TY  - EJOU
AU  - Lee, L. Kar Wai Alvin
AU  - Chan, C. Kwin Wah Lisa
AU  - Lee, L. Cheuk Hung
AU  - Wong, W. Tin Hau Sky
TI  - Clinical Application of Picosecond Laser: An Update and Critical Review
T2  - Journal of Cosmetic and Regenerative Medicine

PY  - 2026
VL  - 1
IS  - 2
SN  - 3107-2933

AB  - Background: Picosecond laser technology has moved beyond its original role in tattoo clearance and now occupies a widening place in medical and aesthetic dermatology. During year 2024–2026, the literature expanded across pigmentary disorders, melasma, nevus of Ota, acne scarring, photorejuvenation, tattoo complications, and several exploratory indications. At the same time, enthusiasm has been tempered by inconsistent study quality, frequent reliance on retrospective series, and persistent concerns regarding dyspigmentation in darker phototypes. Methods: A comprehensive literature review was conducted covering publications from 2024 to 2026 on clinical application of Picosecond laser. The source framework was based on MEDLINE, PubMed, and Ovid database retrieval. Studies included systematic reviews, meta-analyses, randomized trials, retrospective comparative studies, case series, case reports, mechanistic investigations, and technology-focused reviews. All studies were classified according to the Oxford Centre for Evidence-Based Medicine 2009 Levels of Evidence. Results: Recent evidence suggests that picosecond lasers are most strongly supported for selected pigmentary disorders and as an adjunctive modality in skin rejuvenation and acne scarring. Melasma remains the most controversial indication: several studies showed clinical improvement, yet high-level syntheses did not establish clear superiority over established topical regimens and underscored relapse and hypopigmentation concerns. For nevus of Ota and related dermal melanocytoses, results were generally favorable, especially in Asian populations and pediatric cohorts, although most data remained observational. Emerging reports also described use in lichen planus pigmentosus, xanthelasma, androgenetic alopecia, photodamage, argyria, and tattoo-related complications. Mechanistic work supported a dual action of pigment fragmentation and dermal remodeling, but translational gaps remain. Conclusions: Picosecond lasers have become a versatile platform with meaningful clinical utility, particularly for benign pigmented lesions, selected dermal melanocytoses, acne scarring, and rejuvenation. However, the evidence base remains uneven, with relatively few robust randomized studies and limited long-term outcome data. Current practice should therefore emphasize phenotype-specific treatment selection, conservative parameter choice in skin of color, and careful counseling regarding recurrence and dyspigmentation. Better-designed comparative trials and standardized reporting are needed to define the true comparative value of picosecond technology.
KW  - laser therapy
KW  - skin diseases
KW  - pigmentary
KW  - melanosis
KW  - cicatrix
KW  - acne
KW  - nevus
KW  - pigmented
KW  - tattooing
DO  - 10.65381/jcrm.2026.01010016