PICOWAY

PicoWay laser treatments can help with melasma, but because melasma involves pigment at different depths of the dermis, PicoWay alone is usually not enough to completely resolve it. 

Some providers combine the treatment with topical bleaching products or anti-inflammatory skin care creams, as well as oral medications. 

If you're not properly pre-treated, lasers have the potential to cause more pigmentation and melasma.

Pros

• PicoWay is so effective for laser tattoo removal that you’ll have fewer treatment sessions than with other removal options. 
• There’s less pain than with some other lasers because the short picosecond pulses are very fast: a trillionth of a second, the shortest pulse duration on the market.
• The laser works on tattoos of all ink colors, on all skin types and tones. 
• There’s less risk of burning and scarring than with some other laser options. 
• PicoWay works well on tattoos applied by both amateurs and professionals. 
• Beyond tattoos, it can treat a wide variety of skin concerns, from acne scarring and hyperpigmentation to wrinkles.
• There's little to no downtime after a treatment.
• RealSelf members give PicoWay an exceptionally high Worth It Rating. 

Cons

• As with other laser tattoo removal options, you’ll need multiple sessions (sometimes a dozen or more) with the PicoWay system, with eight weeks between sessions to allow your skin to heal and the ink to fade. That means that the whole process could take well over a year.
• Even after a full course of treatment sessions, your tattoo may not fade completely.
• Some RealSelf members report a lot of discomfort during their PicoWay tattoo removal treatment sessions. One who called it "terribly painful and exhausting" was left with a large blister. Others say the first few sessions were the worst, but that it got less painful in later sessions, when there was less pigment. 

RealSelf Tip: Laser tattoo removal isn’t recommended for women who are pregnant or planning to get pregnant soon because the process can take a year (or more). If you get pregnant before your tattoo is completely removed, you should pause treatments and resume once your provider has determined it’s safe.

Cost varies by your provider's level of experience, their practice location, and the number of sessions you’ll need to fully remove a tattoo. 

Some providers offer a reduced price on a series of treatments if you pay for them up-front.

Related: 6 Women Share Their Most Regrettable Tattoo and How Much They Paid to Remove It

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

The number of PicoWay treatments you need will depend on the type and severity of the skin concern you're treating, as well as the placement of the treatment area and intensity of the setting your technician uses. Tattoo removal can take as few as 4 or more than 10 treatment sessions (RealSelf members have had up to 14).

Tattoos that are more than a year old, have ink in the deeper layers of skin, or are located in a lower leg or arm (where the blood supply isn't as strong) usually take longer to remove. 

During your initial consultation, your provider should be able to estimate how many treatments you'll need for significant fading, but you won't really know until you're several sessions in and can see how quickly it's fading.

The short laser pulses of PicoWay are intended to minimize discomfort during the treatment. However, RealSelf members say the treatment can still be painful (especially on higher settings), even with a topical numbing cream. That's because a topical anesthetic only numbs the surface layer of skin, while the laser penetrates the deeper layers. 

The treatment sessions are relatively short (typically 20 minutes or less), so the most painful part doesn't last too long. That said, everyone's pain tolerance is different. If this is a major concern for you, talk with your provider about how to stay as comfortable as possible during your treatment. 

RealSelf Tip: Clinical studies show that smoking makes laser tattoo removal nearly 70% less successful. So by quitting smoking, you’ll have fewer appointments, which means less pain and expense.

Between PicoWay tattoo removal sessions, follow these healing guidelines to speed healing.

• Apply a clean bandage for the first few days. 
• Avoid soaking the treatment site in water (which carries a risk of infection) and don’t use a high-pressure water spray (which could take off your scabs). 
• Don’t shave the area. 
• Avoid self-tanning products or too much sun, since pigmentation changes can skew the laser and cause blistering or burning.  
• Wear loose, comfortable clothing to let the skin breathe. 
• Use an ice pack to help ease swelling or inflammation, and ask your doctor about which over-the-counter painkillers are safe. 
• Don’t touch or pick at any scabs.  

If you have oozing or signs of infection, call your doctor right away.

The PicoSure laser also delivers ultra-short pulses of energy to break up tattoo pigment while minimizing the amount of heat delivered to your skin. 

While it’s popular and FDA-cleared for tattoo removal, it does have less power—0.36 GW, compared to PicoWay's peak power of 0.9 GW. It also has a slightly lower “Worth It” Rating from RealSelf members.

With any laser treatment, the most important factor in the quality of your results is the skill level of your provider and their level of experience in treating your concern. If your skin tone is olive, brown, or deeply pigmented, it's especially important to find a provider who knows how to treat skin of color without creating post-inflammatory hyperpigmentation.