Background: Melasma is one of the most common pigmentation disorders. The Picosecond Laser (PSL) has been positioned as a novel treatment for this pathology. Objectives: To evaluate the reduction pigmentation level obtained with LPS therapy in comparison with any other line of management for melasma treatment. Methodology: A search was performed in Pubmed, Cochrane Library, MEDLINE, EMBASE, LILACS, Epistemonikos, Ovid MEDLINE. The GRADE tool was considered to assess the strength of the body evidence recommendation. Results: Six studies were included (5 experiments and 1 quasi-experiment). The quality of the articles included was moderate to low. Variability of the studies was found in the LPS dosage, its comparators and measurement scales. Adverse events were generally mild and transient. Discussion: During 3 months of follow-up there is no evidence of disease recurrence unlike other energy devices such as the conventional or low-fluency Q-Switched laser. The assessment of the patient's quality of life is a fundamental pillar of integral management. Conclusions: With prudence, it could be said that there is a tendency to suggest superior efficacy of PSL to achieve depigmentation compared to other treatments when administered in combination with other therapies (Low to moderate quality of evidence).
