Pico Genesis: What You Need to Know

Pros

• This relatively painless treatment is fast (about 20 minutes) and can be used anywhere on the face and body.
• Downtime is minimal. You may have some redness and light flaking, but you can resume your normal routine, including applying makeup, right away. 
• The lightning-fast laser pulses reduce the chance of scarring and pigmentation problems (a common concern with most pigment-targeting lasers), even for people with brown and deep skin tones.   
• It’s not just for brown spots: picosecond technology was developed for laser tattoo removal, and it's still a good option.  
• Results are long-lasting, provided you practice good sun-protection habits.

Cons

• At least three (and sometimes as many as five) Pico Genesis treatments are needed to see significant results. RealSelf members who said it was “Not Worth It” didn’t see many changes after their first treatment.    
• You’ll be more sun-sensitive afterward, so you’ll need to pay more attention to covering up when you’re outside and be vigilant about applying sunscreen with SPF 30+ to avoid new sun damage.   
• While it is suitable for people with tan, brown, or deep skin tones, people who naturally have more melanin still have an increased risk of hypo- or hyperpigmentation following a Pico Genesis treatment. If this is a concern, your provider may prescribe a hydroquinone cream to pretreat your skin. This powerful depigmenting agent inhibits melanin production, reducing your risk of complications. 
• Pico Genesis treatments are operator-dependent, so choose your provider carefully. "Technology is great, but experience with the laser is more important," says Dr. Davin Lim, a dermatologist in Brisbane, Australia.

The price you pay will depend on your provider’s level of experience, their practice location, the number of areas you have treated, and how many sessions you have. 

Like other elective cosmetic treatments, Pico Genesis is not covered by insurance, but most providers offer monthly payment plans or financing options.

The Pico Genesis photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

If you have stubborn melasma, uneven skin tone, sun damage, or other hyperpigmentation concerns, Pico Genesis may be an appropriate treatment for you. 

One of the unique benefits of Pico Genesis is that it's considered safer for people of virtually all skin types and tones. "Pico lasers are a better option than other lasers for those who tend toward hyperpigmentation responses because the laser pulse is so fast, the skin doesn't have as much opportunity to 'heat up' and get the pigment rebound," explains Dr. Rebecca Fitzgerald, a dermatologic surgeon in Los Angeles. 

That said, there is always a level of potential risk with any laser system; the pico lasers just happen to be among the least risky of lasers, says Dr. Fitzgerald. 

Your provider may recommend prepping the skin before treatment with a pigment-suppressing topical, if you're at higher risk for post-inflammatory hyperpigmentation.

Unlike traditional lasers that use thermal energy to create controlled injuries that promote skin revitalization, this laser device harnesses a photoacoustic effect that essentially shatters particles of excess pigment.

“It fires so fast, it essentially creates a little earthquake in the skin. This reverberation disrupts the pigment and causes the body to clear it,” explains Dr. Matthew Elias, a dermatologist in Fort Lauderdale, Florida.

It's a nonablative laser, which means that it doesn't remove the top layer of skin, unlike most thermal lasers, which inflict thermal damage to resurface skin by vaporizing all (or a portion of) the top layer. This eliminates downtime, reduces the chance of side effects, and eases recovery.

A single session typically lasts about 20 minutes, depending on the size of the treatment area. 

Your provider may start by applying a topical anesthetic. Once the treatment area is sufficiently numbed, they’ll begin methodically passing the laser’s three-pronged applicator over your skin.

You may see an improvement after just one treatment, most people need three to five treatment sessions to get the results you want. Results will vary for each person, and your provider will develop a personalized treatment plan.

It doesn't hurt for most people; the closest approximation of the sensation is being snapped repeatedly by rubber bands. 

“It feels like being flicked with an elastic band over and over—annoying but not unbearable by any means,” says RealSelf member kangeroomegs.

You can expect to have a few days of mild redness or inflammation (the most common side effect) after each session. 

The dark spots will get darker at first and then scab over. Once the scabs flake off, the skin that’s revealed should be clearer, brighter, and more evenly toned. 

During the healing process, you may feel a bit itchy. Doctors on RealSelf suggest taking an oral antihistamine to help reduce the itch, and your provider may recommend a gentle moisturizer. 

Try to resist the urge to pick at the scabs, which can cause scarring.

Your skin tone will look brighter and more even within a few days, once the excess pigment has scabbed and flaked off. Most people three or more treatments to see optimal skin rejuvenation results.

The collagen-boosting effects of the treatment take some time to develop, but your skin may look firmer and more refreshed within about three months.

Pico Genesis results can last for years—if you can prevent new sun damage and spots of hyperpigmentation from forming. 

Always wear a broad-spectrum sunscreen of at least SPF 30 (higher is better), especially when heading outdoors, and take care to manage conditions like acne, eczema, or psoriasis that may lead to post-inflammatory hyperpigmentation.