Why We Took Five Years Before Introducing Laser Technology at IVONNE®

Bringing laser technology into IVONNE® wasn't a decision driven by marketing claims or the urge to be early adopters.

Long before we added it to our treatment menu, we were already seeing a clear and growing demand from clients seeking pigmentation removal and targeted skin treatments. The need was obvious. What wasn't obvious was which platform actually delivered consistent, reliable results across real skin types in real-world conditions.

So we took a research-first approach—and we took our time.

A five-year clinical observation period

For five years, we studied the market while continuing to encourage clients to explore laser treatments at other clinics using a range of systems and technologies.

The goal was never to influence their decision. It was to learn.

We wanted to understand:

• How different devices performed across diverse skin types
• What downtime actually looked like outside of marketing materials
• How pigmentation responded not just immediately, but weeks and months after treatment

As those clients returned and shared their experiences, a pattern began to emerge—consistent feedback across different platforms, skin tones, and treatment protocols.

That five-year body of real-world observation ultimately became the foundation for our decision-making process.

Why we selected PicoWay®

Those insights led us to select the PicoWay® picosecond laser platform—not because it was new or popular, but because the clinical evidence and client-reported experiences aligned with what we were consistently observing.

The broadest FDA-cleared indication set of any picosecond laser

PicoWay® holds FDA 510(k) clearances across more indications than any competing picosecond platform, including tattoo removal across all ink colours and all Fitzpatrick skin types at 1064nm, benign pigmented lesions, acne scars, wrinkles, melasma, lentigines, café au lait macules, and Nevus of Ota (K220853, October 2022). It also holds Health Canada License 94931.

Four wavelengths—and why that matters

Most picosecond platforms offer two or three wavelengths. PicoWay® delivers four:

This matters because different pigments and chromophores absorb light at different wavelengths. A platform limited to two wavelengths cannot selectively target the full spectrum of tattoo inks or treat both superficial and deep pigmentation in the same session. Four wavelengths means fewer compromises and more precise energy delivery.

Photoacoustic dominance over photothermal platforms

PicoWay® delivers pulse durations between 300 and 450 picoseconds. At these pulse widths, the Acoustic to Thermal Pressure (ATP) index exceeds 1, meaning the mechanism is photoacoustic-dominant—shattering pigment into finer particles rather than relying on heat. Longer-pulse picosecond devices operating at 550–750ps fall below this threshold and are photothermal-dominant, which increases the risk of collateral thermal damage, blistering, and post-inflammatory hyperpigmentation.

What the clinical evidence shows

Melasma

A 2023 randomized controlled trial published in Frontiers in Medicine (Liang et al.) compared PicoWay® 1064nm against PicoSure 755nm and 2% hydroquinone cream in 59 patients with Fitzpatrick III–IV melasma. PicoWay® achieved the greatest MASI score reduction, outperforming both PicoSure (p=0.016) and hydroquinone (p=0.018). PicoSure showed results comparable to hydroquinone alone.

Wong et al. (2021, Lasers in Surgery and Medicine) treated 20 patients—17 of whom were Fitzpatrick IV—with 9 sessions of Resolve 1064nm. mMASI scores dropped from 10.8 at baseline to 2.7 at 6 weeks. Zero cases of hypo- or hyperpigmentation. 90% of subjects showed improvement on independent global assessment.

Tattoo removal

In a prospective comparison by Kono et al. (2020, Laser Therapy), picosecond pulses at 532nm and 1064nm were tested against nanosecond Q-switched pulses in 37 professional tattoos on Fitzpatrick III–IV skin:

• Picosecond 1064nm was significantly superior for black ink
• Picosecond 532nm was significantly superior for red and green ink
• Texture change: 0% in both picosecond groups versus 5.4–8.1% in the nanosecond groups
• Zero scarring across all arms

Nguyen et al. (2021, Lasers in Surgery and Medicine) treated 52 decorative tattoos across 30 patients with dual-wavelength PicoWay®. 88.5% of tattoos exhibited a good response, with 44.2% achieving very good or complete clearance. No hyperpigmentation, scarring, or keloids were observed.

Acne scars

Bernstein et al. (2017, Lasers in Surgery and Medicine) conducted a prospective, blinded evaluation of 27 subjects (Fitzpatrick II–V) treated with PicoWay® Resolve over 4 monthly sessions. Acne scar scores improved significantly (p<0.001), with 81% of subjects showing improvement and 85% reporting satisfaction. Zero pigmentary changes at 12-week follow-up.

A split-face RCT by Shi et al. (2021, Annals of Translational Medicine) compared PicoWay® Resolve against non-ablative fractional laser in 22 Fitzpatrick IV patients. PicoWay® significantly reduced scar height (p=0.041) while the fractional laser did not (p=0.785). No blistering, pigmentation alteration, or scarring on the PicoWay® side.

Benign pigmented lesions

The 730nm wavelength—unique to PicoWay®—has shown particular strength for deeper pigmented lesions. A 2024 split-face RCT by Chen et al. (Journal of Cosmetic Dermatology) found 730nm significantly more effective than 1064nm for ABNOM (Hori's Nevus) at 24 weeks (p=0.027). Fernandez (2024, Lasers in Surgery and Medicine) reported greater than 75% clearance of café au lait macules across all Fitzpatrick types with no adverse pigmentary changes.

In a case series by Loh and Wu (2021, Lasers in Surgery and Medicine), a patient who had failed both PicoSure 755nm and PicoWay® 1064nm for Nevus of Ota achieved near-complete resolution after switching to PicoWay® 785nm—demonstrating why multiple wavelength options matter in clinical practice.

The systematic review

A 2021 systematic review by Wu, Goldman, Wat, and Chan published in Lasers in Surgery and Medicine evaluated 77 studies across all picosecond laser indications and established Level I evidence for tattoo removal and Level II evidence for melasma, photoaging, and scar revision.

Safety in skin of colour

For a clinic in Ottawa serving a diverse client base, safety across skin types was non-negotiable.

A 2019 expert panel of 15 international dermatologists published guidelines in Practical Dermatology reporting a post-inflammatory hyperpigmentation rate of 4.65% with picosecond laser treatment versus 25–47% with Q-switched nanosecond devices.

This is supported across multiple controlled studies:

• Wong et al. (2021) — 17 of 20 patients were Fitzpatrick IV. Zero hypo- or hyperpigmentation after 9 treatments.
• Bernstein et al. (2017) — 27 subjects including Fitzpatrick V. Zero pigmentary changes at 12-week follow-up.
• Shi et al. (2021) — 22 Fitzpatrick IV patients in a split-face RCT. No pigmentation alteration on the PicoWay® side.
• Feng et al. (2021) — 215 patients, Fitzpatrick II–IV. No pigmentation alteration.
• Kono et al. (2020) — PIH rate 21.6% with picosecond 1064nm versus 27.0% with nanosecond 1064nm; 24.3% versus 35.1% at 532nm.

What changed at the Candela ACE Symposium

Our learning didn't stop once the decision was made.

Attending the Candela ACE (Aesthetic Clinical Excellence) Symposium this past weekend further refined our approach—particularly in how we assess skin, apply clinical judgment, and use fluence more precisely to optimise outcomes.

Technology doesn't deliver outcomes—systems do

No device works in isolation. The studies above share a common thread: outcomes depend on the ecosystem around the technology.

• Strong supplier and clinical partnerships — access to ongoing training, clinical support, and peer networks
• Ongoing education and skill development — fluence calibration, skin assessment, and protocol refinement based on emerging evidence
• Exposure to how other clinicians are applying the same technology in real time — symposia like ACE exist precisely because device manuals are not sufficient

This is where we continue to focus at IVONNE®—not just on adopting technology, but on building the clinical intelligence around it to use it properly.