PicoSure and PicoWay are the two most widely used picosecond laser platforms in aesthetic medicine. Both deliver energy in trillionths of a second — roughly 100 times shorter than the nanosecond pulses of older Q-switched lasers — creating a photoacoustic effect that shatters pigment particles into fragments small enough for the body's immune system to clear.
But the platforms differ in wavelength, pulse characteristics, heat profile, and clinical strengths. The choice between them is not abstract: it depends on what color ink is being treated, what skin type the patient has, and whether the target is tattoo pigment, melasma, acne scars, or skin rejuvenation.
Wavelength and what it means for ink color
The most consequential difference between the two platforms is the wavelengths available.
PicoSure (manufactured by Cynosure, now part of Hologic) operates primarily at 755 nm (alexandrite). It received FDA 510(k) clearance in December 2012 as the first picosecond laser for tattoo and pigmented lesion removal. A later clearance added a 532 nm handpiece for warm-colored inks (red, orange, yellow), and a 1064 nm option for treating black ink in darker skin types. The 755 nm wavelength is strongly absorbed by blue, green, and purple pigments — historically the hardest colors to remove with Q-switched Nd:YAG lasers.
PicoWay (manufactured by Candela) operates at 1064 nm, 532 nm, and 785 nm. It received initial FDA clearance in October 2014 (K142372) for tattoo removal, with subsequent clearance for pigmented lesions (510(k) K150326, April 2015). The multiple wavelengths allow same-session treatment of multicolored tattoos: 1064 nm for black and dark brown, 532 nm for red, orange, and yellow, and 785 nm for stubborn blue and green. This multi-wavelength flexibility is PicoWay's primary clinical advantage for complex, colorful tattoos.
In practice: for a tattoo that is predominantly black, blue, or green, PicoSure's 755 nm wavelength may achieve clearance in fewer sessions because the wavelength matches those pigments' absorption spectra closely. For a multicolored tattoo with black outlines, red petals, and yellow highlights, PicoWay's ability to switch wavelengths mid-session gives the provider more tools. A head-to-head comparison in the literature found that the 532 nm picosecond was best for warm colors, 1064 nm for black, and 755 nm had theoretical advantages for blue and green — but that multi-wavelength platforms were essential for multicolor work.
Pulse duration and peak power
PicoWay has shorter pulse durations — as low as 300 picoseconds for the Resolve handpiece — compared to PicoSure's roughly 550–750 picoseconds. Shorter pulses produce a stronger photoacoustic effect relative to photothermal effect, meaning more energy goes into shattering pigment and less into heating surrounding tissue.
PicoWay's peak power is also higher (approximately 0.9 GW vs. PicoSure's 0.36 GW in some configurations). Higher peak power translates to more efficient pigment fragmentation per pulse, which can mean fewer total sessions for some patients.
The clinical significance of these differences is real but not dramatic for most patients. A meta-analysis and several head-to-head trials found that both platforms produce excellent clearance, with PicoWay sometimes achieving equivalent or better results in fewer sessions for multicolored tattoos, and PicoSure showing strong efficiency for its target colors. The British Journal of Dermatology published a study finding virtually no difference in clearance between picosecond and high-quality nanosecond pulses in some settings — suggesting that wavelength match and operator skill may matter more than pulse duration alone.
Skin type and Fitzpatrick safety
This is where the platforms diverge meaningfully.
PicoWay's 1064 nm wavelength penetrates deeper with less absorption by epidermal melanin, making it the safer choice for Fitzpatrick IV–VI skin types. The shorter pulse duration and multi-wavelength options allow the provider to select the wavelength and fluence that minimizes heat in the epidermis while still targeting the pigment.
PicoSure's 755 nm alexandrite wavelength is more strongly absorbed by melanin in the epidermis, which increases the risk of post-inflammatory hyperpigmentation (PIH) in darker skin. The 1064 nm handpiece addition for PicoSure partially addresses this for black ink, but the platform is generally considered better suited to Fitzpatrick I–III.
Candela's clinical data reports that PicoWay can treat patients across nearly all Fitzpatrick types, with 50% pigment clearance after 2 treatments in 96% of treated discolorations for Fitzpatrick types II–V. PicoSure's clinical data similarly shows strong results, but the label and clinical practice favor lighter skin tones for the primary 755 nm wavelength.
For patients with Fitzpatrick IV–VI skin who need tattoo removal or pigmentation treatment, PicoWay is widely considered the safer default. For patients with Fitzpatrick I–III, either platform works well, and the choice should be driven by ink color and clinic availability.
Pigmentation: melasma, solar lentigines, and acne scars
Both platforms are FDA-cleared for benign pigmented lesions. Both can be used for acne scar treatment and skin revitalization with fractional handpieces.
PicoWay carries a specific FDA clearance for melasma treatment — a notable distinction, because melasma is notoriously difficult to treat with lasers and carries high rebound risk. PicoWay's lower heat profile and 1064 nm wavelength make it one of the more conservative laser options for melasma, though no laser is risk-free for this condition and patients should be counseled about rebound potential regardless of platform.
PicoSure's Focus Lens Array is a proprietary handpiece that redistributes laser energy into hundreds of micro-beams, creating a fractional effect that stimulates collagen and elastin production with minimal surface damage. The "PicoSure Focus facial" is widely used for acne scars, fine lines, and skin texture. Clinical data from Cynosure reports 26 publications and 59 abstracts supporting the platform.
Both platforms produce results for pigmentation and skin texture. The practical choice often comes down to which device the clinic owns and the provider's experience with the specific handpiece for the indication being treated.
Tattoo removal: sessions, cost, and what to expect
Both platforms typically require 4–8 sessions for substantial tattoo clearance, spaced 6–8 weeks apart. PicoWay's higher peak power and multi-wavelength flexibility may reduce session count for multicolored tattoos. PicoSure's wavelength match may reduce session count for blue/green-heavy tattoos.
Neither platform guarantees complete clearance. Some inks — particularly white, flesh-toned, and certain cosmetic tattoo pigments — can oxidize and darken with laser treatment. Professional tattoos with dense ink deposits take longer than amateur tattoos. Cover-up tattoos with layered pigment present an additional challenge because underlying ink may be invisible until the surface layer fades.
Approximate per-session costs in the U.S. market (2025–2026):
- Small tattoo (under 4 square inches): $200–$500
- Medium tattoo: $400–$800
- Large or multicolored tattoo: $600–$1,500+
- Total treatment course for a medium multicolored tattoo: $3,000–$6,000
These costs are comparable between the two platforms. The significant cost variable is number of sessions, not per-session price.
What the evidence says about picosecond vs. nanosecond
Picosecond lasers represent a genuine improvement over older Q-switched (nanosecond) technology for most applications. A prospective comparison study in Asian patients (published in PMC, 2020) found that 532/1064 nm picosecond laser treatment produced better clearance than the same wavelengths in nanosecond mode, with the 1064 nm picosecond producing the best clearance for black tattoo ink.
However, the improvement is incremental, not transformative. Some studies have found that high-quality nanosecond lasers at optimized settings perform comparably to picosecond lasers for certain indications. The clinical advantage of picosecond technology is clearest for:
- Blue and green inks (with 755 nm)
- Multicolored tattoos (with multi-wavelength picosecond platforms)
- Patients with darker skin types who need the lowest possible heat profile
- Melasma and pigmentation in skin of color
For straightforward black tattoos in Fitzpatrick I–III patients, both picosecond and well-operated Q-switched lasers produce good results, and the choice may come down to availability and cost.
What to ask a provider
- "Which picosecond platform do you use, and what wavelengths are available?" A clinic with only PicoSure may not have the 532 nm handpiece. A clinic with only PicoWay may not be optimized for blue/green inks.
- "How many sessions do you typically need for a tattoo like mine?" Ask for a range, not a guarantee.
- "What is your approach for my skin type?" If you are Fitzpatrick IV–VI and the provider does not discuss PIH risk and wavelength selection, find a provider who does.
- "Do you have before-and-after photos of tattoos with similar colors to mine?" Ink color drives platform selection more than any other variable.
- "What happens if the ink oxidizes?" White and cosmetic pigments can darken. A knowledgeable provider will discuss this before treatment, not after.
Sources
- Cynosure. PicoSure FDA 510(k) clearance, December 2012. First picosecond laser cleared for tattoo and benign pigmented lesion removal. PR Newswire: https://www.prnewswire.com/news-releases/cynosure-receives-fda-clearance-for-picosure-the-first-picosecond-device-to-remove-tattoos-and-benign-pigmented-lesions-181993511.html
- Cynosure. PicoSure product information, indications, and clinical data: https://www.cynosure.com/product/picosure/
- Candela Medical. PicoWay product information and FDA-cleared applications: https://candelamedical.com/products/picoway/
- Candela Medical. PicoWay patient information: https://candelamedical.com/patient/brands/picoway/
- American Med Spa Association. PicoSure FDA clearance for full-spectrum tattoo removal (1064 nm addition): https://www.americanmedspa.org/news/picosure-cleared-for-full-spectrum-tattoo-removal/
- Kim HJ et al. Prospective comparison study of 532/1064 nm picosecond laser vs 532/1064 nm nanosecond laser in the treatment of professional tattoos in Asians. PMC, 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7447827/
- Bernstein EF et al. A novel dual-wavelength, Nd:YAG, picosecond-domain laser for safe and effective tattoo removal. J Cosmet Dermatol. 2015. Reference in PMC review: https://pmc.ncbi.nlm.nih.gov/articles/PMC4859414/
- FDA. Aesthetic Cosmetic Devices: https://www.fda.gov/medical-devices/products-and-medical-procedures/aesthetic-cosmetic-devices
