BC02 Efficacy and safety of picosecond Nd-YAG laser for tattoo removal in Asian patients: a way to look forward

Abstract

Abstract Picosecond neodymium-doped yttrium aluminium garnet (Nd-YAG) lasers have emerged as the leading technology for tattoo removal due to their shorter pulse lengths and are considered better than other nanosecond lasers. The aim was to study the efficacy and adverse effects of a picosecond quality-switched (QS) Nd-YAG laser in a case series of 15 Asian patients for tattoo removal. Fifteen patients with black- and blue-coloured tattoos were recruited for tattoo removal. All were treated with a 1064-picosecond QS Nd-YAG laser. A single session with one pass was performed using a spot size of 4 mm, a fluence of 0.5–1 J cm–2 and a frequency of 6–10 Hz. The parameters were adjusted based on the size and type of tattoo and the patient’s skin type. Patients were treated at 4–6-weekly intervals. The clearance of pigmentation and local reactions was evaluated based on clinical photographs and dermoscopy, done at each sitting. At the end, both patients and physician assessed the clearance of tattoo. For patient assessment, a visual analogue scale (VAS) was used. To assess the efficacy of laser treatment by the physician, the tattoo removal rate was scored on a 5-point (0–4) scale (4: ≥ 70% removal, excellent improvement; 3: ≥ 50% and < 70%, marked improvement; 2: ≥ 30% and < 50%, moderate improvement; 1: ≥ 10% and < 30%, mild improvement and 0: < 10%, no effect). Patients were asked to assess their satisfaction (0 = dissatisfactory, 10 = satisfactory) and pain (0 = no pain, 10 = worst pain) using the VAS. Clinical photographs were assessed both by the patients and the physicians. Four women and 11 men were included (aged 30–45 years). At the end of treatment, all patients had > 75% clearance and seven obtained almost complete clearance. Thus, all patients had an excellent response. The average patient-reported score for satisfaction was 8.2 and 2.5 for pain. The average score was 4.4 for the number of sessions. A few adverse effects, including erythema, blistering and crusting, were observed. Picosecond lasers allow for the most effective delivery of thermal radiation to tattoo particles through more specific photothermal and photomechanical effects than traditional nanosecond lasers. They also have an additional effect of minimizing the collateral damage to the surrounding dermis and epidermis. Thus, a picosecond laser is a safe and effective method for tattoo removal in Asian people.