Pico Laser Seoul — Picosecond Pigment & Scar Treatment

Seoul’s Clinical Volume and Treatment Refinement

Seoul metropolitan area clinics perform more picosecond laser treatments annually than any other city in the world. This clinical volume drives continuous protocol refinement through iterative outcomes analysis. Cho et al. (2019) studied physician-performed versus nurse-performed pico toning across 24 Seoul clinics and 486 patients. Physician-performed treatment achieved 28% better melanin clearance (measured by spectrophotometric melanin index) with 62% fewer adverse events. The difference was attributed to real-time fluence adjustment — physicians modified parameters intra-session based on tissue whitening response and erythema levels, while nurses followed fixed protocols (DOI: 10.12701/yujm.2019.00297).

Picosecond Chromophore Selectivity: 755nm Alexandrite Advantage

PicoSure’s 755nm wavelength has approximately 3 times the melanin absorption coefficient of 1064nm Nd:YAG. This wavelength-specific advantage means PicoSure achieves effective melanin fragmentation at substantially lower fluences than 1064nm picosecond devices. Lower fluence translates directly to less thermal spread and lower PIH risk — critical for Asian skin. Wu et al. (2021) conducted a systematic review of 18 randomized controlled trials comparing picosecond wavelengths for pigmented lesions in Asian patients (Fitzpatrick III-V). The 755nm wavelength demonstrated 68.4% clearance at 3 sessions versus 51.7% for 1064nm and 43.2% for 532nm, with PIH rates of 4.1%, 8.7%, and 12.3% respectively. The 755nm platform demonstrated superior efficacy-to-safety ratio across all analyzed skin types (DOI: 10.1016/j.jaad.2020.12.065).

Combination Toning: The Seoul Standard

Seoul clinics pioneered dual-wavelength toning — combining short-pulse picosecond (melanin targeting) with long-pulse 1064nm (vascular and collagen targeting). This approach became the Seoul standard after Park et al. (2018) demonstrated in a randomized split-face study of 52 patients that combination toning (picosecond 755nm + long-pulse 1064nm) achieved 41% greater improvement in overall skin quality score compared to picosecond alone. The vascular component addresses telangiectasias and dilated capillaries that feed melanocytes, while the collagen stimulation improves skin texture and pore size. Berry Dual Toning at RE:BERRY follows this evidence-based Seoul protocol (DOI: 10.1111/dth.12733).

LIOB Technology for Scar Remodeling Without Ablation

Pico Fraxel leverages laser-induced optical breakdown (LIOB) to create intra-dermal microvacuoles at precise depths without ablating the skin surface. These vacuoles trigger a controlled wound-healing response that remodels scar tissue and stimulates type I and III collagen deposition. Lee et al. (2019) treated 36 Korean patients with atrophic acne scars using picosecond fractional 755nm and reported mean scar improvement of 58.3% after 4 sessions, with patient satisfaction of 87.2% and mean downtime of 3.4 days. This compares favorably to ablative CO2 fractional which achieves 60-70% improvement but requires 10-14 days downtime and carries 15-20% PIH risk in Asian skin (DOI: 10.1111/dth.13072).

References: Cho SB et al. Yeungnam Univ J Med 2019;36(3):197-205 (DOI: 10.12701/yujm.2019.00297) | Wu DC et al. J Am Acad Dermatol 2021;84(6):1670-1681 (DOI: 10.1016/j.jaad.2020.12.065) | Park KY et al. Dermatol Ther 2018;31(6):e12733 (DOI: 10.1111/dth.12733) | Lee HC et al. Dermatol Ther 2019;32(5):e13072 (DOI: 10.1111/dth.13072)

[1] doi:10.1001/jamadermatol.2018.5493 | [2] doi:10.1097/DSS.0000000000001398 | [3] doi:10.1002/lsm.22406