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What is the PicoSure laser tattoo removal Laser?

The PicoSure laser  is the world’s first picsosecond laser (one trillionth of a second), which creates an almost pure photoacoustic, or pusled shock wave effect on the tattoo pigments, with little thermal effect.Tattoos are created by embedding ink particles in the deeper layers of the skin, called the dermis, to create artistic patterns or designs. Modern tattoos often contain numerous colours of inks. These colours can be difficult to remove with standard or traditional laser technology.  Prior to the last 10-15 years of artistic tattoo design, most tattoos were black ink and could be removed relatively effectively with Q-switched nanosecond pulsed 1064-nanometer, (Nd YAG lasers) or 755-nanometer Alexandrite lasers.  With nanosecond pulsed technology the lasers created both a photothermal injury to the tattoo ink particle and a photoaccoustic or shock wave effect.  The nanosecond tattoo lasers used today still have a dominant thermal effect, rather than the more effective, less inflammatory picosecond laser. Thus, the nanosecond laser will require twice as many treatments, with usually a less effective tattoo removal. They will also have a higher risk of complications, such as lightening of the surrounding skin color (hypopigmentation). The PicoSure acoustic shock wave is extremely efficient resulting in tattoo removal of >90%+ in as few as 4 treatments. The near absence of a thermal effect means little risk of hypopigmenation seen with the more common and less effective nanosecond lasers.

PicoSure Laser Tattoo Removal Before and After

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What is the difference between the PicoSure and the more common Nanosecond tattoo removal lasers?

The problems of these common, older generation nanosecond tattoo removal lasers are that many colours of ink, specifically the yellow colours or orange, blue, yellow, purple and light green are difficult to remove with these traditional nanosecond laser machines. The more thermal effects will often lighten the surrounding skin but leave resistant tattoo ink around. The typical consequences of the nanosecond tattoo removal lasers are resistant recalcitrant tattoos, 8-16 treatments and “ghosting”.

PicoSure tattoo removal is the newest of the laser devices and is manufactured by Cynosure. PicoSure  is a revolution in laser tattoo removal due to its extremely ultra-short pulse duration. Most laser tattoo removal devices have pulse durations measured in nanoseconds, (which is one-billionth of a second). The PicoSure laser magnitude pulse duration is significantly shorter, measured in picoseconds (one-trillionth of a second). Traditional laser tattoo removal devices work by the emitted photon, or light energy interacting directly with the tattoo pigment particle and primarily creating heat. The heat can be harmful as it will damage the surrounding pigment forming structures called melanocytes. This can lighten your normal skin as well as the tattoo, a process called ghosting. The Nanosecond lasers, also have a non-thermal mechanical effect, where the short nanosecond pulse duration acts as “acoustic wave” shattering the tattoo ink particle. Also photothermally, with a heat interaction period. The heat interaction can sometimes lead to hypopigmentation changes in the skin colour, or ghosting, where the previous tattoo used to be. In addition, the more colourful tattoo pigments do not often respond to traditional tattoo wavelengths of light. The acoustic effect of the older, more commonly used nanosecond pulsed lasers results in the desired effect of breaking up the tattto ink particles. But this happens in relatively large “pepples” rather than grains of sand. Thus with the nanosecond lasers, the effect is less efficient than the PicoSure laser. The nanosecond lasers can require twice as many treatments and be less successful compared to the PicoSure laser.

The ultra-short pulse duration of the PicoSure laser means that its light energy interacts with the tattoo particles in an almost purely photomechanical or acoustic fashion. An acoustic photomechanical reaction is like a shockwave that shatters the pigment, regardless of the colour of that pigment, with little photothermal effects. The absence of significant photothermal attraction generally means that the risk of hypopigmentation is very low. In addition, the ultra-short pulse duration of the PicoSure laser means it will be effective on any colour of tattoo. It is effective removing dark black, green, light green, purple, blue, yellow, orange or red coloured tattoo inks. The PicoSure is so effective and efficient that it generally requires half the number of treatments compared to traditional nanosecond pulse laser tattoo devices.

Picosure Laser

Figure 1. PicoSure laser tattoo removal, the world’s first picosecond laser. The pulse duration is so short, the near total photoacoustic shock wave can remove most tattoo ink pigments in 3-6 treatments, with clearances of >90%+ and little risk of hypopigmenation or lightening of the surrounding skin.

PicoSure Tattoo Removal


Figure 2.  A.  A typical dark ink tattoo with large ink particles (100 nm in size). B.  A typical nanosecond laser will use a predominantly a photothermal combined with a smaller photoaccoustic effect to break up the ink particles into “pebbles”. These pebbles are still difficult for the body’s internal systems to remove, so multiple treatments are required and often the ink particles remain large, cannot be removed by the body and you have a visible resistant tattoo after as many as 16 or more treatments. C.  The same dark in particles treated by the PicoSure with the ultra-short picosecond pulse duration, works in a very efficient photo-acoustic shock wave fashion. With little or no thermal effect and shatters the ink particle of the tattoo in “fine grains of sand”. These are small enough to be efficiently removed by the bodies own systems.  This results in excellent outcomes in 3-4 PicoSure treatments and very low risk of a resistant or recalcitrant tattoo.

PicoSure Laser Toronto

Figure 3. The left side of this multi-color Tattoo was treated 3 times by a current Nanosecond pulse duration laser (NdYAG and 532nm). The right side was treated 3 times with the PicoSure laser, with near clearance and 100% more efficiency.

laser tattoo removal

Figure 4. The more common Nanosecond laser tattoo devise are less efficient, resulting in 8-16 treatments and clearance rates averaging 80%.  Another side effect of the Nanosecond pulsed laser tattoo devices is the risk of hypopigmentation. The tattoo above required 14 treatments with a nanosecond laser tattoo device but the photothermal effect that predominates the nanosecond lasers resulted in heat damage to the normal skin and its pigment forming structures called the melanocyte, resulting in permanent hypopigmentation, lightening or ghosting of the skin where the tattoo used to be.  This “ghosting” effect is a much less complication with the PicoSure as the ultra short picosecond pulse duration is more acoustic wave shattering of the tattoo ink particles that the deleterious thermal effect.

How does PicoSure laser tattoo removal work?

After a thorough history and physical examination with one of SpaMedica’s laser physician specialists, a multiple-visit treatment program is outlined. Depending on the size and number of colours of the tattoo will often determine the number of laser treatments required. These factors also decide on the kind of lasers that may need to be deployed. Generally, Laser Tattoo Removal patients in Toronto can expect the first 4 treatments or more to be with the PicoSure lasers. After the PicoSure laser is selected to initiate the treatment, the appropriate settings for the laser are selected and the tattoo undergoes a laser treatment. The specific energy from the PicoSure light beam is directed at the skin where the tattoo ink particles reside. By photomechanical or acoustic wave shattering, generally the ultra-short wavelengths of the various tattoo lasers create a shockwave in the skin, in around the ink particles, and shatter the particles. The shattered particles then flake off from the surface of the skin. The deeper ones, are reduced in size to “tiny grains of sand”. These are then consumed naturally over the subsequent 6 weeks by the body’s elimination and immune system.

In general, nanosecond laser tattoo removal takes multiple sessions. Normally they take in the order of 8 to 16 sessions at an affordable price per session. With PicoSure and its efficient picosecond pulse duration, the number of treatments can be reduced in half. It often only requires 3-6 treatments for over 90%+ successful tattoo removal. Each Picosure session may take between 5-15 minutes minuets of active laser treatment, depending on the size of the tattoo. Most of the procedures are performed under topical anesthesia and an air chilling device, although some patients may prefer local anesthesia.

Picosure laser before and after

Figure 5.  PicoSure laser tattoo removal before and after. The ultra short picosecond pulse duration can result in over 90% tattoo removal in as few as 3-4 treatments, with a low risk of lightening of the skin.


laser tattoo removal before and after

Figure 6.  Non-picosecond lasers have a significant thermal effect on the tattoo ink particles as well as the skin. This can cause lightening of the skin, in addition to reduction of the tattoo. Above is a tattoo from several years ago that was treated 10 times using a Nanosecond 1064nm pulsed laser. There is significant lightening or ghosting of the normal skin occurred in addition to reduction of the tattoo ink.  This tattoo, if treated today would be best treated with Picosure. We likely would achieve a 100% reduction in as few as 3 treatments, with a much less risk of ghosting.

Who is a candidate for PicoSure laser tattoo removal?

Candidates for PicoSure laser tattoo removal Toronto treatment are those patients with a tattoo that are unhappy with the appearance of that tattoo and would like to have all or part of it removed in the least possible number of treatments with the least possible side effects. Darker skin type patients can be treated with the PicoSure laser tattoo removal. The PicoSure laser is safer than Nanosecond lasers devices for patients with darker skin. Unfortunately, there is a higher risk of skin lightening. Patients should have realistic expectations in that they should anticipate 80% to 100% reduction of their tattoo after four to six treatments. If there are resistant ink particles after using the PicoSure 4-6 times, Dr. Mulholland may deploy one or more of his multiple SpaMedica Tattoo lasers to achieve the best possible results. The treatments can be performed under local anesthesia and a topical chilling device.

Contraindications to PicoSure laser tattoo removal include those individuals with unrealistic expectations and/or those individuals with severe wound-healing diseases or metabolic conditions, such as uncontrolled diabetes or lupus and scleroderma.

What kind of anesthetic is used for PicoSure laser tattoo removal?

Most laser tattoo removal Toronto patients have their tattoo removed at SpaMedica under topical anesthetic with an air chilling system. Some patients prefer the use of local anesthesia and that can be performed as well. Most laser tattoo removal treatments are very short and last five to ten minutes. PicoSure tattoo removal too lasts five to ten minutes. The treatments are well-tolerated and certainly less painful than getting the Tattoo performed in the first placed.  Most SpaMedica Tattoo removal patients will take an anti-inflammatory before coming into the clinic. That combined with the topical numbing cream and air chillers makes the PicoSure discomfort acceptable.

How long does the PicoSure laser tattoo removal treatment take?

The actual PicoSure laser tattoo removal treatment is quick and efficient and lasts between five and ten minutes. The procedure results in a small, white frosting on the surface where the tattoo pigment is. This white frosting fades to a mild red, swollen appearance on the tattoo in a matter of minutes, which turns into a crust over 24 to 48 hours.  In general, for the first four to five days, topical anesthetic ointment is placed on the tattoo. Occlusive dressing is applied to prevent rubbing.  The tattoo itself can be washed immediately the following day after treatment.  Once the crusting has fallen off, the tattoo continues to fade. In general, 15% to 25% of the tattoo occurs after each PicoSure laser tattoo removal treatment.  The PicoSure Tattoo removal laser has a much more efficient photomechanical effect than the less effective Nanosecond laser. As a result there is less crusting and inflammation following a treatment with PicoSure compared to less effective nanosecond lasers.

Picosure laser tattoo removal toronto

Figure 7PicoSure laser side effects. The left side of this tattoo was treated once with the PicoSure laser. The right side of the tattoo in the figure was treated once with a nanosecond 1064nm Nd;YAG laser. We see the tattoo 24 hours after the treatment. The PicoSure has an almost pure photomechanical, acoustic shock wave non-thermal effect and as is visible on the left side of the PicoSure treated tattoo. There is far less redness and inflammation that the more photothermal nanosecond laser treated right side.

How long is the recovery following the PicoSure laser tattoo removal treatment?

The recovery period after the initial white frosting is characterized by mild flaking and redness for approximately seven days. Topical antibiotic ointment and occlusive dressing, with frequent tepid water cleansing in the shower is all that is required post-treatment.  It is recommended that sun tanning or sun avoidance is followed for several weeks following each treatment to avoid hyperpigmentation of the treatment area.  After two weeks, most tattoos can also have cosmetic makeup or cosmetic foundation and cover-up placed over it.

What kind of PicoSure laser tattoo removal results can laser tattoo removal Toronto patients expect following their treatment?

In general, the PicoSure laser tattoo removal system can remove 85% to 100% of a tattoo after 4-6 treatments.  Each treatment is approximately six to eight weeks apart.  This is a far more successful laser than any other nanosecond laser system. Where between 8 and 16 treatments are required for a 65% to 80% reduction.  One of the big advantages of the PicoSure laser, in addition to fewer number of treatments, is it’s pure acoustic or photomechanical effects and near absence of a photothermal effects. This results in far less risk of hypopigmentation or lightening of the skin where the tattoo existed; a phenomenon called “ghosting”.

What are laser tattoo removal Toronto patients saying about the SpaMedica PicoSure tattoo laser removal program?

Most patients are delighted about the laser tattoo removal Toronto program at SpaMedica and the PicoSure laser tattoo removal system.  They are delighted with their tattoo reductions of >90%+ in as few as 4 treatments. They are also happy with the lower risk of lightening or “ghosting” of their skin.

PicoSure laser tattoo removal

Figure 8.  PicoSure on Black Ink. Black, yellow and red tattoo ink are difficult to remove particles. Here are the picosure laser tattoo removal results one month after only 3 treatments.

Laser Tattoo Removal Toronto

Figure 9.  Difficult to remove red, orange and the less resistant black tattoo ink particles over only 3 treatments with the PicoSure laser.

PicoSure Results

Figure 10.  Near 100% tattoo removal after only 4 treatments with the PicoSure laser

I have a resistant Tattoo treated with many other Lasers at different laser clinics. Will PicoSure work for me? 

There are many patients in the SpaMedica tattoo removal program who have had multiple treatments with other laser systems and removal clinics and now have recalcitrant to difficult-to-remove pigment.  This difficult-to-remove pigment and these multiply-treated tattoos generally will not respond to subsequent treatments on older nanosecond technology.  But they do respond exceptionally well to the PicoSure laser tattoo removal machine. SpaMedica attracts those laser tattoo removal Toronto patients that desire to have the best possible reduction of their tattoo, in the fewest number of treatments with the least number of side effects.  In addition, those individuals with multi-coloured tattoos or tattoos that have not been able to be successfully removed, have gravitated to the SpaMedica laser tattoo removal program

Picosure Laser

Figure 11. A. The tattoo above was treated over 20 times with a nanosecond pulsed Nd YAG laser  B. The tattoo removal became resistant, as the ink particles were shattered to sizes too big to removal my the bodies own removal systems. C. After just 4 treatments with the PicoSure the resistant, recalcitrant tattoo was almost 100% gone.

How long will the results of the PicoSure laser tattoo removal last? AND is there any maintenance required following the PicoSure laser tattoo removal?

There’s no specific maintenance required once the end point of the laser tattoo removal program has been achieved, which is almost complete eradication.  At the end of the PicoSure Tattoo removal process, if there is some faint residual tattoo ink particles, Dr. Mulholland may switch lasers to effect a more complete tattoo ink particle reduction.  In addition, at the end of your PicoSure sessions, there may be some textural changes in the skin or very feint residual ink particles. They may respond better to one of SpaMedica’s ablative and non-ablative fractional resurfacing technologies. Such as fractional CO2, Erbium, Fractional RF needle based resurfacing and infra-red non-ablative fractional lasers.  One of the many valuable aspects of having your tattoo treated by SpaMedica is the wide array of lasers; both tattoo and surface resurfacing that can be used to improve the removal of almost any tattoo

Can you tattoo over a laser removed tattoo?

Some patients do elect to tattoo over a tattoo that has been removed by a laser. This is possible approximately 12 weeks following your final treatment.

PicoSure Laser Tattoo Removal Cost

How much does PicoSure laser tattoo removal cost?

In general, most tattoos, depending on their size, cost between $250 and $750 per treatment. One of the big advantages of PicoSure laser tattoo removal system is that only half the numbers of treatments are usually required compared to other, older nanosecond laser tattoo removal technologies. Thus making the whole process more affordable.

Why choose SpaMedica and Dr. Mulholland for PicoSure laser tattoo removal?

Dr. Mulholland and SpaMedica have been pioneers in the area of laser tattoo removal. No other center in Canada has as much laser tattoo removal experience using the PicoSure and Revlite tattoo removal lasers. Dr. Mulholland has spared no expense to assemble the finest lasers to ensure the best possible outcome with the least possible side effects in the shortest number of treatment times.

Dr. Mulholland is an acknowledged worldwide pioneer in PicoSure and Revlite laser tattoo removal. He frequently lectures in the United States and around the world on behalf of Cynosure and other technology companies on the art and science of laser tattoo removal.

How can I show Dr. Mulholland my concerns and see if I am a candidate?

PicoSure laser tattoo removal Toronto patients should simply fill out the appointment request form or “ask a question” form and upload up to 3 photos for Dr. Mulholland to review.

How do I schedule a consultation for a PicoSure laser tattoo treatment program?

To schedule a tattoo removal consultation for PicoSure laser tattoo removal, simply fill out the on-page, e-mail consultation request form or call 877-211-8367 to speak to a customer service representative. They will respond quickly to set up a consultation for you.  Call or book now to begin a tattoo-free you.


Cosmetic Surgery and Laser Skin Care Spa:
66 Avenue Road Suite 4
Toronto, Ontario M5R 3N8
Tel: 1-877-712-8367