Picosecond Lasers for Common Benign Pigmentary Disorders in Asian Skin: A Systematic Narrative Review

Picosecond (PS) lasers represent a major advancement in dermatologic laser technology, providing highly efficient clearance of various benign pigmentary disorders (BPDs) primarily through photomechanical disruption of melanin granules and laser-induced optical breakdown (LIOB). These mechanisms enable finer pigment fragmentation and accelerated macrophage-mediated clearance while markedly reducing collateral thermal injury compared with conventional nanosecond systems. Asian skin, accounting for approximately 59.7% of the global population, exhibits distinctive melanogenic instability that predisposes individuals to a wide spectrum of BPDs associated with significant cosmetic and psychosocial burden. Traditional quality-switched (QS) lasers achieve reasonable efficacy but carry elevated risks of post-inflammatory hyperpigmentation (PIH), hypopigmentation, burns, and textural changes in this phototype, often necessitating conservative parameters that compromise outcomes. PS lasers overcome these limitations by utilizing lower fluences and ultra-short pulse durations, conferring a favorable “less irritation, more efficacy” (LIME) profile ideally suited to Asian patients. This narrative review summarizes current evidence on PS laser applications for common Asian BPDs, incorporating verified studies published between 2020 and 2026 on novel wavelengths, optimized protocols, and comparative clinical outcomes.