Given that the pigment particles in tattoos have a relaxation time of <10 ns, picosecond lasers would be expected to be more effective than nanosecond lasers in tattoo removal. To systematically review the evidence regarding the effectiveness and safety of picosecond lasers for tattoo removal, Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and reference lists were searched for relevant trials. The primary outcome was >70 % clearance of tattoo pigment. Secondary outcomes were 90–100 % clearance of tattoo pigment, number of laser sessions required, and adverse effects. Eight trials were included, six with human participants (160 participants) and 2 with animal models. Seven of the eight trials explored the usage of either 755, 758, 795, 1064, or 1064/532-nm picosecond lasers for black and blue ink tattoos. In the human trials, 69–100 % of tattoos showed over 70 % clearance of pigment after 1–10 laser treatments. Reported side effects included pain, hyperpigmentation and hypopigmentation, blister formation and transient erythema, edema, and pinpoint bleeding. Included articles varied in type of laser investigated, mostly non-comparative studies and with a medium to high risk of bias. There is sparse evidence that picosecond lasers are more effective than their nanosecond counterparts for mainly black and blue ink tattoo removal, with minor side effects.
This is a preview of subscription content, log in to check access
The review protocol was registered on the PROSPERO international prospective register of systematic reviews (CRD42015023458).
The authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
Institutional review board approval was not required.
Goldman L, Wilson RG, Hornby P, Meyer RG (1965) Radiation from a Q-switched ruby laser. Effect of repeated impacts of power output of 10 megawatts on a tattoo of man. J Invest Dermatol 44:69–71CrossRefPubMedGoogle Scholar
Ho DD-M, London R, Zimmerman GB, Young DA (2002) Laser-tattoo removal—a study of the mechanism and the optimal treatment strategy via computer simulations. Lasers Surg Med 30:389–397. doi:10.1002/lsm.10065CrossRefPubMedGoogle Scholar
PRISMA 2009 Flow Diagram. From Moher D, Liberati A, Tetzlaff J, Altman DG. The PRSIMA Group (2009) Preferred Reporting Items for Systematic Reviews and Meta-analyses: The PRISMA STATEMENT, PLoS Med 6(6): e10000097. (2009)Google Scholar
Herd RM, Alora MB, Smoller B, Arndt KA, Dover JS (1999) A clinical and histologic prospective controlled comparative study of the picosecond titanium:sapphire (795 nm) laser versus the Q-switched alexandrite (752 nm) laser for removing tattoo pigment. J Am Acad Dermatol 40:603–606. doi:10.1016/S0190-9622(99)70444-5CrossRefPubMedGoogle Scholar
Izikson L, Farinelli W, Sakamoto F, Tannous Z, Anderson RR (2010) Safety and effectiveness of black tattoo clearance in a pig model after a single treatment with a novel 758nm 500 picosecond laser: a pilot study. Lasers Surg Med 42:640–646. doi:10.1002/lsm.20942CrossRefPubMedGoogle Scholar
Brauer JA, Reddy KK, Anolik R, Weiss ET, Karen JK, Hale EK, Brightman LA, Bernstein L, Geronemus RG (2012) Successful and rapid treatment of blue and green tattoo pigment with a novel picosecond laser. Arch Dermatol 148:820–823. doi:10.1001/archdermatol.2012.901CrossRefPubMedGoogle Scholar
Ferguson JE, August PJ (1996) Evaluation of the Nd/YAG laser for treatment of amateur and professional tattoos. Br J Dermatol 135:586–591CrossRefPubMedGoogle Scholar
Mankowska A, Kasprzak W, Adamski Z (2015) Long-term evaluation of ink clearance in tattoos with different color intensity using the 1064-nm Q-switched Nd :YAG laser. J Cosmet Dermatol. doi:10.1111/jocd.12162PubMedGoogle Scholar