Lasers in Medical Science

, Volume 31, Issue 7, pp 1397–1405 | Cite as

Picosecond lasers for tattoo removal: a systematic review

  • Ofer ReiterEmail author
  • Lihi Atzmony
  • Lehavit Akerman
  • Assi Levi
  • Ruben Kershenovich
  • Moshe Lapidoth
  • Daniel Mimouni
Original Article


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),, 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.


Laser Laser treatment Tattoo Tattoo removal Nd-YAG 755 nm 758 nm 795 nm 1064 nm 532 nm 



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.


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Copyright information

© Springer-Verlag London 2016

Authors and Affiliations

  • Ofer Reiter
    • 1
    Email author
  • Lihi Atzmony
    • 1
  • Lehavit Akerman
    • 1
  • Assi Levi
    • 1
  • Ruben Kershenovich
    • 1
  • Moshe Lapidoth
    • 1
    • 2
  • Daniel Mimouni
    • 1
    • 2
  1. 1.Department of Dermatology, Rabin Medical CenterBeilinson CampusPetach TikvaIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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