aims to assess the effectiveness and safety of the 730-nm picosecond laser, the 532-nm picosecond laser, and the Q-switched 694-nm nanosecond laser in treating freckles and solar lentigines. METHODS: The randomized clinical trial included 42 participants who met the specific eligibility criteria for freckles and solar lentigines. On each participant's face, three distinct skin areas affected by...

Journal Article, Randomized Controlled Trial

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tier1 A systematic review of comparative clinical trials on the efficacy, safety, and patient satisfaction of ablative and non-ablative laser therapies for atrophic, hypertrophic, and keloid scars. Lasers in medical science · 2025 · PMID 40515775

Abstract summary (English) Scar formation is a common outcome of tissue injury, manifesting as atrophic, hypertrophic, and keloid scars, which can significantly impact quality of life. Laser therapy has emerged as a promising treatment modality for scars, encompassing ablative and non-ablative approaches, yet there are gaps in understanding their comparative efficacy, safety, and patient satisfaction. This study aims to comprehensively review...

Journal Article, Systematic Review, Comparative Study

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tier1 Long-term efficacy and safety of fractional 1064-nm picosecond laser for minimization of post-mammoplasty scar in Asians: a prospective randomized controlled study. Archives of dermatological research · 2025 · PMID 40434559

Abstract summary (English) Various types of lasers and energy-based devices have been used to prevent scar formation following primary surgical wound closure. While picosecond lasers have demonstrated potential in treating hypertrophic scars, limited data exists regarding their role in minimizing surgical scar formation. This study aimed to evaluate the safety and effectiveness of a fractional 1064-nm picosecond laser in reducing scar...

Journal Article, Randomized Controlled Trial

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Suggested interpretation

Strong evidence base

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