PicoSure vs Fraxel Laser: which laser goes deeper under the skin?

Question

one Doctor said that one Fraxel treatment is equal to 3 Picosure Focus treatments for treating dermal pigments. i did 40 treatments with fraxel 1551 (30 energy, 6 level, 8 pass) on my face for treating deep pigments, and the result about 60%, so it means i need 120 treatments with Picosure to reach the same result? which laser goes deeper under skin? i have brown, north african medetreanean skin, and i got those pigments on 2008 from a hair spray (accidentally on my face and i was on the beach)

Sheila S. Nazarian, MD · Answer

I would be hesitant to use Fraxel on Brown skin.  That is why I acquired the Picosure device.  On brown skin with pigment issues, it's not about how deep you go.  It's about treating the pigment without causing worse hyperpigmentation.  I would feel very confident to treat your skin with Picosure.  I would hesitate with Fraxel.Dr. N

Anna Avaliani, MD · Answer

Hello and thank you for reaching out and asking this question.  I would have loved if you provided a photograph of your face/concern in order to try to help you better.  My practice offers both laser treatment options Fraxel 1540 and PicoSure Laser. As far as I understood, you primary concern is pigmentation and your skin is darker, so likely type 4, possible 5.  1540 Fraxel was a gold standard for many concerns but it does not help with pigment much, also it is definitely not the best option for darker skin types due to increased chances of hyperpigmentation. I have never heard of 40!!!!! treatments, this is just insane and absurd to me. My state of the art practice has any laser for any concern for any skin type and we treat variety of skin conditions.  Now having said that, I am the biggest and top provider of PicoSure Skin rejuvenation treatments on East Coast of United States.  I customizes all my treatments and to remove pigment, most of pigment is gone in 1-2 treatments and the remainder in addition 2 more sessions. Protocol calls for 4 sessions, likely more might be needed but it is discussed after 4 sessions have been completed. Picosure is amazing for skin pigmentation and not to mention is THE ONLY LASER to be used for darker skin types due to decreased risk of causing burns and or PIH. Please remember that laser is just a tool. It is the experience and knowledge of the provider that ultimately determines your results. I am happy to say I have patients from all over the world flying to see me for my custom laser treatments. I am  Picosure clinical instructor and Cynosure center of excellence center and I wish more counties could offer this amazing procedure which is currently only available in United States and China. PICOSURE  is the first Pico laser, has the most FDA approvals for numerous skin concerns and virtually give no downtime ( my treatments are a little different because My protocols are custom). Please stop your Fraxel treatments because they obviously have been ineffective. I hope this helps. Best, Dr.Avaliani

David S. Rosenberg, MD · Answer

If you are treating pigment then I would use the Picosure, however don't use the Focus Lens, you the flat lens.

Laura Riehm, MD · Answer

Thanks for your question, but it will take some explaining...  PicoSure fires at 755nm vs. Fraxel at 1551nm.  As lasers go up in wavelength, generally intensity increases.  Therefore, Fraxel will treat deeper than PicoSure but Fraxel 1551 primary target isn't pigment.  We have a PicoSure and a platform similar to Fraxel called ICON.  There is no comparison that a laser is X times better / deeper than another that is scientifically based.  We offer treatments based on each patient's chief concern.  It depends if it is hyperpigmentation, fine lines, deeper lines or broken blood vessels.  PicoSure works really well on hyperpigmentation, fine lines, acne scars and stretch marks.  The ICON IPL PhotoFacial does a great job on bot hyperpigmentation and vascular lesions, but really doesn't do any texture correction.  IPL should only be performed on Skin Types I-III.  ICON 1540 and Fraxel 1551 does a really great job on texture correction, but we don't recommend it for color correction.Since your primary concern was hyperpigmentation, we would probably offer you a PicoSure with the Flat & FOCUS lenses or IPL PhotoFacial.  I still don't understand how you had 40 treatments.  We get rid of most pigment in 4 treatments.  Best of luck.

Davin Lim, MBBS, FACD - Account Suspended · Answer

I work with Fraxel and Pico, and use both lasers in darker skin types. Fraxel 1927 is the standout Fraxel wavelength, having said that, Picosure off label in the Focus setting can also help achieve skin rejuvenation. Now, if one is experienced in using the Fraxel 1927, this can give excellent results, so can the Pico. The difference is your Specialist - see someone who has all types of lasers including nano, pico, all the Fraxels, Co2, erbium , as well as microneedling RF- this is when a good dermatologist will select a device to meet your expectations, skin concerns and downtime. All the best, Dr Davin Lim

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