Does Picosure stimulate collagen and rejuvenate skin With the same effect as dermaneedling?

In the correct skin type, yes it can stimulate collagen, however the settings need to be well over the company guidelines. The laser is excellent in skin type 3 and above and can be used in conjunction with medical therapy for melasma. The X factor is not the laser but your dermatologist or plastic surgeon performing this procedure. Melasma is a very common cause of skin pigmentation. It can not be completely cured, however effective treatment are possible. This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour. The mainstay of treatment is strict UV protection- hats, sunglasses and SPF every 4 hours. This forms the foundation of all treatments. 



I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams or Meladerm. I start my patients on laser (low dose Q switch or Picosure) as this has shown to decrease pigment production by decreasing the activity of the cells that produce pigment. Laser itself is not aimed at ‘blasting’ pigment, but to slow down the rate of melanin production. Another laser I use is the Clear and Brilliant in the 1927 Permea setting combined with creams. IPL should never be used to treat mixed melasma as it often worsens the condition (this is termed ‘Rebound Melasma’) 



In some cases I combine glycolic AHA peels, and in other cases I use a tablet called Tranexamic acid to help. Melasma treatments should be tailored to each patient according the type of melasma. Majority of patients will have mixed dermal and epidermal melasma. Approach melasma as a medical condition and not a cosmetic concern, and the success rate will be much higher. 

Consult a Board Certified Laser dermatologist with a special interest in disorders in pigmentation as well as one who has experience in treating all skin types, including darker Ethnic skin. 



All the best, Dr Davin Lim. Laser, surgical and aesthetic dermatologist. Brisbane, Australia.

you should plan at least 3 Picosure sessions, spaced a month apart. Use a good sunblock. It is the worlds best laser for melasma and evening up the skin discoloration from the sun. it can used on  the face, neck, chest and back of the hands. I have treated my wife, who had a lot of sun damage with great results. microneedling will also stimulate collagen production. the Picosure is probably better but I am not aware of any controlled studies between the two methods. david berman md