Did Mokdong Pico Toning Not Work for You? The Papers Say It Should Be Done Like This

Did Mokdong pico toning not work for you?

The papers say it should be done like this

Mokdong pico toning

Hello. I’m Kim Jin-hyun, chief director at Yonsei? No, sorry, at YOU&I Clinic Mokdong Branch.

"I’ve had pico toning several times,

but honestly, I can’t tell what changed."

"My melasma got better, then came back up again.

Is that supposed to happen?"

If you tried pico toning but didn’t feel the results you expected, you probably felt disappointed.

Since it’s not a small expense, it’s only natural to wonder, "Is this really right?"

But the reason you felt it didn’t work may not have been a problem with the procedure itself; it may have been that the conditions you received were not appropriate.

Today, instead of reviews, I’ll summarize how pico toning should be done for it to be effective, based on paper data.

If you read for just 3 minutes, you’ll have a clear standard for judging your next treatment.

Table of Contents
1. Pico toning: why didn’t it work? 2. What the papers showed: the conditions for effective pico toning 3. To maintain the effects of pico toning, be sure to take care of this too

1. Pico toning: why didn’t it work?

Mokdong pico toning

The key variable that determines the effectiveness of pico toning is not "whether a picosecond laser was used," but "what energy settings and protocol were used."

Conventional nanosecond laser (Q-switched Nd:YAG)-based laser toning has also shown effectiveness in treating melasma, but limitations have been reported, such as post-procedure post-inflammatory hyperpigmentation and frequent recurrence.

A picosecond laser delivers energy in a much shorter pulse duration than a nanosecond laser, meaning on the order of 300 to 500 picoseconds.

To use an analogy, even if you strike with the same force, if the contact time is extremely short, the shock wave is transmitted more precisely.

PicoAlex device

The advantage of picosecond lasers is that, at the same fluence, they create stronger melanin fragmentation than nanosecond lasers while causing less thermal damage to surrounding tissue.

However, if the energy is too high, it can instead stimulate melanocytes and cause post-procedure hyperpigmentation; on the other hand, if it is too low, melanin fragmentation may not be sufficient, making it difficult to feel the effect.

In addition, if the number of treatment sessions is insufficient, it means stopping before the melanin has been adequately removed.

So what protocol has actually been proven effective? Let’s look at the paper data.

2. What the papers showed:

Conditions for effective pico toning

Mokdong pico toning

Effectiveness of the Pico-toning Technique for the Treatment

of Melasma with a Low Fluence 1,064-nm Nd:YAG Laser in

Asian Patients

I’ll summarize the content of a paper published in the journal Medical Lasers in 2020.

This study analyzed the effectiveness of pico toning using a picosecond 1,064 nm Nd:YAG laser in 23 Asian women diagnosed with melasma at Soonchunhyang University Bucheon Hospital (mean age 51.1 years).

The key feature of the protocol used in the study was "low intensity."

Specifically, the wavelength was 1,064 nm, spot size 7 to 10 mm, fluence 0.5 to 0.8 J/cm², frequency 10 Hz, and up to 3 passes, with an average of 5 sessions per patient.

Rather than delivering a strong beam at once, the strategy of this protocol was to gradually fragment melanin by repeating low-energy passes multiple times while minimizing damage to surrounding tissue.

Fig. 3. Comparison before treatment and 2 months after the final treatment

(Top) before treatment (Bottom) after treatment

Looking at the results, the mean mMASI score, which indicates melasma severity before treatment, was 5.1, and it decreased significantly to 2.6 two months after the final treatment.

That is almost a 50% improvement.

Patient satisfaction averaged 3.8 out of 5, with "satisfied" being the most common response, and a strong correlation was also confirmed: the greater the decrease in mMASI score, the higher the patient satisfaction.

In addition, among the 23 patients, there was only 1 case of erythema and 1 case of edema, and there were no cases at all of the most concerning side effects, post-inflammatory hyperpigmentation or hypopigmentation.

The conclusion of the paper is clear: using low intensity improved safety, and as a result, better outcomes were achieved with fewer side effects.

This study shows that pico toning is not a procedure to be done strongly in one session, but rather something that works best when repeated consistently with appropriate low energy.

3. To maintain the effects of pico toning,

be sure to take care of this too

Mokdong pico toning

Even if effectiveness has been confirmed in a paper, it is good to remember that melasma is closer to a condition that requires management than one that can be completely cured.

Because there are many aggravating factors such as ultraviolet exposure, hormonal changes, and genetic predisposition, even if the condition improves through treatment, it can recur if management is not maintained.

That is why sun protection is the most basic yet most important part of melasma management.

No matter how effective the procedure is, if sun protection is inadequate, melanin production can become active again.

The paper also cites a study showing that combining hydroquinone cream with a picosecond laser produced better results than hydroquinone alone,

so combining the procedure with topical treatment is also worth considering.

PicoCare Majesty device

And there is one more important point. In this paper, meaningful results were shown after an average of 5 treatment sessions.

If you had only 1 or 2 sessions and concluded that it "didn’t work," it may be that you stopped before completing enough sessions.

It is wise to discuss with your doctor, create a treatment plan suited to your skin condition, and then judge the results after completing a sufficient number of sessions.

So far, I’ve summarized effective protocols and management methods based on paper data for those who felt disappointed with Mokdong pico toning.

The key is to stay consistent with low intensity, and to also take care of sun protection and management after the procedure.

I hope this article was helpful for those considering pico toning, and I’ll end here.

Thank you for reading this long post. This was Kim Jin-hyun, chief director at YOU&I Clinic Mokdong Branch. ^^

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