Abstract
The purpose of this study was to evaluate the safety and efficacy of a new combined method of Q-S laser-assisted tattoo removal. Ten patients with 13 professional, mostly mono-chromatic black tattoos were recruited. All tattoos received the same Q-S laser treatment sequence. An objective evaluation of tattoo clearing was assessed by careful analysis of a standardized collection of digital images taken from each tattoo, 2 months after each laser session, with the help of a custom-made pigment-fading percentage photographic ruler. The percentages of pigment clearance and side effects were evaluated by 4 independent dermatologists. Patient satisfaction and perceived discomfort during and post-procedure were evaluated according to specific scales. Clinical evaluators confirmed an average photographic pigment clearance of 97% after a median 4.85 treatment sessions. The Frac-Tat® method required 40% fewer sessions compared to those calculated by Kirby-Desai estimates. Photographic assessment of laser-exposed skin quality performed 2 months after tattoo clearing was considered almost comparable with untreated peripheral skin, confirming a very low side effect score. The Frac-Tat QS laser-assisted tattoo removal sequence used in our study showed a high degree of safety and efficiency, clearing exogenous pigments in a relatively few number of sessions. Preliminary ablative photo-acoustic fractional 1064-nm Q-S laser micro-drilling was considered an essential step in optimizing tattoo removal, increasing wavelength-independent micro-columnar clearing of deeper dermal exogenous pigments. Our preliminary observations also confirmed a significant improvement of tattoo procedure-induced micro-textural changes thanks to a tissue remodeling effect induced by the 1064-nm Q-S fractional laser photo-acoustic ablation.
Highlights
Tattoos have been well established visual expression means of communication used by single or groups of individuals since ancient times [1, 2]
From Q-S laser-assisted tattoo removal strategies, inter-session intervals vary according to the anatomical location of exogenous pigments, ranging from a minimum of 2 months for the upper body to a maximum of three/four for lower limbs
To try to overcome this problem, Kosida and colleagues proposed the so-called R-20 method consisting in four sequential Q-S laser passes, spaced 20-min apart, during the same laser session
Summary
Tattoos have been well established visual expression means of communication used by single or groups of individuals since ancient times [1, 2]. The significant rise in tattoo removal procedures was undisputedly triggered by the advent of modern pigment-specific Q-switched (Q-S) laser technologies Their ultrashort nanosecond (ns) or picosecond (ps) pulses are able to selectively interact with intradermal pigment particles in full accordance with the universally accepted selective photo-thermolysis theory leading to a super-confined photo-thermal-photo-acoustic destruction of wavelengthspecific absorbing pigments with minimal tissue collateral damage [4, 5]. To try to overcome this problem, Kosida and colleagues proposed the so-called R-20 method consisting in four sequential Q-S laser passes, spaced 20-min apart, during the same laser session They stated their method was able to significantly reduce the total number of sessions producing better clinical results when compared to single laser PPS techniques [10]. Even this solution did not come free of drawbacks such as increased costs to be inevitably added to laser procedures [11, 12]
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