I'm looking for a better option to Picosure. Any recommendations? (photo)

Question

I've had 11 removal sessions with the Picosure laser to-date. The tattoo is fading, but this process is going much slower and less effective than I would like (please see photo). The tattoo was done with black ink. Is there any other recommended lasers I should try like Pico4, for example?

Jason Emer, MD · Answer

Tattoos should be removed with q switched or pico lasers. It will take a series of treatments for removal. I recommend getting a formal evaluation with a laser tattoo removal expert. Best, Dr. Emer

Adaeze Okeke, MD · Answer

Hi, after 11 treatments your tattoo should be gone. Although pico technology has been heavily marketed to providers and patients, there is no real evidence that it is any better then nano Q-switched technology. Additionally the wavelength of the Picosure is 755nm which is not ideal for black ink. From your picture it looks like what's left of your tattoo should respond very well to a Q-switched Nd:Yag laser. Brand names you might find in community would be Revlite, Medlite, Quanta or Spectra. You will probably also find that your treatment price will be significantly less as your provider will not have to charge more to cover the exorbitant costs of a pico lasers. Do your research and choose your provider carefully. Good luck!

Steven F. Weiner, MD · Answer

There is a lot of hype behind the Picosure. Unfortunately, it is not the right wavelength for black ink, the most popular color of ink used. You need a 1064 nano and picosecond laser such as the Enlighten, Picoway, or Piqo4. I prefer the Piqo4 because it has the highest power.

Mark A. Blair, MD · Answer

Hello, thank you for your question and for including a photo.  Here in our office we use the Pico technology, but we have the PicoWay laser manufactured by Candela.  The PicoWay laser has all 3 wavelengths (1064nm, 785nm and 532nm wavelengths)  The 1064nm wavelength is best for black.  The ink in your tattoo looks pretty light, line art only and should respond well to the PicoWay laser.  I am not sure what wavelength they have been using on your tattoo, but 1064nm is best for black ink.  You can click on the weblink below and put in your zip code to find a provider of this technology in your area. Good Luck!

Warren B. Seiler III, MD · Answer

I agree with another comment here that if it is pure black then you probably will see a better result with a nanosecond QSwitch ND:YAG laser.  I use the Fotona device in my practice and get great results.  I agree that the Pico lasers have had a ton of marketing behind them without any proof that they are better than the nanosecond QS lasers.  I would discuss your results first with your provider and see if they can provide an explanation and then consider getting a second opinion with a trained expert in laser tattoo removal at a physician's office that specializes in tattoo removal.  Hope that helps!

I'm looking for a better option to Picosure. Any recommendations? (photo)

Answers (5)

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