Doug Howard, MD
Dr. Howard is Advanced Laser Skin Clinic’s Medical Director and Advisor. He graduated from the University of Saskatchewan College of Medicine in 1991. Dr. Howard reviews all clinic protocols, approves product selection and works closely to ensure all safety procedures and standards are met. Dr. Howard actively participates in staff training with all new lasers, technology and techniques.
A message from Dr Howard
KNOW YOUR LASERS!
As Medical Director for ALSC (Advanced Laser Skin Clinic), I stand behind Mary's decision to exclusively use Cynosure lasers. They are the largest research/development laser manufacturer in the world, and since acquiring Palomar, are the leaders in the field.
Cynosure was the first to develop the Picosecond technology (prior to that, Q-switch was the standard for 50 years but is now falling out of favour for very specific reasons), the first to bring it to market in 2013, and the Picosure is widely considered the world's best available tattoo removal laser. Picosecond (one trillionth of a second) pulsing means the laser creates a photoacoustic (pressure wave), or pulsed shock wave effect on the tattoo pigments breaking it down into microscopic dust molecules, with very little thermal (heat) effect. Lower thermal energy used during treatment means less risk and side effects. PicoSure comes with a 755nm wavelength which is proven for green and blue inks (most predominant tattoo ink) and a 532 nm hand piece to optimize red, orange and yellow inks.
The Picosure also offers a focus hand piece which is ideal for skin rejuvenation, acne scar reduction and wrinkle re-surfacing (again using low thermal energy and high pressure photoacoustic pulse to prevent side effects and improve results). It has FDA clearance (and Canadian Health Canada approval) for these applications, the other Pico technologies DO NOT. PicoSure also has the most peer reviewed studies and support data to prove performance and safety as compared to all other tattoo technologies. It can achieve more than 90% removal of ink particles in as little as 4 treatments. No side effects, no recalcitrant tattoos or ghosting (residual white skin left after most other tattoo removal technologies have removed the ink) post treatment.
Newer "pico" laser imitations include the Picoway and the PiQo4.
The Picoway has a wavelength of 785nm which has significantly less absorption into blue and green ink as compared to the PicosSure 755nm (despite seemingly close in number, pigments respond in very narrow ranges) but more importantly it lacks the pico second pulsing which allows the Picosure to create a higher pressure wave (70% more than other Pico technologies) to help break up the ink without using heat. This means that the Picoway has to gain a result by using much more heat, therefore more side effects such as heat damage and hyper pigmentation.
The PiQo4 lacks the 755 nm wavelength to treat blues and greens as well. It also lacks the pressure pulse and relies more on heat to break up the ink, which means more chance of burning and blistering. It is less effective and has no validated studies to back it up.
Both Picoway and PiQo4 are 'copycat' technologies with very little research and performance data to back up performance. These systems took years to come to market due to difficulties achieving results and preventing side effects. Picoway only achieved a 50% clearance of tattoos in their FDA submission papers. As well, the competitive devices have no proof of skin type versatility as 26 of 27 subjects were skin type I-III with only one IV in their study. PicoSure can treat all skin types safely because of the pressure wave and very low heat usage. This is why the majority of tattoo removal clients choose PicoSure! It is the #1 sought after treatment in the world!
Bottom line: Make sure you understand the risks and disadvantages of other Pico technologies before you go anywhere else, and only compare apples to apples!
PicoSure is the #1 tattoo and skin rejuvenation device in Asia and North America. There is a reason for that!! PicoSure has 5X the 'searches' to any other tattoo technology in the world.
As a side note and as we have previously discussed the PicoWay has shown very poor clearance in their clinical studies and their published paper (Lead author Dr. Eric Bernstein) which showed only 79% clearance after an average of 6.5 treatments, which mirrors our Revlite. The RevLite has shown similar clearance in less treatments. As noted below you can see some key takeaways from their paper and presentation at ASLMS.
PicoWay averaged only 79% clearance after an average of 6.5 treatments1. But...
- Clearance similar to Q-Switched/Revlite platform which showed 75% clearance after only 4 Tx in 19932
- May require more than 7 Tx as 79% cleared PicoWay tattoos (mostly black) are still quite visible
- No proof of skin type versatility as 26 of 27 subjects were skin type I-III with only one IV
- Limited multicolor data; blue ink only present in 2 out of 31 tattoos, and blue/green ink showed poor clearance