Many of our patients here at Marmur Medical visit us to remove moles, hyperpigmentation, birthmarks, sun damage, tattoos, and similar skin conditions. Our experts often suggest using the Q-Switched ND YAG laser or the PiQo4 laser, which are innovative technologies that can significantly lighten pigmented lesions and tattoos.
Celebrity dermatologist and dermatologic surgeon Dr. Ellen Marmur specifically chose these two lasers because of their reputation for safety, versatility, and extraordinary results. Marmur Medical is committed to serving our patients with world-class dermatology care. Our primary goal is to make you happy and comfortable in your own skin!
Learn about the many benefits of the PiQo4 and Q-Switched ND YAG lasers in New York City by reading on. You can also contact Marmur Medical’s elite team of dermatology experts by calling 212-996- 6900 or contacting us online today.
The Q-Switched ND YAG laser works by targeting concentrated areas of pigmentation and different color tattoo inks in the skin. The laser utilizes two energy frequencies: 1064 nanometers to target deeper skin layers, and 532 nanometers to address pigment in the more superficial layers. Due to its versatility, the Q-Switched Nd YAG laser can be used to treat a variety of concerns.
There are several uses for this laser that we frequently recommend for our patients in New York City. Q-Switched ND YAG Laser works tremendously in treating pigment-related conditions such as age spots, freckles, moles, and birthmarks. The laser is also an exceptional platform for laser tattoo removal. It can provide dramatic lightening of most tattoo colors but tends to be most effective on darker inks. It can also work wonders on dark circles under the eyes and poikiloderma, or areas of mottled discoloration from chronic sun damage. We also remove undesirable eyebrow makeup from microblading, and other makeup like eyeliner and lipliner.
When administered by Marmur Medical’s industry-renowned experts, the Q-Switched ND YAG laser should be considered very safe. We go to great lengths to extensively train our team and ensure they demonstrate mastery of laser devices. Our team can administer the latest treatment techniques effectively and safely.
To begin your treatment, we will numb the area with a topical or local anesthetic to make your treatment as comfortable as possible. We will also provide protective eyewear for you.
Next, your doctor or PA will calibrate specific settings and treat your skin with precise energy bursts to break down the pigment. You may feel some slight discomfort during this stage, as the laser will cause micro-damage in the skin. However, most patients handle this procedure very well, and our providers work diligently to ensure maximum comfort.
We typically recommend that our patients schedule multiple treatment sessions to achieve the best results. The number of sessions primarily depends on the treatment area’s size and the specific issues you are looking to address. Dr. Marmur generally recommends between one and five sessions; sometimes one session is enough for freckles but often you might require at least 3 sessions for larger spots. Tattoos are made from different inks that have different longevity and are unpredictable when estimating how many treatments will be necessary. Dr. Marmur usually finds it takes between three and five sessions spaced at 6 week intervals to see a significant fading of the tattoo inks.
Results with the Q-Switched ND YAG Laser are generally long-lasting, as long as patients closely adhere to all of our recommended aftercare instructions.
PiQo4 is an ultrafast pulsed pigmentation treatment that’s effective on all skin types with varying parameters Its unique technology offers four wavelengths in order to treat the broadest range of pigment/tattoo colors on the broadest range of skin types. These four wavelengths – 1064nm, 532nm, 650nm, and 585nm – target 9 of the most frequently used tattoo colors ranging from light orange to dark black.
PiQo4 addresses discoloration and pigmentation on the neck, face, arms, chest, hands, and back but can be used on all non hair bearing skin. By using high-energy light beams, it can improve several skin issues, including post-inflammatory hyperpigmentation, melasma, sun damage, and tattoos. PiQo4 laser treatments address a wide range of pigment shades with high energy and fast results. It may come as a surprise but the PiQo4 fractional laser also improves wrinkles.
One of PiQo4’s most significant benefits is that we can use it safely on almost all skin tones. Many laser treatments are unsafe for treating darker skin tones or removing skin pigment. PiQo4 is considered to be relatively safe for all patients and can significantly improve all skin tones due to the safety benefit of the ultrafast pulse width that can treat super-specific pigment particles with less collateral damage to normally pigmented skin. Dr. Marmur recommends meticulous sun protection and skincare before and after laser treatments.
The PiQo4 laser focuses its energy quickly and precisely on the areas of concern, immediately microscopically shattering the pigment with minimal heat generated. This gives the PiQo4 laser an advantage over other lasers and devices where bulk heating of surrounding tissues can cause increased tissue injury, patient downtime, or even the worsening of pigmentation, especially on darker skin. Additionally, the spot size is entirely adjustable to treat small and large areas, and treatments are typically associated with minimal downtime.
While patients may find the treatment to be mildly uncomfortable, most find it tolerable, especially as sessions are short. Patients more sensitive to pain can choose a numbing gel, or cold air can be used to make the treatments more comfortable. After treatment, meticulous skincare with MMSkincare Revive and Repose serums and masks and the green MMSphere LED light is clinically proven to successfully optimize results.
We may recommend either one or a series of scheduled treatments to gain the best results, depending on your issues. Like the Q-Switched Nd YAG laser, the number of sessions depends on the size of the treatment area and your unique concerns.
Results should be enduring with proper care.
The piQo4 laser focuses its energy quickly and precisely on the areas of concern, immediately shattering the pigment with minimal heat generated. This gives the piQo4 laser an advantage over other lasers and devices where bulk heating of surrounding tissues can cause increased tissue injury, patient downtime, or even the worsening of pigmentation, especially on darker skin. Additionally, the spot size is entirely adjustable to treat small and large areas, and treatments are typically associated with minimal downtime.
While patients may find the treatment to be mildly uncomfortable, most find it tolerable, especially as sessions are short. Patients more sensitive to pain can choose a numbing gel, or cold air can be used to make the treatments more comfortable. During your initial consultation, Dr. Marmur and the Marmur Medical team will review what you can expect post-treatment. Please see the post-procedure care guide below.
Post-procedure care:
Marmur Medical’s state-of-the-art dermatology practice is home to many of the industry’s leading laser treatments, including Clear + Brillant | Fraxel DUAL | HALO, Laser Peels | Deep Laser Resurfacing, IntraCel | ClearScan YAG, and more. The best way to see which method is right for you is to schedule a consultation with the Marmur Medical team.
Our MMSkincare Post-Laser Revive Bundle has been created for your ongoing post-treatment skincare.
The Marmur Medical team is excited to share these two state-of-the-art laser treatments with our current and prospective New York City dermatology patients. If you would like to learn more, we invite you to visit us in one of our New York City offices for an in-depth consultation to evaluate your concerns. We are committed to providing world-class dermatology care and services.
We invite you to visit us in one of New York City’s best dermatology facilities. To get started, call us at 212-996-6900 or contact us online to schedule your NYC today!
PiQo4 and Q-Switched NDYAG lasers are powerful tools offered by Marmur Medical in New York for addressing a wide range of pigment-related skin issues. These treatments are applied to lighten age spots, freckles, sun damage, and birthmarks. They are also used for tattoo removal (especially darker inks), for unwanted pigment from microblading or permanent makeup like eyeliner or lip liner, and for treating mottled discoloration or poikiloderma (uneven color and texture due to long-term sun exposure).
Both lasers work by delivering energy pulses that break down pigmentation or tattoo ink particles in the skin. The Q-Switched ND YAG laser uses bursts at two specific wavelengths—1064 nm for deeper pigment layers and 532 nm for more superficial pigment. When the laser energy is absorbed by pigment or ink particles, it causes them to shatter, after which the body’s immune system gradually clears away those fragments. PiQo4 builds on that by offering four wavelengths for broader spectrum treatment. Together, those wavelengths target multiple pigment and ink colors while allowing precision tuning for different skin tones. Its ultrafast, short pulses help limit heat damage to surrounding skin, which improves safety and reduces downtime. Both devices require multiple sessions for full fading or removal because pigment may be present at different depths, and tattoo inks vary in how well they respond to treatment.
Good candidates are individuals who have clearly visible pigment concerns — such as sunspots, birthmarks, tattoos, freckles, or those with uneven skin tone, melasma, or dark circles under the eyes. Because PiQo4 is safer for a spectrum of skin types, people with darker skin tones may also have viable treatment options. Patients should have realistic expectations and understand that pigment removal can be significant, but full erasure may not always happen, especially with deeply infiltrated ink, stubborn pigment, or repeated sun exposure. The best candidates are in good general skin health and follow pre- and post-treatment care.
To begin, the treatment area is cleaned and often numbed with a topical or local anesthetic to maximize comfort. Protective eyewear is provided because laser light can damage the eyes. The provider sets the device to the wavelength appropriate for your pigment or ink type, then delivers energy pulses in small bursts. You may feel a snapping sensation or heat in treated spots—many describe it as like tiny rubber-band snaps or mild pinpricks. For darker inks or more resistant pigments, higher energy or repeated pulses may be needed. After treatment, the skin may be red, slightly swollen, with possible mild crusting or microscopic blistering, depending on the aggressiveness of treatment. In most cases, discomfort is mild and tolerable, and many patients are comfortable with over-the-counter pain relief or simple soothing creams. Sessions can vary depending on the size of the treatment area, number of ink colors, or depth of pigment.
At Marmur Medical, the number of sessions depends primarily on the issue being treated. For freckles or superficial pigmentation, sometimes one session can produce noticeable change. More often, 3-5 sessions scheduled about 6 weeks apart are needed to experience significant fading of tougher pigment or dark tattoos. Tattoo removal in particular demands multiple treatments because different inks and depths respond variably — black inks often respond fastest, while colored inks (i.e., greens, blues, yellows) may take more sessions. The PiQo4 device, because of its multiple wavelengths, may reduce the number of sessions needed compared to using a single-wavelength device for complex or multicolor tattoos.
When treatment is successful, results are often very long lasting. Pigmentation lightening or ink fading tends to endure if skin is protected from repeated damage. That means utilizing good sun protection, avoiding tanning beds, and following a strict skincare regimen. Without UV protection, new pigments can appear, or old pigments may intensify again.
PiQo4 and Q-Switched ND YAG lasers are considered safe when used by expert providers. At Marmur Medical, our team is highly trained and uses precise settings to minimize risk. Common side effects may include temporary redness, swelling, mild irritation, and light flaking or crusting where pigment has been destroyed. In individuals with dark skin tones, there’s a higher risk of temporary hyperpigmentation (darkening of the skin) or hypopigmentation (light spots) if settings are too aggressive or aftercare is not followed. Rare risks can include blistering, infection, or scarring, though these are uncommon. Pain management and pre-treatment evaluation are part of our safety considerations. Additionally, patients with recent sun exposure, active skin infections, or certain skin conditions may be advised to wait or choose an alternative treatment.
There are many options for treating pigmentation — chemical peels, IPL (intense pulsed light), fractional lasers, dermabrasion — but each has pros and cons. PiQo4’s advantage is its ability to use multiple wavelengths, making it effective in treating a broader variety of pigment colors and depths. The precision of the Q-Switched ND YAG laser offers strong results for deep pigment and darker inks and skin types compared to IPL, which works best on broad superficial pigment (red or brown) and may carry risks for damage with treatment of deeper pigments. Additionally, the PiQo4 and Q-Switched ND YAG lasers tend to result in less recovery time than other, more aggressive resurfacing treatments.
Before treatment, avoid intense sun exposure, stop using any harsh skin-irritating products, and follow any instructions about skin care or topical agents. Make sure skin is healthy, well-hydrated, and free from active breakouts or sores. After treatment, it’s essential to moisturize frequently, use gentle cleansers, and avoid exfoliants, retinoids, or harsh products for at least a week. During this time, it’s also critical to protect skin from UV rays with broad-spectrum sunscreen, apply soothing serums and healing masks when necessary, and follow the usage of our post-laser care products. Avoid picking at any crust or flaking skin to help prevent scarring and pigment irregularity. Keeping the area clean and following the provider’s instructions helps accelerate healing and maintain pigment clearance.
