Efficacy of PicoSure Laser in Treating Lichen Planus Pigmentosus and Pigmentary Demarcation Lines in Patients With Skin of Color

Background Lichen Planus Pigmentosus (LPP) and Pigmentary Demarcation Lines (PDL) are common pigmentary disorders among individuals with skin of color (SoC), presenting challenges for treatment due to risks of side effects, such as post‐inflammatory hyperpigmentation (PIH). PicoSure laser, a 755‐nm picosecond laser, has shown promise in treating pigmentary conditions with minimal adverse effects. Aims To evaluate the safety and efficacy of PicoSure laser treatment in patients with LPP and PDL, focusing on pigmentation reduction, patient satisfaction, and adverse effects. Patients/Methods A prospective case series was conducted over 16 weeks, involving 10 patients (5 LPP, 5 PDL) with Fitzpatrick skin types III–V. Patients underwent PicoSure laser treatment using a 755‐nm wavelength, with assessments based on pigmentation reduction, patient satisfaction (via a visual analogue scale), and adverse effects. Results All patients demonstrated significant improvement in pigmentation. In LPP cases, 4 patients achieved > 90% improvement (Grade V), while 1 patient showed > 75% (Grade IV) improvement. PDL patients had > 75% (Grade IV) improvement in the majority of the cases. No significant adverse effects were reported, with minimal PIH observed. High patient satisfaction was reported across all cases. Conclusions PicoSure laser offers a safe and effective treatment for LPP and PDL in patients with skin of color, providing significant pigmentation reduction with minimal risk of PIH. It serves as a promising treatment alternative to traditional lasers, with potential for broader application in this demographic. Further studies with larger sample sizes are warranted to confirm long‐term efficacy.