Evaluation of the Efficacy and Safety of PiQo4 System for the Treatment of Pigmented Lesions

Inclusion Criteria:

1. Healthy Female or Male

2. Age= 21-70 (Adults)

3. Fitzpatrick skin phototype = I-V

4. Congenital or acquired benign pigmentation on face with optional pigmentation on hand.

5. Presence of at least 4 lesions of similar pigmentation intensity in the treatment
area, in diameters larger than 2 mm

6. Able to read, understand and provide written Informed Consent

7. Able and willing to comply with the treatment/follow-up schedule and requirements

8. Women of child-bearing potential are required to use a reliable method of birth
control (such as an intrauterine device, birth control pills, condom with spermicidal,
NuvaRing, partner with vasectomy, Implanon or other FDA-approved devices, or
abstinence) during the course of the study

9. Willing to have digital photographs taken of the treatment area

10. Willing to refrain from using any prescription or over the counter topical creams used
for the treatment of pigmentation (e.g., hydroquinone, retinoids, and/or
corticosteroids) in the treatment area during the study period.

11. Willing to protect from sun exposure and use an approved sunscreen of SPF 30 or higher
in the treatment area daily during the entire duration of the study, including the
follow-up period.

12. Agree not to undergo any other procedure(s) for the treatment of pigmentation or solar
lentigines during the study.

Exclusion Criteria:

1. History of post inflammatory pigmentary disorders, particularly a tendency for hyper-
or hypo-pigmentation

2. Melasma

3. Excessive underlying vascular conditions (e.g. dense network of capillaries)

4. Pregnant, intending to become pregnant during the course of study, less than 3 months
postpartum or less than 3 months after completion of breastfeeding

5. Prior skin laser, light, or other energy device treatment in treated area within 6
months of initial treatment or during the course of the study

6. Prior ablative resurfacing procedure or face-lift in treated area with laser or other
devices within 12 months of initial treatment or during the course of the study

7. Prior treatment with medium-depth or deeper chemical peels or dermabrasion in treated
area within 3 months of initial treatment or during the course of the study

8. Prior use of any prescription or over the counter topical creams used for the
treatment of pigmentation (e.g., hydroquinone, retinoids, and/or corticosteroids) in
the treatment area within 3 months of initial treatment or during the course of the
study

9. Any other surgery in treated area within 9 months of initial treatment or during the
course of the study

10. Hypersensitive to light exposure or the use of photosensitive medication for which
light exposure is contraindicated

11. Multiple dysplastic nevi in area to be treated

12. Significant concurrent illness (e.g. uncontrolled diabetes) or any disease state that
in the opinion of the Investigator would interfere with the treatment or healing
process

13. Any dermal/epidermal damage or disorder, mainly vascular or textural lesions, in the
treatment area.

14. Any underlying tattoo in the treatment area.

15. Unable or unlikely to refrain from tanning, including the use of tanning booths,
during the course of the study

16. Participation in a study of another investigational device or drug involving the same
anatomical site within 3 months prior to enrollment or during this evaluation, or if
not involving the same anatomical site, as per the Investigator's discretion

17. History of keloid or any other type of hypertrophic scar formation or poor wound
healing

18. Signs and symptoms of hormonal disorders such as Melasma, as per the Investigator's
discretion.

19. Concurrent inflammatory skin conditions, open laceration, or abrasion of any sort on
area to be treated during the course of treatment

20. Active Herpes Simplex (perioral or facial) at the time of treatment or having
experienced more than three episodes of Herpes Simplex eruption within a year of study
enrollment

21. Having a bleeding disorder or taking anticoagulation medications, including daily use
of aspirin, in a manner which does not allow for a minimum 10 day washout period prior
to treatment (as per the discretion of the subject's primary care physician)

22. History of immunosuppression/immune deficiency disorders (including HIV infection or
AIDS) or the use of immunosuppressive medications

23. Having any form of active cancer at the time of enrollment and during the course of
the study or history of skin cancer on the face/hands

24. Pigmented lesions in the areas to be treated that are suspicious for pre-malignancy or
malignancy and/or are not deemed suitable for phototherapy, as per the Investigator's
discretion

25. Unable to understand or provide written Informed Consent (e.g. mental incompetence or
evidence of active substance abuse)

26. Any condition that, in the Investigator's opinion, would make it unsafe (for the
subject or for the study personnel) to treat the subject as part of this research
study

27. If undergoing punch biopsy, allergic to lidocaine or epinephrine