Ever hear of a Pyrrhic victory? The term dates back to ancient Greece, and one King Pyrrhus of Epirus, and it essentially means a costly success, a ruinous triumph, a devastating win with consequences so grave you hardly feel like queuing up Queen’s “We Are the Champions.” In the beauty world, circa now, beating acne is often a Pyrrhic victory. The battle can take a serious toll on skin, leaving it pitted and discolored. And those scars are even more formidable than their pimple predecessors; in fact, nothing can erase them entirely. Until now, our best bets have been fractional lasers, fillers, and—for the deepest of divots—surgery.
Enter the picosecond laser, the latest weapon in dermatologists’ acne-scar arsenal. It delivers energy to the skin in trillionths of a second—that’s a thousand times faster than a nanosecond laser, like the Q-switched—which is why it was originally engineered for tattoo removal and benign age spots. This sort of rapid-fire capability is “very helpful for breaking apart the tiny particles of ink that make up tattoos,” explains Robert Anolik, a clinical assistant professor of dermatology at NYU School of Medicine and a coauthor of the 2015 JAMA Dermatology study proving the picosecond laser’s efficacy for acne scars. Driven by curiosity, Anolik and his colleagues added a special handpiece to their picosecond laser—a lens that fractionates the beam, allowing it to deliver varying intensities of heat to the skin, thus boosting its safety and effect on scars—and organized a small pilot study.
Seventeen subjects received six treatments each, four to eight weeks apart. One month after the final zap, blinded assessors—unbiased dermatologists called in to judge results—saw a range of 25 to 75 percent improvement in the appearance of subjects’ scars. Three-dimensional images taken at three-month follow-up visits showed scar volume had decreased by about 27 percent. Biopsies also revealed new collagen growth and healthier elastic fibers three months out.
Beyond speed, what sets the tricked-out picosecond laser apart from other lasers is the way in which it stimulates collagen production. “We believe it causes a vibrational shift on the skin’s surface, which then sends a signal down to the dermis, triggering changes in cellular behavior,” says Anolik. These changes in collagen production aren’t possible without that energy-altering lens, he adds. So instead of using heat to prod fibroblasts into action—the traditional means of jump-starting collagen growth—the picosecond laser sparks cellular communication. It gets those cells talking, encouraging each other to make more collagen and fix frayed elastic fibers. True to its pigment-blasting roots, it also fades post-zit stains that may otherwise linger for months.
What’s more, the picosecond laser is “remarkably safe on even the darkest skin,” notes Anolik, and downtime and discomfort are minimal—as in no numbing cream needed and only a couple hours of pinkness once you leave the office. “It’s really the only no-downtime laser for acne scars that is truly effective,” he says, noting that other scar-targeting lasers often require “a minimum of five or six sessions, with at least a week of healing following each.” For a single picosecond-laser treatment for the face, expect to drop between $600 and $1,500. Not cheap, we realize, but if the payoff inspires your inner Freddie Mercury, that’s money well spent.