{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:03:36Z","timestamp":1790053416548,"version":"4.0.1"},"reference-count":44,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Conventional ablative and photothermal lasers are commonly used to treat superficial pigmentary lesions but often induce thermal injury and post\u2010inflammatory hyperpigmentation (PIH), particularly in Asian skin. Picosecond 755\u2010nm alexandrite lasers with diffractive lens arrays (DLA) create laser\u2010induced optical breakdown (LIOB) through a non\u2010thermal photomechanical effect. However, the efficacy and adverse events of small\u2010spot, high\u2010fluence, ablation\u2010dominant LIOB remain poorly defined in Asian patients. Ablation\u2010dominant LIOB refers to high\u2010fluence LIOB in which photomechanical effects predominate and produce direct tissue disruption with minimal thermal injury. This study aimed to evaluate a 5\u2010mm high\u2010fluence LIOB approach in Asian patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective chart review was conducted on patients who received 5\u2010mm high\u2010fluence LIOB. Demographics, diagnoses, treatment parameters, and serial photographs were collected. Clinical outcomes were independently assessed by two dermatologists using the Global Aesthetic Improvement Scale (GAIS) and pigmentation clearance rate (PCR). Treatments were delivered with a 5\u2010mm 755\u2010nm picosecond laser at 1.3\u20131.5\u2009J\/cm\n                      <jats:sup>2<\/jats:sup>\n                      and 750\u2009ps. All adverse events were documented.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010three patients met the inclusion criteria. Superficial pigmentary lesions associated with photoaging or melasma were the most common indications. A mean of 1.45 treatment sessions had been completed by the efficacy evaluation day, with a mean follow\u2010up of 66 days. The mean GAIS score was 3.67, and the mean PCR was 68.25%, with 80.65% of pigmentary lesions achieving good\u2010to\u2010excellent clearance. Non\u2010pigmentary conditions demonstrated limited clinical responses. In selected complex photoaging cases, adjunctive large\u2010spot (8\u2010mm) low\u2010fluence treatment was used before primary 5\u2010mm LIOB\u2010based ablation, with a mean GAIS score of 3.59. One patient developed a mild allergic reaction; no cases of scarring or PIH were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A high\u2010fluence, 5\u2010mm small\u2010spot picosecond LIOB treatment protocol suggests a favorable safety and efficacy profile for superficial skin ablation in pigmentary and photoaging\u2010related lesions in Asian patients, with minimal adverse effects. Pigmentary lesions showed more favorable responses than non\u2010pigmentary lesions. Selected complex photoaging cases treated with adjunctive large\u2010spot therapy showed favorable clinical improvement, supporting further investigation of this combined approach. This technique may broaden the role of picosecond lasers from pigment clearance to overall skin rejuvenation. Prospective controlled studies are warranted to confirm these preliminary findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lsm.70205","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T12:50:36Z","timestamp":1788958236000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Small\u2010Spot 755\u2009nm Picosecond Laser\u2010Induced Optical Breakdown for Novel Photomechanical Skin Ablation in Asian Patients"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9450-7025","authenticated-orcid":false,"given":"Nai\u2010Wen","family":"Chai","sequence":"first","affiliation":[{"name":"School of Medicine, College of Medicine China Medical University Taichung 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