The PicoSure Laser 

The gold standard for laser tattoo removal for the past several decades has been the Nd:YAG laser.  Initially it was the ConBio Medlite II®, which was eventually replaced by the Medlite C6® and Revlite® lasers.  Nd:YAG stands for neodymium ytrium aluminum garnet which is the crystal in the laser that creates the specific wavelength of light unique to that laser.  

By definition, a laser is a single wavelength of light as opposed to standard visible light, which contains thousands of different wavelengths.  For the Nd:YAG laser, the wavelength is 1064nm (nanometers) which is very good for most black tattoo inks and, because it is a relatively long wavelength, it penetrates deeper into the skin than shorter wavelength lasers. 

Frequency Doubling

In addition, most Nd:YAG lasers also have a frequency doubling crystal which, when activated, cuts the wavelength in half to 532nm which is very good for most red inks as well as some orange and purple colored tattoos.  One of the biggest problems with the 532nm wavelength is that it is also well absorbed by human pigment, which competes with the tattoo ink for the laser energy.  As a result, the laser can permanently remove skin pigment as well as ink pigment;  the darker the skin, the higher the risk of pigment loss is.  This is one reason why patients are encouraged to protect their skin from the sun in the tattoo being treated is in 

Unfortunately, these lasers generally do not do well with most blue and green inks which have become popular colors for tattoos. 

PicoSure®

In 2013, the PicoSure® laser was introduced by Cynosure as the biggest advance in laser tattoo removal technology in many years.  One change, which is not all that new, is that it is an Alexandrite laser, giving it a wavelength of 755nm; making it very good for green and blue ink while still very good for black ink.  However, it is not absorbed by red ink, so anyone who performs a lot of tattoo removal procedures will need an Nd:YAG laser as well. 

Faster Firing Speed

The real technological advance is the speed at which it fires.  The Nd:YAG lasers fire in nanoseconds (billionths of a second) which is pretty fast.  The PicoSure® laser fires in picoseconds (trillionths of a second).  According to Cynosure, this faster firing speed fragments the ink particles into smaller fragments, which are more easily removed from the skin by your immune system.  As a result, the tattoo ink fades in fewer treatments than with most Nd:YAG lasers. 

Pain

Laser tattoo removal can be painful and most physicians will have their patients apply an anesthetic cream for two to three hours before their treatment to reduce pain during the procedure.  The application of ice before the procedure can also help along with blowing cold air on the area during the laser treatment.  In our experience, most patients say that the PicoSure® laser treatment hurts a little less than the Nd:YAG laser. 

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