CynoSure’s latest treatment innovation, picotoning, combines Focus and Picosecond technology to create unprecedented results in skin toning and pigmentation reduction.
Laser skin toning is a popular and effective treatment across a wide patient demographic. Toning targets unwanted epidermal and dermal pigmentation, as well as superficial textural irregularities associated with solar damage and natural ageing.
Now, picosecond technology has taken toning treatments to a new level of efficacy and applicability. PicoToning from Cynosure has opened a new way to treat pigmentation, pore size and texture inconsistencies.
Traditionally, in using a Q-Switched laser in skin toning, results can be improved by increasing the fluence or number of passes. But this is not without risk. Heightened energy delivery can also result in hypopigmentation and small areas of textural changes. According to a white paper by Shamshik Shin and Emil Tanghetti, entitled PicoToning: A novel laser skin toning approach for the treatment of Asian skin types (2015), patients with Fitzpatrick skin types III-IV should be treated with caution for this reason.
This is set to change with the introduction of PicoToning, from Cynosure. The shorter pulse durations of picosecond technology, and the way it incurs a photomechanical effect on melanin (as opposed to a photothermal effect, as seen in traditional technologies) could reduce unwanted thermal side effects and increase treatment safety when addressing darker skin types.
The PICO concept
Creating a photomechanical process in the skin – as opposed to a purely thermal response – has been shown to achieve improved results in the clearance of both melanin and tattoo ink. According to Shin and Tanghetti’s paper, picosecond pulse durations reduces the photothermal reaction at the treatment site and significantly heightens the photomechanical response.
Cynosure’s 755 nm PicoSure was the first picosecond device to become commercially available.
It uses an electronic shuttering mechanism to create a 750 picosecond pulse duration, which can now be adjusted to 550 picoseconds. The resulting photothermal reaction is patented the ‘Pressure Wave”.
The FOCUS Lens Array for pigmentation
Focus is a hexagonal, close packed diffractive lens array, designed to redistribute the light energy into a multitude of high fluence, tightly focused spots embedded in a low fluence background. This is intended to make treatment more efficacious with the delivery of high energy in small spots, while at the same time increasing patient safety.
The Focus Lens Array can be used with a 6mm, 8mm or 10mm optic, to permit different types of treatment based on the patient’s skin type and main treatment indications.
In using the Focus, up to 10 per cent of the tissue is exposed to high fluence on each pass. According to Shin and Tanghetti’s research, this makes multiple passes possible and renders treatable darker skin types by reducing the risk of post- inflammatory hyper pigmentation.
FOCUS and PICO combined = PicoToning
As Shin and Tanghetti explain, the combination of the Focus Lens Array and picosecond technology delivers superior and, in some cases, unprecedented results in skin toning.
“The toning effect of the Focus Lens Array in combination with the picosecond pulse duration is unique and it provides dual benefits,” the report states. “For epidermal
pigmentation, this device with the Focus optic both heats and fractures melanosomes in order to diminish unwanted pigmentation.”
When combined with the 755 nm picosecond alexandrite, the Focus optic produces laser induced optical breakdown in the epidermis. The histologic studies cited in the white paper show localised areas of intra-epidermal injury, however the surrounding edpidermal cells and melanocytes show no obvious areas of injury.
“After a series of treatments there is decreased epidermal pigmentation as well as an increase in dermal collagen, elastin and mucin,” the report states. AMP
For more information
visit www.cynosureaustralia.com and www.picosure.com.au
The PicoToning ProtocolDr Shin at the Clear Dermatology & Laser Clinic in Gwangju, South Korea has developed a protocol for PicoToning that has been shown to achieve consistent results and minimal complications in hundreds of patients – the Clear Dermatology & Laser Clinic was one of the earliest PicoSure locations in Asia. In the white paper study, 20 patients were selected from Dr Shin and his colleagues’ clinics to receive the toning treatment using the protocol listed below. Patients received 8 mm Focus Optic for full face, except for treatments where pore size was a main concern and the 6mm spot size was applied. The treatment protocol was as follows: • 5000-6000 pulses (3-4 passes) Pigmentation, superficial skin texture and pore size all improved over the series of treatments. Dr Shin also reported up to 40 per cent lightening in a single treatment. There was an average improvement of 90-95 per cent in unwanted pigmentation, 70-75 per cent in texture and 50-60 per cent in pore size. Patients experienced mild erythema and oedema for up to five hours post-procedure. Two cases of transient hypopigmentation occurred in initial treatments when shorter treatment intervals were used along with the standard optic. According to Dr Shin, the shorter treatment interval of one treatment every week did not afford enough time for healing, so there was a loss of pigmentation. Lengthening treatment intervals and employing the Focus optic resolved this issue. “755 nm picosecond toning with the Focus optic has opened a new way to treat pigmentation, pore size and texture inconsistencies. The fractional delivery of energy appears to be well suited to all skin types, without the problem of hyperpigmentation and rare scar formation,” Shin and Tanghetti’s report concludes. |
