Abstract
Picosecond lasers are a new commercial development in cutaneous laser surgery. While the importance of short picosecond laser pulses for the treatment of tattoos has long been known, the development of picosecond lasers has only recently been commercially viable. The picosecond lasers are able to photomechanically fragment tattoo ink particles more effectively than traditional Q-switched lasers. Similarly, pigmented lesions can be effectively treated with picosecond technology. New handpieces are able to fractionate and focus the picosecond laser pulse to cause light-induced optical breakdown in the dermis. The nonthermal dermal injury stimulates collagen production benefitting those with cutaneous scarring and photoaging. As newer systems are developed with multiple picosecond wavelengths, the clinical indications for their use will continue to expand.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance
Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science. 1983;220:524–7.
Altshuler GB, Anderson RR, Manstein D, et al. Extended theory of selective photothermolysis. Lasers Surg Med. 2001;29:416–32.
Kilmer SL, Lee MS, Grevelink JM, Flotte TJ, Anderson RR. The Q-switched Nd:YAG laser effectively treats tattoos. A controlled, dose-response study. Arch Dermatol. 1993;129:971–8.
Alster TS. Q-switched alexandrite laser treatment (755nm) of professional and amateur tattoos. J Am Acad Dermatol. 1995;33:69–73.
Leuenberger ML, Mulas MW, Hata TR, Goldman MP, Fitzpatrick RE, Grevelink JM. Comparison of the Q-switched alexandrite, Nd:YAG, and ruby lasers in treating blue-black tattoos. Dermatol Surg. 1999;25:10–4.
Kluger N, Koljonen V. The surgeon, the tattoo and the black lymph node. J Plast Reconstr Aesthet Surg. 2013;66:561–2.
Hogsberg T, Loeschner K, Loft D, Serup J. Tattoo inks in general usage contain nanoparticles. Br J Dermatol. 2011;165:1210–8.
Green JB, Metelitsa AI. Optimising outcomes of laser tattoo removal. Skin Ther Lett. 2011;16:1–3.
Jow T, Brown A, Goldberg DJ. Patient compliance as a major determinant of laser tattoo removal success rates: a 10-year retrospective study. J Cosmet Laser Ther. 2010;12:166–9.
Ho DD, London R, Zimmerman GB, Young DA. Laser-tattoo removal-a study of the mechanism and the optimal treatment strategy via computer simulations. Lasers Surg Med. 2002;30:389–97. Computer stimulation study that describes the importance of picosecond pulse durations in creating photomechanical effect.
Ross V, Naseef G, Lin G, et al. Comparison of responses of tattoos to picosecond and nanosecond Q-switched neodymium:YAG lasers. Arch Dermatol. 1998;134:167–71. First demonstrated the superiority of picosecond pulse durations.
Herd RM, Alora MB, Smoller B, Arndt KA, Dover JS. A clinical and histologic prospective controlled comparative study of the picosecond titanium:sapphire (795nm) laser versus the Q-switched alexandrite (752 nm) laser for removing tattoo pigment. J Am Acad Dermatol. 1999;40:603–6.
Izikson L, Farinelli W, Sakamoto F, Tannous Z, Anderson RR. Safety and effectiveness of black tattoo clearance in a pig model after a single treatment with a novel 758 nm 500 picosecond laser: a pilot study. Lasers Surg Med. 2010;42:640–6.
Ibrahimi OA, Sakamoto FH, Anderson RR. Picosecond laser pulses for tattoo removal: a good, old idea. JAMA Dermatol. 2013;149:241.
Brauer JA, Reddy KK, Anolik R, et al. Successful and rapid treatment of blue and green tattoo pigment with a novel picosecond laser. Arch Dermatol. 2012;148:820–3.
Saedi N, Metelitsa A, Petrell K, Arndt KA, Dover JS. Treatment of tattoos with a picosecond alexandrite laser: a prospective trial. Arch Dermatol. 2012;148:1360–3.
Au S, Liolios AM, Goldman MP. Analysis of incidence of bulla formation after tattoo treatment using the combination of the picosecond Alexandrite laser and fractionated CO2 ablation. Dermatol Surg. 2015;41:242–5.
Bernstein EF, Schomacker KT, Basilavecchio LD, et al. A novel dual-wavelength, Nd:YAG, picosecond-domain laser safely and effectively removes multicolor tattoos. Lasers Surg Med 2015 [epub ahead of print]
Alabdulrazzaq H, Brauer JA, Bae YS, Geronemus RG. Clearance of yellow tattoo ink with a novel 532-nm picosecond laser. Lasers Surg Med. 2015;47:285–8.
Anderson RR, Geronemus R, Kilmer SL, Farinelli W, Fitzpatrick RE. Cosmetic tattoo ink darkening. A complication of Q-switched and pulsed-laser treatment. Arch Dermatol. 1993;129:1010–4.
Bae YC, Alabdulrazzaq H, Brauer J, Geronemus R. Successful treatment of paradoxical darkening. Lasers Surg Med 2016. [Epub ahead of print]
Felton SJ, Al-Niami F, Ferguson JE, Madan V. Our perspective of the treatment of nevus of Ota with 1,064-, 755- and 532-nm wavelength lasers. Lasers Med Sci. 2014;29:1745–9.
Chesnut C, Diehl J, Lask G. Treatment of nevus of Ota with a picosecond 755-nm alexandrite laser. Dermatol Surg. 2015;41:508–10.
Chan JC, Shek SY, Kono T, et al. A retrospective analysis on the management of pigmented lesions using a picosecond 755-nm alexandrite laser in Asians. Lasers Surg Med. 2016;48:23–9.
Rodrigues M, Bekhor P. Treatment of minocycline-induced cutaneous pigmentation with the picosecond alexandrite (755-nm) laser. Dermatol Surg. 2015;41:1179–82.
Moore M, Mishra V, Friedman DP, Goldman MP. Minocycline-induced postsclerotherapy pigmentation successfully treated with a picosecond alexandrite laser. Dermatol Surg. 2016;42:133–4.
Habbema L, Verhagen R, Van Hal R, et al. Minimally invasive non-thermal laser technology using laser-induced optical breakdown for skin rejuvenation. J Biophotonics. 2012;5:194–9. Study that demonstrated the development of laser-induced optical breakdown with fractionated, focused picosecond pulses.
Brauer JA, Kazlouskaya V, Alabdulrazzaq H, Bae YS, Bernstein LJ, Anolik R, et al. Use of a picosecond pulse duration laser with specialized optic for treatment of facial acne scarring. JAMA Dermatol. 2015;151:278–84.
Wu DC, Fletcher L, Guiha I, Goldman MP. Evaluation of the safety and efficacy of the picosecond alexandrite laser with specialized lens array for treatment of the photoaging décolletage. Lasers Surg Med. 2016;48:188–92.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Dr. Terrence Keaney declares that he has no conflict of interest. Dr. Keaney reports personal fees from Syneron Candela, other from Cutera, personal fees and other from Invisible Ink, during the conduct of the study; personal fees and non-financial support from Allergan, personal fees and non-financial support from Skinceuticals/L’Oreal, personal fees from Restoration Robotics, outside the submitted work.
Dr. Alster reports non-financial support from Syneron Candela, during the conduct of the study; personal fees from Merz, stock from Home Skinovations, and personal fees from Galderma, outside the submitted work.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
This article is part of the Topical Collection on Laser Therapy
Rights and permissions
About this article
Cite this article
Keaney, T., Alster, T. Tattoos and Beyond: the Clinical Evolution of Picosecond Laser Technology. Curr Derm Rep 5, 217–221 (2016). https://doi.org/10.1007/s13671-016-0149-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13671-016-0149-2