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American Journal of Clinical Dermatology

, Volume 2, Issue 1, pp 21–25 | Cite as

Laser Removal of Tattoos

  • Marina Kuperman-Beade
  • Vicki J. Levine
  • Robin Ashinoff
Review Article

Abstract

Tattoos are placed for different reasons. A technique for tattoo removal which produces selective removal of each tattoo pigment, with minimal risk of scarring, is needed. Nonspecific methods have a high incidence of scarring, textural, and pigmentary alterations compared with the use of Q-switched lasers. With new advances in Q-switched laser technology, tattoo removal can be achieved with minimal risk of scarring and permanent pigmentary alteration.

There are five types of tattoos: amateur, professional, cosmetic, medicinal, and traumatic. Amateur tattoos require less treatment sessions than professional multicolored tattoos. Other factors to consider when evaluating tattoos for removal are: location, age and the skin type of the patient.

Treatment should begin by obtaining a pre-operative history. Since treatment with the Q-switched lasers is painful, use of a local injection with lidocaine or topical anaesthesia cream may be used prior to laser treatment. Topical broad-spectrum antibacterial ointment is applied immediately following the procedure.

Three types of lasers are currently used for tattoo removal: Q-switched ruby laser (694nm), Q-switched Nd:YAG laser (532nm, 1064nm), and Q-switched alexandrite laser (755nm). The Q-switched ruby and alexandrite lasers are useful for removing black, blue and green pigments. The Q-switched 532nm Nd:YAG laser can be used to remove red pigments and the 1064nm Nd:YAG laser is used for removal of black and blue pigments.

The most common adverse effects following laser tattoo treatment with the Q-switched ruby laser include textural change, scarring, and pigmentary alteration. Transient hypopigmentation and textural changes have been reported in up to 50 and 12%, respectively, of patients treated with the Q-switched alexandrite laser. Hyperpigmentation and textural changes are infrequent adverse effects of the Q-switched Nd:YAG laser and the incidence of hypopigmentary changes is much lower than with the ruby laser. The development of localized and generalized allergic reactions is an unusual complication following tattoo removal with the Q-switched ruby and Nd:YAG lasers.

Since many wavelengths are needed to treat multicolored tattoos, not one laser system can be used alone to remove all the available inks and combination of inks. While laser tattoo removal is not perfect, we have come a long way since the advent of Q-switched lasers. Current research is focusing on newer picosecond lasers, which may be more successful than the Q-switched lasers in the removal of the new vibrant tattoo inks.

Keywords

Thermal Relaxation Time Carbon Dioxide Laser Alexandrite Laser Tattoo Removal Tattoo Pigment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Kilmer S.L. Cosmetic laser surgery. In: Alster T.S., editor. Laser treatment of tattoos. Wiley-Liss Inc.: New York, 1999: 289Google Scholar
  2. 2.
    Crittenden F.M. Salabrasion: removal of tattoos by superficial abrasion with table salt. Cutis 1971; 7: 295–300Google Scholar
  3. 3.
    Bailey B.N. Treatment of tattoos. Plast Reconstr Surg 1967; 40: 361–371PubMedCrossRefGoogle Scholar
  4. 4.
    Goldstein N., Penoff J., Price N., et al. Techniques of removal of tattoos. J Dermatol Surg Oncol 1979; 5: 901–910PubMedGoogle Scholar
  5. 5.
    Dvir E., Hirschowtiz B. Tattoo removal by cryosurgey. Plast Reconstr Surg 1980; 66: 373–378PubMedGoogle Scholar
  6. 6.
    Scutt R.W. The chemical removal of tattoos. Br J Plast Surg 1972; 25: 189–194PubMedCrossRefGoogle Scholar
  7. 7.
    Spicer M.S., Goldberg D.J. Lasers in dermatology. J Am Acad Dermatol 1996; 34: 1–25PubMedCrossRefGoogle Scholar
  8. 8.
    Reid W.H., Miller I.D., Murphy M.J., et al. Q-switched ruby laser treatment of tattoos: a 9-year experience. Br J Plast Surg 1990; 43 (6): 663–669PubMedCrossRefGoogle Scholar
  9. 9.
    Taylor C.R., Anderson R.R., Gange W. et al. Light and electron microscopic analysis of tattoos by Q-switched ruby laser. J Invest Dermatol 1991; 97: 131–136PubMedCrossRefGoogle Scholar
  10. 10.
    Taylor C.R., Gange R.W., Dover J.S., et al. Treatment of tattoos by Q-switched ruby laser. Arch Dermatol 1990; 126 (7): 893–899PubMedCrossRefGoogle Scholar
  11. 11.
    Apfelberg D.B., Maser M.R., Lash H., et al. Comparison of the argon and carbon dioxide laser treatment of decorative tattoos: a preliminary report. Ann Plast Surg 1985; 14: 6–15PubMedCrossRefGoogle Scholar
  12. 12.
    Anderson R.R., Parrish J.A. Selective photothermolysis: precise microsurgery by selective absorption of pulse radiation. Science 1983; 22: 524–527CrossRefGoogle Scholar
  13. 13.
    Kilmer S.L. Laser treatment of tattoos. Dermatol Clin 1997; 15 (3): 409–417PubMedCrossRefGoogle Scholar
  14. 14.
    Boulnois J.H. Photophysical processes in recent medical laser developments: a review. Lasers Med Sci 1986; 1: 47–66CrossRefGoogle Scholar
  15. 15.
    Anderson R.R., Geronemus R., Kilmer S.L., et al. Cosmetic tattoo ink darkening: a complication of Q-switched and pulsed laser treatment. Arch Dermatol 1993; 129: 1010PubMedCrossRefGoogle Scholar
  16. 16.
    Geronemus R.G. Surgical pearl: Q-switched Nd:YAG laser removal of eyeliner tattoo. J AM Acad Dermatol 1996; 35: 101–102PubMedCrossRefGoogle Scholar
  17. 17.
    Herbich G.J. Ultrapulse carbon dioxide laser treatment of iron oxide flesh-colored tattoo. Dermatol Surg 1997; 23: 60–61PubMedCrossRefGoogle Scholar
  18. 18.
    Moreno-Arias G.A., Camps-Fresneda A. Use of the Q-switched alexandrite laser for eyebrow tattoo removal. Lasers Surg Med 1999; 25 (2): 123–125PubMedCrossRefGoogle Scholar
  19. 19.
    Levine V.J., Geronemus R.G. Tattoo removal with the Q-switched ruby laser and the Q-switched ND:YAG laser: a comparative study. Cutis 1995; 55 (5): 291–296PubMedGoogle Scholar
  20. 20.
    Gravelink J., Duke D., Van Leeuwen R.L., et al. Laser treatment of tattoos in darkly pigmented patients: efficacy and side effects. J Am Acad Dermatol 1996; 34: 653–656CrossRefGoogle Scholar
  21. 21.
    Fitzpatrick R.E., Goldman M.P. Tattoo removal using the alexandrite laser. Arch Dermatol 1994; 130: 1508–1514PubMedCrossRefGoogle Scholar
  22. 22.
    Alster T.S. Q-switched alexandrite laser treatment 755nm of professional and amateur tattoos. J Am Acad Dermatol 1995; 33: 69–73PubMedCrossRefGoogle Scholar
  23. 23.
    Gravelink J.M., Casparian J.M., Gonzalez E., et al. Undesirable effects associated with the treatment of tattoos and pigmented lesions with Q-switched lasers 1064nm and 694nm: The MGH clinical experience. Lasers Surg Med Suppl 1993; 5: 55Google Scholar
  24. 24.
    Ashinoff R., Levine V.J., Soter N.A. Allergic reactions to tattoo pigment after laser treatment. Dermatol Surg 1995; 21: 291–294PubMedCrossRefGoogle Scholar
  25. 25.
    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: 167–171PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 2001

Authors and Affiliations

  • Marina Kuperman-Beade
    • 1
  • Vicki J. Levine
    • 1
  • Robin Ashinoff
    • 1
  1. 1.Ronald O. Perelman Department of DermatologyNew York University School of MedicineNew YorkUSA

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