Expert Settings For PicoSure Laser Treatment

The world’s first and ONLY PicoSure laser workstation has revolutionized the areas of tattoo removal and skin rejuvenation. Tattoos, once thought impossible to remove, can now be removed quite easily. Facial rejuvenation that once required CO2 ablation (burning off the affected tissue) can now be accomplished with a fractionated “Focus Lens” with zero downtime. Thank you Cynosure engineers!

I’m often asked what settings to use on the PicoSure laser for various skin conditions. And if you’re an operator seeking help feel free to reach out to me with questions. The short answer is that there’s a set of “rules” to be followed for effective treatment and I wrote many of them myself. For example, the spot size, which is the diameter of the beam, is crucial because this determines the focal point of the energy. But the pulse count, meaning the number of times the laser fires, is even more critical.

We can think of the Joules/cm2 as the strength of the treatment – similar to an aspirin having 325mg, which is the strength of the tablet. Now think of the number of pulses as the dosage. For example, a single treatment might be: 4.25 J/cm2 x 4,000 pulses. The energy multiplied by the dose gives us a therapeutic range known to be beneficial to the condition. Anything less than therapeutic will result in little change to the condition, like taking a baby aspirin for a massive migraine – the result would be ineffective.

If you’re not getting the results you want with your PicoSure, chances are you’re using the wrong strength and the wrong dosage. For help with this, I can be reached at or you can call my office at Austin Medspa 512-479-9997

Brendan Leigh, MS, RN

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