Red Tattoo Research Articles

P20 Red tattoo reactions

Tattoos are becoming increasingly popular, although reactions to tattoos remain relatively uncommon. We describe 4 patients with a variety of red tattoo reactions, one responding well to intralesional steroid therapy.Case 1: A 50‐year‐old man presented with a florid, inflammatory reaction confined to the red area of his forearm tattoo. Biopsy showed a dense lymphocytic and focal macrophage response to tattoo pigment. Mass spectrometry of biopsy tissue revealed high concentrations of titanium and iron. Patch testing was negative. Intralesional steroid injection has produced a marked improvement.Case 2: A 42‐year‐old man presented with an inflammatory reaction affecting the red area of his leg tattoo. Biopsy revealed a florid lymphoid reaction.Case 3: A 30‐year‐old man presented with an eczematous reaction within the red/brown pigmented areas of his tattoos, which was exacerbated by sun exposure. Patch testing showed a (+) positive reaction to cadmium after 96 hours. Photo patch testing was negative. The reaction settled spontaneously within 12 months.Case 4: A 37‐year‐old woman presented with a florid, indurated inflammatory reaction involving the red area of a shoulder tattoo. Patch testing revealed a (++) and (+) positive reaction to nickel and cobalt respectively with a doubtful (?+) reaction to mercury 0.5% in petrolatum after 96 hours. Tattoo reactions, especially red tattoo reactions can present with a spectrum of histological changes, including lichenoid, granulomatous, hypersensitivity, nodular, pseudolymphomatous or sarcoidal reactions. One of our cases responded well to intralesional steroid injection and one case resolved spontaneously.

Multiple Color Changes Following Laser Therapy of Cosmetic Tattoos

OBJECTIVE To emphasize the wisdom of small test areas when treating cosmetic tattoos and the need for multiple laser systems. METHODS A 48-year-old woman requested removal of permanent makeup (cosmetic tattoos) of her eyebrows and around her lips. Physical examination revealed a brown tattoo of both eyebrows and dark red lip liner around both lips. A test area was performed on the red tattoo of the lips. A frequency-doubled Nd:YAG laser (532 nm, 2.0 J/cm2, 2 mm spot size) was used for the lip area, while the same laser at 1064 nm, 3.9 J cm2, 2 mm spot size was utilized for the eyebrows. The lip area immediately turned black. The patient returned for follow-up 1 month later; the black ink on the lip was treated with the same laser at 1064 nm, 3 mm spot size, 4.2 J/cm2, with satisfactory resolution in two monthly treatments. Both brown eyebrow turned bright orange and were treated with 532 nm, 3 mm, 3.0 J/cm2. One month later the eyebrows were a mixture of yellow ink and dark green. The yellow area was treated with 532 nm, 3 mm, 2.3 J/cm2, while the dark green was treated with the 1064 nm, 3 mm spot size, 4.2 J/cm2. One month later little improvement was noted, so Q-switched ruby laser at 694 nm, 6 mm spot size, 16 J/cm2 was utilized. An additional four monthly treatments were given utilizing a combination of both ruby and 532 nm ND:YAG lasers for green and yellow pigment, respectively. RESULTS Significant but incomplete resolution of the tattoo ink was achieved. CONCLUSION Multiple laser systems are needed to remove cosmetic tattoos. Test areas must be done before treatment.

Using a Side Effect to Therapeutic Advantage: The Darkening of Red Eyebrow Tattoo Pigment Following Q-Switched Laser Treatment

Q-switched lasers are commonly used to achieve tattoo removal, utilizing the principle of selective photothermolysis. However, certain tattoo pigments may darken following laser pulsing. To determine whether this side effect can be used to therapeutic advantage in a woman who previously had her eyebrows enhanced with a dark tattoo that spontaneously changed to a reddish hue over time. The woman's eyebrows were pulsed with the Q-switched Nd:YAG laser at both 532 nm and 1064 nm. The test areas pulsed with the 1064 nm laser revealed partial clearing. However, 532 nm Q-switched Nd:YAG pulses produced darkening of tattoo pigment both at the test sites and in the subsequent treatment. Q-switched lasers can produce darkening of red tattoo pigment. In some cases this side effect can be used to therapeutic advantage.

The Q-switched neodymium: YAG laser and tattoos: a microscopic analysis of laser-tattoo interactions

The Nd:YAG laser effectively removes or lightens amateur and professional tattoos. The biomechanics of the removal of tattoo particles at the cellular level are incompletely understood. We examined biopsies obtained from 35 amateur and professional tattoos (including coloured tattoos), treated on three or more occasions with the Nd:YAG laser. Biopsies taken immediately after laser treatment showed vacuolation with complete clearance of tattoo particles in the most superficial layers of the dermis, as assessed by light and electron microscopy. We propose that the 'disappearance' of the tattoo particle arises from the formation of atomic species and gaseous products, which are rapidly dissolved in the extracellular fluid. Residual fragmented particles that are commonly found in the mid- and lower dermis are rephagocytosed. The interaction between the Nd:YAG laser and black tattoo particles at 1064 nm, and red tattoo particles at 532 nm, appears to be specific, as there was little evidence of thermal damage to adjacent cells or stromal collagen.

Evaluation of the Nd/YAG laser for treatment of amateur and professional tattoos

Two hundred and twenty-one amateur tattoos and 27 professional tattoos were treated with a Nd/YAG laser (lambda 1064 nm and 532 nm). The response was expressed as the percentage area cleared of tattoo. Seventy-nine per cent of amateur black tattoos were > or = 75% clear after one to five treatments (mean 2) at 1064 nm. The response of professional tattoos was slower and less complete. Seventy-four per cent of black professional tattoos were > or = 75% clear after one to 11 treatments (mean 6.3) at 1064 nm. Red tattoos responded well to 532 nm and were > or = 75% clear after one to five treatments. Yellow, orange, blue and green tattoos were resistant to treatment. Side-effects included minor scarring in 1.2% of tattoos and transient pigmentary changes in 77% of patients.

Skin Reflectance-Guided Laser Selections for Treatment of Decorative Tattoos

A fundamental idea of laser treatment of tattoos is that the wavelength must be well absorbed by the tattoo color. In this study, absorption by different tattoo colors was therefore measured in vivo by skin reflectance to establish optimal laser wavelengths for different tattoo colors. Spectral reflectance by tattooed skin and by normal, uninvolved skin was measured in 10-nm steps in a wavelength range from 300 to 800 nm on eight human volunteers with a total of 13 tattoos, which consisted of 14 different tattoo colors. Wavelength ranges for maximal absorption were established. We found that tattoos absorbed maximally in the following ranges: red tattoos, from 505 to 560 nm (green spectrum); green tattoos, from 630 to 730 nm (red spectrum); and a blue-green tattoo, in two ranges from 400 to 450 nm and from 505 to 560 nm (blue-purple and green spectrums, respectively). Yellow tattoos absorbed maximally from 450 to 510 nm (blue-green spectrum), purple tattoos-absorbed maximally from 550 to 640 nm (green-yellow-orange-red spectrum), blue tattoos absorbed maximally from 620 to 730 nm (red spectrum), and orange tattoos absorbed maximally from 500 to 525 nm (green spectrum). Black and gray absorbed broadly in the visible spectrum, but these colors were most effective from 600 to 800 nm. Optimal and suboptimal laser wavelengths are proposed. We recommend that wavelength ranges should be established for maximal tattoo absorption before laser treatment of decorative tattoos to select the most optimal laser wavelength present.

Q-switched alexandrite laser treatment (755 nm) of professional and amateur tattoos

Background: Several laser techniques have been proposed for the removal of decorative tattoos. The lasers that have been used most successfully are Q-switched red or near-infrared systems because of their ability to target tattoo pigment selectively with minimal risk of scarring or permanent pigmentary changes. Objectives: The objectives of this study were to determine the clinical effectiveness of the newest Q-switched system, the alexandrite laser, in removing amateur and professional tattoos and to observe side effects. Methods: Twenty-four multicolored professional tattoos and 18 blue-black amateur tattoos were treated with the Q-switched alexandrite laser (755 nm, 100 nsec) at 2-month intervals until total clearing was achieved. The 510 nm pulsed dye laser was used to treat tattoos that contained red pigment. Results: Professional tattoos required an average of 8.5 alexandrite laser treatments for total clearance, whereas only 4.6 treatments were necessary to remove amateur tattoos. Red tattoo pigment was successfully treated with an average of two 510 nm pulsed dye laser sessions. No scarring or long-standing pigmentary changes were seen in laser-irradiated skin. Conclusion: The Q-switched alexandrite laser is highly effective in removing multicolored professional and amateur tattoos without adverse sequelae. The 510 nm pulsed dye laser was useful in eliminating red tattoo pigment.

Laser ablation of facial cosmetic tattoos

The application of facial cosmetic tattoos (eyeliner, lipliner, and rouge) has become popular over the past five years and has resulted in an increasing number of patients requesting removal of these permanent cosmetics. Poor positioning or misapplication of the tattoo pigment has been the most common reason for requesting removal. Because of the almost inevitable probability of scarring, removal of these facial tattoos has been difficult at best. We report the successful removal of facial cosmetic tattoos in ten different patients with the use of five different lasers. We have found the superpulsed CO2 laser and the Q-switched alexandrite laser to be effective in removal of black tattoo pigment. The alexandrite laser is effective without causing scarring, and the CO2 laser is extremely precise and provides the capability of removing tattoo pigment between eyelash or eyebrow hairs without damaging the hair follicles. Both the argon laser and the flashlamp pumped dye laser reacted with red tattoo pigment and offered some improvement but were not ideally suited for tattoo removal. However, the flashlamp pumped dye laser for pigment was very effective in removing red tattoo pigment possibly because of its short pulse width (300 ns) in addition to its appropriate wavelength. The combination of these three lasers (super-pulsed CO2, alexandrite, and flashlamp pigment lasers) is very effective in removing black and red (or shades thereof) facial tattoos. Caution must be taken to determine the presence of flesh-colored tattoo pigment, as this pigment (FE2O3) will reduce to black (FeO) upon laser impact.

Use of the alexandrite laser (755 nm, 100 nsec) for tattoo pigment removal in an animal model

All previous treatment modalities for the removal of tattoos, with the possible exception of the Q-switched ruby and YAG lasers, result in scarring. The purpose of this study was to investigate the use of a new laser that may remove tattoo pigment without leaving a scar. A Yucatan micropig was tattooed by a professional tattoo artist with black, blue, green, and red pigments. These tattoos were then treated with single overlapping pulses with the alexandrite laser (wavelength 755 nm, pulse 100 nsec) and evaluated clinically and histologically. Comparison treatment with an argon laser (wavelength 488 nm, 514 nm, continuous-wave) and flashlamp-pumped dye laser (wavelength 585 nm, pulse 450 microseconds) was performed as well for removal of red tattoo pigment. The alexandrite laser was found to be very effective in removal of professional and amateur black tattoo pigment, moderately effective in removal of blue and green pigment, and minimally effective in removal of red pigment. No scarring was seen clinically or histologically. The alexandrite laser shows promise as a treatment modality for tattoo removal without scarring.

510‐nm Pigmented Lesion Dye Laser

Benign pigmented lesions are of a cosmetic concern to many individuals. Numerous treatments exist, including several types of lasers. The Candela 510 nm pigmented lesion dye laser has recently been added to this armamentarium. It is designed specifically for the treatment of superficial pigmented lesions while significantly decreasing the risk of scarring and prolonged hypopigmentation. To describe the characteristics of the Candela pigmented lesion dye laser and report on the therapeutic outcome of patients treated for actinic lentigines, café-au-lait macules, melasma and red tattoos by one of the authors (RCG). The Candela 510 nm pigmented lesion dye laser was used to treat solar lentigines, café-au-lait macules, melasma and red tattoo. Excellent outcomes resulted on facial and hand lentigines (89% and 88% of patients had greater than 75% clearing, respectively), but often required more than one treatment. Lentigines located on the upper extremities and trunk improved less dramatically. Immediate greying occurred universally. Bruising was often noted. Treatment failures have been observed especially in treating lentigines located on the lower extremities. Café-au-lait macules responded inconsistently, with facial lesions giving the best results. Melasma responded poorly, often with hyperpigmentation. Three red tattoos cleared. Treatment failure may be related to inaccurate clinical assessment of pigment depth or regrowth of the lesion. Several cases are presented to demonstrate clinical and histologic effects of the laser. The Candela 510-nm pigmented lesion dye laser is an effective treatment for superficial pigmented lesions. Its associated morbidity is minimal.

Red tattoo reactions: X-ray microanalysis and patch-test studies

Eighteen patients who developed cutaneous reactions to red tattoos were studied to identify the chemicals responsible for the reactions to modern red tattoo pigments. Biopsies from the tattoos were examined histologically and the chemical composition of the red pigments was analysed by X-ray microanalysis. A variety of metallic elements including aluminium, iron, calcium, titanium, silicon, mercury and cadmium were detected. Patch tests were performed to the relevant chemicals in nine cases, and only one patient reacted to mercury. This study demonstrates that although reactions to mercury still occur, other red dyes containing a variety of inorganic pigments may provoke a cutaneous inflammatory response.

Inflammatory reactions from organic pigments in red tattoos.

Two different red pigments used for tattooing were found to give rise to inflammatory reactions in the skin. No inorganic component was found in the pigments. NMR and MS analyses elucidated the molecular structures of two different organic compounds. A bright red pigment was found to be an aromatic azo-derivative, and a red-violet pigment was found to be linear quinacridone. A strong exposure to UV-light was reported in most cases prior to the onset of the inflammation.

Retattooing After the Treatment of a Red Tattoo Reaction with the CO2 Laser

Retattooing After the Treatment of a Red Tattoo Reaction with the CO₂ Laser

Lichenoid Delayed Hypersensitivity Reactions in Tattoos

Two patients with an inflammatory reaction in a red tattoo had histopathologic changes of lichen planus. The lesions demonstrated a lymphocytic bandlike infiltrate, liquefaction degeneration, acanthosis, hypergranulosis, and orthokeratosis and many hyaline bodies. Metal particles were observed in the region of the dermal-epidermal reaction. This probably is another example of the lichenoid reaction produced by delayed cellular hypersensitivity.

Reactions to red tattoos

Reactions to red tattoos

Reactions to red tattoos

Reactions to red tattoos

Studies of chronic inflammation in a red tattoo by electron microscopy and histochemistry

No abstract available

Studies of a red tattoo. Appearances in electron microscope, and analysis by chemical means, laser microprobe and selected-area diffraction of tattooed material.

In the electron microscope, mercuric sulfide (cinnabar), long implanted in skin as a tattoo, and mercuric sulfide, freshly embedded in agar, were found to have similar appearances. Qualitative chemical analysis for mercury in tissue from the tattoo indicated it was present. Laser-microprobe analysis showed that material in the tattoo was identical to cinnabar embedded in agar. Selected-area diffraction studies revealed that the material in the tattoo was crystalline, and had interplanar spacings corresponding closely to those of mercuric sulfide.

Bumps and Lumps in the Sun—Mercury Sensitivity in Tattoos—A Photo-Allergic Reaction in Red Pigment.

Excerpt Allergic reactions to tattoo pigments are infrequently seen. Previous investigators reporting reactions to red tattoo pigment (mercuric sulfide) claim mercury-containing ointments or immuni...

REACTIONS TO LIGHT IN YELLOW TATTOOS FROM CADMIUM SULFIDE.

Of 24 patients with yellow tattoos, 18 observed a swelling reaction in them when they were exposed to sunlight. Four of these patients also observed a similar type of reaction in the red tattoos. Tattoos done experimentally with cadmium sulfide were shown to give a swelling reaction when exposed to the wavelengths 3,800, 4,000, and 4,500 Angstroms (A). Photopatch testing with cadmium sulfide was negative. Cadmium sulfide is a compound with marked photoconducting properties. The swelling reaction provoked by light in tattoos of cadmium sulfide seems to be phototoxic in nature.