Evaluation of Temperature Distribution on Human Skin During Philaser Tattoo Removal

Q-switched 1064 nm/532 nm Nd: YAG Lasers present important characteristics which can contribute toward the removal of tattoos, for having the ability to reach only specific targets with minimal damage to the tissue. Despite reports of their clinical benefits, only a few scientific studies demonstrate the efficacy and safety of these types of lasers in the short and long term. To substantiate the effects, benefits, and safety of the application of Q-switched 1064 nm/532 nm Nd: YAG lasers, a systematic review was carried out from September to December of 2019, about the studies which report their use in the removal of tattoos, published in the last 20 years. Randomized clinical trials in humans were considered, as long as they evaluated the efficacy, safety, and benefits of the application of Q-switched 1064 nm/532 nm Nd: YAG lasers in the removal of black and color tattoos in different skin phototypes. One hundred and twenty-two articles were identified after the titles, abstracts were read, and duplicates were removed; six articles were left, which were included in the research (188 individuals). The Q-switched 1064 nm/532 nm Nd: YAG lasers seem promising in the short term, with minimal adverse effects; however, the efficacy and safety in the long term still present limitations. Consequently, future research is necessary, with better methodological standardization applied and with a follow-up for a longer period of evaluation of possible permanent adverse effects, to determine the standardization and safety of the therapy with the lasers Nd: YAG de 1064 nm/532 nm Q-switched.

The purpose of this study is to evaluate the efficacy of tattoo removal using topical imiquimod 5% cream in conjunction with the 1,064-nm Nd:YAG laser. This procedure for tattoo removal will be compared to laser treatment alone, which is the standard for cosmetic removal of tattoos. Previous studies have linked partial tattoo removal to imiquimod application in a guinea pig model. This was a small-sized, double-blinded, placebo-controlled trial with patients with Fitzpatrick skin types I-IV (light skin) who were 18-65 years of age. The patients were required to have had two tattoos of similar age and dark blue or black in color in areas that can be covered by clothing. There were four visits in total, with laser treatment and photography being performed on the first visit. Laser settings were with 1,064-nm Nd:YAG with a 10-ns pulse, 3-mm spot size, and 4 J of energy, a standard laser used for tattoo removal. During the second visit, tattoos were randomized and chosen to receive either the laser-imiquimod treatment course or laser-vehicle cream treatment. The patients returned 1 month after the completion of cream application (week #10) and 2 months after the completion of treatment with cream (week #14) for final evaluation and photographing. Three patients were enrolled in this study. All of them are Fitzpatrick skin type IV. All of the patients were compliant with the drug application and have good tolerability with only mild pruritus without changing of vascularity or pigmentation. None of the patients had ulceration or scar development during the cream application. imiquimod plus laser therapy demonstrated a more favorable outcome when evaluated by the investigators or subjects. The mean scores for tattoo clearance from baseline to 2 months after completion of treatment with 5% imiquimod cream versus placebo cream were 4.3 versus 2.7 as rated by investigators and 4.7 versus 2.3 as rated by subjects. No textural changes were observed after therapy and were not shown to be different between the two groups. Further large-scale studies are important in developing a role for the use of imiqumod in laser-assisted tattoo removal.

A tattoo is a pigment permanently deposited into the skin to create different patterns. The worldwide percentage of tattooed individuals, as well as the level of tattoo regret, complications, and removal, has increased. However, data from Saudi Arabia are lacking. To determine the rates of tattoo regret, complications, and removal among tattooed individuals in Saudi Arabia. A cross-sectional study using an online survey was conducted in Riyadh, Saudi Arabia. A link to the survey was distributed through social media and contained twenty questions about participants' demographics, tattoo practices, regret, removal, and complications. Data were analyzed using the Statistical Package for Social Sciences (SPSS). A P value <0.05 was considered statistically significant. A total of 181 tattooed individuals participated in the study. Most of them were females (95.6%), and 76.7% had their first tattoo at an age over eighteen years. A total of 47.5% had one tattoo session, and the most common body site was the eyebrows (57.5%). Fifty-eight percent regretted their tattoo, and 42.5% attempted to remove it. Upper extremity tattoos were significantly associated with regret (72.3%) (P=0.004) and removal (56.9%) (P=0.003). Tattoo removal was mostly due to cultural reasons (74%). Local itching (32%), pain (22.7%), and infection (10.5%) were reported and associated with tattoo regret (P < 0.05). Itching was significant in 65.4% of head and neck tattoos and 41.5% of upper extremity tattoos (P < 0.05). Participants were aware that laser is the best method for tattoo removal. Among tattooed individuals in Saudi Arabia, the rate of tattoo regret and removal is high, and the most reported complication is pruritus.

Laser tattoo removal in Thai students

Background : Decorative tattooing gained popularity in many western countries throughout the 1990s. Some estimates show that approximately 10 % of men in the United States already have tattoos. However, tattoos often become a personal regret. As recent surveys suggest, 17 % of people that have obtained a tattoo and more than 50 % of adults over the age of 40 in the United States of America consider having them removed. The same trend can be observed in our country as well. Laser therapy is the gold standard for tattoo removal. In Slovenia, laser tattoo removal therapy is available and widely accessible. There is a wide range of facilities offering laser tattoo removal, ranging from different private clinics to beauty salons. Different facilities use different lasers, but not all lasers, however, are optimal for successful and complete tattoo removal, as inappropriate use can cause many unwanted side effects. Methods : Eleven (11) patients (2 men and 9 women) requesting tattoo removal were treated in our department. When treating our patients, we used Fotona’s QX MAX quality-switched Nd:YAG laser which offers four different wavelengths in a single system; 1064 nm Nd:YAG was used to treat and remove dark pigments, 532 nm KTP for red, tan-colored, purple and orange tattoo inks, 650 nm dye for green tattoo inks and 585 nm dye for sky-blue colored inks. Results : Satisfactory tattoo removal was achieved in all patients treated. Patients were very satisfied with the success and the number of treatments needed for tattoo removal. There were mild unwanted side effects and the pain was moderate. The average number of treatments required for complete tattoo removal was less than 7, ranging from 3 to 21 treatments. Patients’ satisfaction with tattoo removal was estimated at 5.2 (on a scale from 1 to 6). Conclusions : Our study showed that Q-switched lasers successfully remove tattoo ink, however several treatments are required for satisfactory tattoo removal

Decorative tattoos including permanent make-up are very popular world-wide. However, some people regret tattooing and seek tattoo removal. Tattooed skin contains numerous solid particles of tattoo pigments. A major mechanism of tattoo removal is laser assisted fragmentation of these particles, which are then transported away from the skin. For many years, Q-switched lasers with nanosecond pulse durations at high light intensities have been applied to cause such fragmentation via rapid heating up while sparing the adjacent tissue. Despite the long-lasting use of such laser treatment, the exact mechanisms of laser assisted fragmentation are hardly investigated. Due to short and intense laser pulses applied, non-linear effects of light (e.g. photoacoustic and optical breakdown) and nonlinear thermal properties in tattoo particles may play a crucial role. In the past few years, lasers with even shorter pulse duration in the sub-nanosecond range were launched for tattoo removal. Theoretical considerations assumed that pulse durations shorter than nanoseconds allow even more effective fragmentation of tattoo particles. A couple of initial studies affirm the effectiveness of picosecond pulses in tattoo treatment, especially in clearing black tattoos. Furthermore, treatment with picosecond lasers seems to be less painful. Consequently, picosecond technology may be a new strategy for more effective removal of tattoo pigments at a lower rate of side effects. But there is an urgent need for more well-designed and randomized controlled trials to compare this treatment modality to the traditional nanosecond technology regarding efficacy and adverse reactions.

Dear Editor, We describe the clinical case of a 79-year-old woman, phototype I, who wanted to have removed an orange eyebrow tattoo that had been placed years previously (Fig. 1). After treating a test area, we treated the tattoo with a Q-switched Nd:YAG laser (532 nm, 3 mm beam, mean fluence 2.5 J/ cm) in a single session. The procedure was well tolerated, and healing occurred within 2 weeks. Two months later the patient was re-examined and had no visible pigment (Fig. 1). The first procedures used in the removal of tattoos were classic surgery and cryosurgery [1]. However, these were associated with permanent side effects, particularly scarring and alopecia of pilose areas. The advent of laser therapy opened new perspectives in this field. Currently available laser include Q-switched Nd:YAG, alexandrite, ruby, pulsed dye green light and carbon dioxide laser. The absorption spectra of tattoo pigments are variable with some pigments reacting differently to the various devices. As a result, a combination of laser systems can be used sequentially to remove a single polychromatic tattoo [2]. Some pigments, such as green, sky blue and yellow, are more resistant to laser treatment [1]. Laser removal of eyebrow tattoos is a challenge due to the potential for damage to follicles. For this purpose, a Qswitched Nd:YAG laser at a wavelength of 1064 nm has been used to minimize absorption by the eyebrow hair. This is an excellent choice for removing black pigment, but it produces less satisfactory results with other pigments. Usually multiple treatments are necessary (four to six for

Tattoo removal by laser therapy is a frequently performed procedure in dermatological practices. Quality-switched ruby, alexandrite, or Nd:YAG lasers are the most suitable treatment devices. Although these techniques are regarded as safe, both temporary and permanent side effects might occur. Little has been published on the frequency of complications associated with laser tattoo removal. We performed an Internet survey in German-speaking countries on characteristics of laser tattoo removal and associated side effects. A total number of 157 questionnaires entered the final analysis. Motivations for laser tattoo removal were mainly considering the tattoo as youthful folly (29%), esthetic reasons (28%), and 6% indicated medical problems. One third of participants were unsatisfied with the result of laser tattoo removal, and a complete removal of the tattoo pigment was obtained in 38% only. Local transient side effects occurred in nearly all participants, but an important rate of slightly visible scars (24%) or even important scarring (8%) was reported. Every fourth participant described mild or intense tan when the laser treatment was performed, and the same number of people indicated UV exposure following laser therapy, which should normally be avoided in these circumstances. As reported in the literature, nearly half of the participants experienced hypopigmentation in the treated area. Our results show that from the patients' point of view there is an important rate of side effects occurring after laser tattoo removal. Appropriate pretreatment counseling with regard to realistic expectations, possible side effects, and the application of test spots is mandatory to ensure patient satisfaction. Laser treatment should be performed by appropriately trained personnel only.

The Q-switched laser method is the most effective method of tattoo removal compared to other methods of i.e. chemical, mechanical and surgical. The objective of this study is to investigate the effect of Nd:YAG laser to remove the tattoo and also to utilize 808 nm diode laser to enhance the wound healing at post-treatment. Q-switched Nd: YAG laser with fundamental wavelength of 1064 nm is applied to remove tattoo pigment with different energy fluencies. Additionally, 808 nm diode laser will be applied on wound created after tattoo removal to enhance the healing process. More than 15 Sprague Dawley rats will be involved and tattooed with black inks on their back by a tattoo gun. A single session treatment is use in the energy about 400mj for tattoo removal. The exposure to diode laser treatment will be conducted daily. The experimental observation will be hold for 9 days, and 5 rats from each group will be sacrificed on day 3, 6 and 9 respectively. The skin biopsy will be removed for H&amp;E and Masson’s trichrome histology examination. The effect of tattoo removal and healing progress of skin analyzed via photothermal.. The preliminary findings of this study indicate that 1064 nm wavelengths of Q-switched Nd-YAG laser treatment with 400mj pulse energy exhibit significant progress of black tattoo removal.

The causes behind complications in laser-assisted tattoo removal are currently not well understood, and in the literature relating to tattoo removal the emphasis on removal treatment is on removal technologies and tools, not best parameters involved in the treatment process. Additionally, the very challenge of determining best practices is difficult given the complexity of interactions between factors that may correlate to these complications. In this paper we apply a battery of classical statistical methods and techniques to identify features that may be closely correlated to causes of complication during the tattoo removal process, and report quantitative evidence for potential best practices. We develop elementary statistical descriptions of tattoo data collected by the largest gang rehabilitation and reentry organization in the world, Homeboy Industries; perform parametric and nonparametric tests of significance; and finally, produce a statistical model explaining treatment parameter interactions, as well as develop a ranking system for treatment parameters utilizing bootstrapping and gradient boosting.

A Revista Brasileira de Cirurgia Plástica é o órgão oficial de divulgação da Sociedade Brasileira de Cirurgia Plástica (SBCP), tem como objetivo registrar a produção científica em Cirurgia Plástica, fomentar o estudo, aperfeiçoamento e atualização dos profissionais da especialidade.

Lasers have been widely used for tattoo removal, but the limited light penetration depth caused by high skin scattering property restricts the therapeutic outcome of deep tattoo. Skin optical clearing method, by introducing optical clearing agent (OCA) into skin, has shown some improvement in the effect of laser tattoo removal. In this study, the enhanced laser tattoo removal has been quantitatively assessed. OCA was applied to the skin of tattoo animal model and Q-switched Nd:YAG laser (1064 nm) irradiation was used to remove the tattoo. The skin evaluation instrument (Mexameter probe, MPA580) was applied to measure the content of tattoo pigment before and after laser treatment, and then the clearance rate of pigment was calculated. Further, Monte Carlo (MC) method was utilized to simulate the effect of skin optical clearing on light transmission in tattoo skin model. By comparing the pigment change of tattoo areas respectively treated with OCA plus laser and single laser, it was found that pigment clearance of the former tattoo area was increased by 1.5-fold. Further, the MC simulation verified that the reduced light scattering in skin could increase the effective dose of luminous flux reaching to the deep tattoo regions. It can be concluded from both experiment and theoretical simulations that skin optical clearing technique could improve the outcome of laser tattoo removal, which should be beneficial for clinical laser tattoo removal and other laser pigment elimination.

The topical transparent perfluorodecalin-infused (PFD) silicone patch has been demonstrated to reduce epidermal whitening produced in association with laser-assisted tattoo removal. This optical clearing agent has enabled multiple laser passes to be made in one treatment session. Previous studies using the PFD patch have showed enhanced clearance with picosecond and Q-Switched lasers on blue/black tattoos in Fitzpatrick skin types I-III. We sought to explore the safety and efficacy of using the PFD patch with Q-Switched and picosecond lasers in Fitzpatrick skin types IV-VI. A retrospective, single institution chart review was used to assess the safety of treating tattoos using the PFD patch with Q-Switched and picosecond lasers in Fitzpatrick skin types IV-VI. A total of 14 patients, ages 23-66 with Fitzpatrick skin types IV-VI were treated with the PFD patches and liquid PFD using the picosecond (532, 785, and 1064 nm) and the Q-switched Nd:YAG (1064 nm). The treated tattoos contained blue, black, red, green, purple, and pink ink. Patient reported adverse events were evaluated. The PFD patch and liquid PFD were used with the picosecond (532, 785, 1064 nm) and the Q-switched Nd:YAG (1064 nm) lasers to treat tattoos safely in 14 patients with Fitzpatrick skin types IV-VI. Furthermore, the PFD patch was used safely when treating tattoo containing blue, black, red, green, purple and pink ink. Multiple passes were better tolerated in patients when using the PFD patch. No adverse effects were reported. Our retrospective chart review supports the safety and efficacy of the PFD patch in protecting the epidermis from thermal injury during laser-assisted tattoo removal of multicolored tattoos in patients with Fitzpatrick skin types IV-VI. Lasers Surg. Med. 51:23-26, 2019. © 2018 Wiley Periodicals, Inc.

With rapid advancement in cutaneous laser therapy, Q-switched lasers have become the standard treatment for tattoo removal. The longer wavelength Q-switched Nd:YAG laser is used when removing tattoos in darker skin patients to avoid scarring and permanent pigment changes. Nevertheless, the local experience revealed that nearly 25% of the Chinese patients developed scarring. Meanwhile, multiple clinical studies have shown that Contractubex gel (Merz Pharma, Frankfurt, Germany) was effective in the treatment and prevention of hypertrophic scars and keloids. To evaluate the efficacy of Contractubex gel in the prevention of scarring after laser removal of tattoos in Chinese patients. A total of 120 Chinese patients with 144 professional blue-black tattoos were recruited into the study. They were randomly assigned into the Contractubex group or the control group. All patients were treated with a QS 1,064-nm Nd:YAG laser using a 3-mm spot size, a 10-Hz repeat rate, a pulse duration of 6 nanoseconds, and fluences that ranged from 3.6 to 4.8 J/cm2 (mean fluence, 4.2 J/cm2). The treated areas were assessed 3 months after the last treatments for clinical clearance and complications. Fifty-two patients with 61 tattoos in the Contractubex group were able to achieve a mean clearing rate of 82.3+/-11.6%. There were 7 tattoos in 7 patients that developed scarring, 4 patients had permanent hypopigmentation, and 3 patients had transient hyperpigmentation. In contrast, 55 patients with 68 tattoos in the control group had a mean clearing rate of 80.4+/-11.3%. Among them, 16 tattoos in 14 patients developed scarring, 4 patients had permanent hypopigmentation, and 5 patients had transient hyperpigmentation. Although there was no significant difference in age, sex, fluence, treatment session, and clinical clearance between the two groups, the Contractubex group had a statistically significantly lower rate of scarring than the control group (p<.05). Contractubex gel is effective in scar prevention in Chinese patients having laser removal of tattoos.

Cosmetic tattoos are difficult to remove, and their response to picosecond laser treatment has seldom been investigated. We compared the efficacy and adverse effects of picosecond versus Q-switched lasers for the removal of cosmetic tattoos. White, flesh-colored, and brown inks were irradiated using 532/1064nm picosecond and Q-switched Nd:YAG lasers, and their absorption spectra before and after laser irradiation were analyzed. Nine rats were tattooed with all three inks. Each tattoo was divided into three sections and treated at 1064nm with a picosecond laser or Q-switched laser, or left untreated, in four sessions at 1-month intervals. Skin biopsies were taken from treated and untreated sites. In vitro study showed the 1064 nmpicosecond laser caused the least paradoxical color shift. In vivo study showed that all white tattoos achieved poor response scores, six flesh-colored tattoos achieved fair to good response scores, and seven brown tattoos achieved good to excellent response scores with the picosecond laser. The picosecond laser was superior to the Q-switched laser for removing flesh-colored tattoos (P < 0.05), but the effectiveness for white and brown tattoos was similar for both lasers. The degree of paradoxical darkening when removing the white and flesh-colored tattoos was significantly lower with the picosecond than that with the Q-switched laser (P < 0.01). Transmission electron microscopy showed that many tattoo ink particles had decreased in size after irradiations with both pulse durations. The 1064nm picosecond Nd:YAG laser causes mild paradoxical darkening and might be more appropriate for removal of flesh-colored and brown cosmetic tattoos.