Persistent eschar-like wound healing after Q-switched 1064 nm hybrid nanosecond-picosecond laser monochromatic tattoo removal: management and evolution.

Q-switched (QS) Nd: YAG lasers are frequently utilised light sources for tattoo removal due to their precise micro-confined photo-acoustic interaction with exogenous and endogenous pigments. In order to achieve optimal results, several treatment sessions are usually required. However, the number of sessions depend on tattoo size, design complexity, pigment quantity within dermal layers, and anatomical location. Higher energy settings have often been used to reduce treatment sessions to a minimum however, this approach may lead to possible post-laser skin complications such as pathological wound healing. This case report highlights the importance of recognizing early stages of pathological wound healing encountered after high fluence 1064 nm QS laser tattoo removal. Early implementation of a proportional wound care strategy with anti-neoangiogenic and anti-inflammatory properties through the unconventional use of potent topical steroids applied in a pulsed fashion resulted in positive control of the tissue repair processes. This approach led to effective wound healing re-modulation achieving near normal skin remodelling and optimal tissue healing which in turn, permitted the completion of necessary QS tattoo removal sessions to accomplish successful and safe tattoo fading whilst maintaining overall patient satisfaction.

Assessing the readability and quality of online patient information for laser tattooremoval.

Just as tattoos continue to increase in popularity, many people with tattoos also seek removal, often due to career concerns. Prospective clients interested in laser tattoo removal may do research about the procedure online, as the internet increasingly becomes a resource to get preliminary health information. However, it is important that the online health information on the topic be of high quality and be accessible to all patients. We analyzed 77 websites from a Google search query using the terms "Laser tattoo removal patient Information" and "Laser tattoo removal patient Instructions" to assess this. The websites were evaluated for their readability using multiple validated indices and comprehensiveness. We found that websites had a broad readability range, from elementary to college, though most were above the recommended eighth-grade reading level. Less than half of the websites adequately discussed the increased risk of pigmentary complications in the skin of color clients or emphasized the importance of consulting with a board-certified dermatologist/plastic surgeon before the procedure. Over 90% of the websites noted that multiple laser treatments are likely needed for complete clearance of tattoos. The findings from our study underscore a significant gap in the accessibility and quality of online information for patients considering laser tattoo removal, particularly in addressing specific risks for patients with darker skin tones and emphasizing the need for consulting a board-certified physician before undergoing the procedure. It is important that online resources for laser tattoo removal be appropriately written to allow better decision-making, expectations, and future satisfaction for potential clients interested in the procedure.

In vitro hyperspectral analysis of tattoo dyes.

BACKGROUND: There is no method that can guarantee effective, quick, and noninvasive removal of tattoo dyes. Laser methods are considered to be the method of choice. In this study, an attempt was made to determine the in vitro spectral characteristics of selected dyes used in permanent makeup and tattoos and to analyze the obtained parameters in terms of laser treatments optimization. MATERIALS AND METHODS: Hyperspectral analysis was performed to determine the spectral characteristics of the dye on the entire surface of the slide. Seven dyes used in permanent makeup and tattoos were analyzed in vitro. The maximum reflectance and the wavelength for a given dye were determined for the maximum reflectance in the studied wavelength range: 400-1000 nm. The optical properties of the dyes were determined based on visible light imaging using camera. RESULTS: The maximum radiation reflectance ranges from 634 to 732 nm for the tested dyes. Visually very similar colors may differ significantly in the wavelength for which the maximum absorption of the radiation occurs. White and yellow dyes are characterized by the highest reflectance value. The black dye is characterized by the lowest reflectance coefficient. Low reflectance of black dye results in more safe and effective removal treatments. CONCLUSION: The homogeneity of radiation absorption can be identified using methods of analysis and processing of images in visible light. Optimization of the wavelength of which the maximum absorption/reflectance of radiation occurs may allow us to increase the effectiveness of laser treatments for removing permanent makeup and tattoos.

Liberating more than light: Laser removal of branding tattoos is impactful in the recovery of sex trafficking survivors.

OBJECTIVES: Sex trafficking involves the use of force, fraud, or coercion to compel another person to engage in commercial sex acts. In 2020, 16,658 individuals were identified as sex trafficking victims in the United States, with thousands more not reported. Many victims are branded by their traffickers with tattoos conveying ownership, including names, symbols, and barcodes. We have partnered with local non-profits in Houston supporting sex trafficking survivors by providing pro bono laser tattoo removal, however we believe there is a greater need at a national level to support these survivors, allowing them to reclaim their bodies. METHODS: An online survey aimed at assessing the need and potential impact for pro bono branding tattoo laser removal services was distributed to United States organizations that support sex trafficking survivors. RESULTS: Forty organizations based in the Northeast (15%), Midwest (20%), South (45%), and West (20%) responded. Organizations support on average 81 survivors annually, ranging from 3 to 600 survivors, and estimate that 47% of survivors have branding tattoos. Among survivors with branding tattoos, approximately 67% were identified at an appropriate recovery stage to undergo laser removal. On a scale of 1-10 with 10 being the most impactful on recovery, removal of branding tattoos received an average impact score of 9.2. On a scale of 1-10, with 10 being the most need, pro bono services for laser removal received an average need score of 9.1. Qualitative responses provided several insights: laser removal may be associated with enhanced healing compared to tattoo cover-up, and survivors frequently move during their recovery process thus a successful removal campaign would require a nationwide network of partnering laser surgeons. CONCLUSIONS: Approximately 1 in 2 sex trafficking survivors are estimated to have branding tattoos and the removal of these tattoos is recognized as highly impactful on recovery. We propose a philanthropic campaign which involves the American Society for Laser Medicine and Surgery (ASLMS) establishing a national directory to connect sex trafficking survivors seeking removal of branding tattoos with interested ASLMS board-certified physician members.

Objective monitoring of laser tattoo removal in human volunteers using an innovative optical technique: A proof of principle.

OBJECTIVES: Assess the suitability of the technique for objective monitoring of laser tattoo removal by an extended treatment protocol. MATERIALS AND METHODS: One half of the tattoo in the first volunteer was treated with nanosecond and the other half with picosecond laser pulses at 1064 nm. In the second subject, four test areas were treated repeatedly using different radiant exposures from 1.5 to 6 J/cm2 . Measurements of diffuse reflectance spectra and photothermal radiometric transients were performed 4-20 weeks after each treatment session. Inverse Monte Carlo analysis based on a three-layer model of tattooed skin was applied to assess the tattoo characteristics and analyze their changes. RESULTS: The results clearly indicate a gradual reduction of the ink content and an increase of the subsurface depth of the tattoo layer with all treatments at a radiant exposure of 3 J/cm2 or higher. The observed dependences on laser pulse duration, radiant exposure, and a number of treatments are in excellent agreement with visual fading of the tattoo. CONCLUSIONS: The presented methodology enables noninvasive characterization of tattoos in human skin and objective monitoring of the laser removal treatment.

Picosecond lasers in cosmetic dermatology: where are we now? An overview of types and indications.

Q-switched lasers have undeniably revolutionized the field of laser dermatology since four decades ago. Just as the first-generation laser emits its photonic signal in a few nanoseconds, the picosecond laser delivers pulse widths of at least ten times shorter. These devices offer a powerful tool for treating a wide range of skin conditions with a minimal downtime for visible improvement. For the current study, a literature research was performed on the dermatological applications of picosecond laser. The literature searched on this topic between 1999 and 2023 accessible through various platforms produce a result of 62 articles. The included studies have discussed the application of picosecond laser technology in tattoo removal, treatment of epidermal and dermal pigmentation, and collagen remodeling. After sifting the data from the articles into tables, the results were discussed in detail. The study shows a lot of evidence towards the efficacy of picosecond laser, yet it draws attention to its downsides.

Comparative study of 1064 nm nanosecond, 1064 nm picosecond, 755 nm, and 595 nm lasers for tattoo removal: An essential role by macrophage.

OBJECTIVES: Tattoo removal is in high demand, and many types of lasers can be used for tattoo removal. Macrophages play an important role in the persistence of tattoos. However, comparative studies of the efficacy of tattoo removal with different lasers versus the relationship between the destruction of pigment particles or recruitment of macrophages after laser treatment are lacking. MATERIALS AND METHODS: Tattoo models were established on the rat dorsal surface and randomly treated with 1064 nm nanosecond, 1064 nm picosecond, 755 nm, and 595 nm lasers for one session. Clinical photographic evaluation, melanin index, hematoxylin and eosin staining, identification of macrophages by CD68 staining, and transmission electron microscopy were conducted at different time points. RESULTS: Regardless of the pulse duration, all lasers included were effective for the removal of black tattoos, with 1064 nm lasers having the best efficacy, followed by 755 and 595 nm lasers. The diameter of the pigment particles and recruitment of dermal macrophages correlated with the efficacy of tattoo removal. CONCLUSIONS: In this study, the 1064 nm lasers were found to be the most effective for black tattoo removal. However, there was no significant difference between the 1064 nm picosecond and the nanosecond lasers. Macrophage recruitment plays an essential role in pigment metabolism during laser-tattoo removal.

A Descriptive Analysis of the Epidemiology and Motivations for Laser Tattoo Removal in an Underserved Population.

Tattoos of formerly gang-involved and incarcerated individuals can negatively impact their ability to reintegrate into society. Laser tattoo removal is essential to helping individuals obtain employment, re-cultivate positive relationships, and disengage from gangs. The objective of this study is to describe the demographics and motivations for laser tattoo removal at a large nonprofit clinic. This was a single center retrospective study conducted on patients presenting to Ya'stuvo Tattoo Removal between January 2016-December 2018 and had at least three laser tattoo removal sessions. Data was recorded on patient demographics, geographic location of residence (e.g. zipcode), comorbidities, probation/parole status, referral source, transportation mode, and motivations for receiving and removing tattoos. A representative sample of 862 patients was used to conduct our analysis. Average age at first visit was 30. 16% (n = 134) were on probation, 8% (n = 66) were on parole, and 63% (n = 544) did not report their probation/parole status. Reasons for receiving a tattoo included gangs (46%, n = 368), a current or ex-relationship (28%, n = 223), and decoration (20%, n = 159). The most common reasons for tattoo removal were employment (66%, n = 546), readiness to change life (47%, n = 392), maturity (47%, n = 392), family (43%, n = 356), and negative attention from tattoos (37%, n = 303). The current study highlights the importance of laser tattoo removal in reintegration and gang disengagement. Expanding cost efficient laser tattoo removal is paramount to meet the safety and socioeconomic needs of this population.

Laser tattoo removal: laser principles and an updated guide for clinicians.

Tattoos have become ingrained in our society and have served varied purposes throughout human civilization. So long as tattoos have existed, there has been demand for their removal. Lasers are currently the modality of choice in the removal of tattoos, as they are more efficacious than previously used methods. The most common lasers are the 532 nm and 1064 nm neodymium-doped yttrium aluminum garnet lasers, the quality-switched 694 nm Ruby laser, and the quality-switched 755 nm alexandrite laser. However, picosecond lasers are rapidly gaining favor in tattoo removal. An in-depth understanding of laser principles and how they can be applied in the setting of tattoo removal is key. Also, a greater understanding of the origin of and colors within a tattoo, the presence of tattoo layering, and a patient's Fitzpatrick skin type increase the odds of satisfactory results. This review provides dermatologists with a comprehensive summary on laser fundamentals, an overview on treatment principles, and recent developments in the field of laser tattoo removal.

Laser tattoo removal: Fundamental principles and practical approach.

Tattoos have long become a part of human civilization. However, as the number of people who get tattoos increases, so is the number of people who wish to have their tattoos removed. Compared to other methods, laser-based devices are associated with the best efficacy and least side effects in tattoo removal. Lack of understanding of the fundamental principles of laser and managing its parameters may result in suboptimal result and increased risk of side effects. Recognizing and mastering multiple factors including skin types, nature and color of tattoos, and proper selection of laser parameters such as wavelength, fluence, and pulse, are central in achieving an optimal tattoo removal outcome. This review provides a comprehensive overview on the fundamental principle of laser and practical approaches in tattoo removal.

Safety and Efficacy of Tattoo Removal Using a Dual-Wavelength 1064/532-nm Picosecond Laser in Patients With Fitzpatrick Skin Type III and IV.

BACKGROUND AND OBJECTIVES: To investigate the safety and efficacy of a dual-wavelength 1064/532-nm picosecond-domain laser for tattoo removal in Vietnamese patients. STUDY DESIGN/MATERIALS AND METHODS: This prospective clinical study enrolled 30 subjects with 52 decorative tattoos treated with up to six treatments of laser removal at intervals of 6-8 weeks. Safety and efficacy were assessed at each treatment session and at 4 weeks after the final session. A "good" response was defined as at least 75% clearance of tattoo pigments. RESULTS: A significant reduction of tattoo appearance was achieved in all subjects. 88.5% of tattoos exhibited a "good" response to treatment by the end of the six sessions and more than 36% of tattoos exhibited better than "good" responses. Adverse events were common in the early period after treatment but did not persist in most patients. Only one case of prolonged hypopigmentation was reported. CONCLUSIONS: Treatment using a 1064/532-nm picosecond laser is an effective approach for removal of decorative tattoos, which poses a minimal risk of long-term adverse events in patients with Fitzpatrick skin type III or IV. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

High power Q-switched 1064 nm / 532 nm Nd:YAG Laser in tattoo removal: A systematic review.

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.

Fast tattoo removal using Q-Switching ND-YAG laser technique with multi pass sessions.

Laser therapy is the gold standard method to remove unwanted tattoos. It is available and widely accessible. This study was done to assess the efficacy of the R20 method (multi-time separated passes in one session for 20 min) using Q-switched ND: YAG laser for the removal of tattoos and was compared with the traditional method. Forty patients with 40 Tattoos were included. These tattoos were separated into two halves left and right. One half was treated with a single pass and the other half with R20. Both halves were treated using Q-switched ND-YAG laser with 10 J/cm2, 1.064 µm, 8 ns pulse width, and 3 mm spot size. The treatment regimen included three sessions at three-week intervals. Tattoo bleaching was evaluated in each session by means of using the imaging process by two dermatologists. It could be concluded that the treatment with traditional single-pass is less effective than the R20 method in the three-month period. Epidermal healing period needs more than three weeks with the R20 method. The amateur tattoos have a significantly better response than professional tattoos. The R20 method is better than the traditional method to remove a tattoo, where most tattoos can be removed in one session. Amateur tattoo is removed faster compared to professional tattoo using R20 method because amateur tattoo affects the skin surface.

Treatments of a phthalocyanine-based green ink for tattoo removal purposes: generation of toxic fragments and potentially harmful morphologies.

Since tattoos became overwhelmingly fashionable worldwide, the demand for removal has proportionally increased, Nd:YAG Q-switch laser being the most commonly used tool for the purpose. In this framework we investigated the composition and products of laser treatment of green tattoo ink, the Green Concentrate from Eternal. The ink characterization has been carried out by IR, UV-Vis, EDX spectroscopies, and SEM imaging. It revealed the presence of the pigment PG7, rather than PG36 as reported on the bottle label, along with non-fully halogenated analogues. The morphology is an extended sheath with embedded grains. Subsequent laser treatments were performed on both dried and extracted inks, dispersed either in water or in propan-2-ol, chosen for their different polarities, as it is the case in the skin layers. The products were analyzed by gas chromatography-mass spectrometry, UV-Vis spectroscopy, SEM imaging, and dynamic light scattering. The outcome is a complex fragmentation pattern that depends both on the solvent and on the initial aggregation state. The fragment compounds are toxic at various degrees according to the Classification Labelling and Packaging regulations. Several shapes of aggregates are produced as an effect of both downsizing and re-aggregation, with potentially harmful aspect ratios.

Successful Treatment of Scalp Micropigmentation With 1064 nm Picosecond Nd:YAG Laser.

BACKGROUND AND OBJECTIVES: Scalp micropigmentation (SMP) is a useful technique that applies permanent camouflage for hair loss and scarring. However, suboptimal outcomes necessitate removal. To date, there have been no reports of SMP removal with a picosecond laser. In this report, we demonstrate the safety and efficacy of 1064 nm picosecond neodymium yttrium aluminum garnet (Nd:YAG) laser for the removal of SMP. STUDY DESIGN/MATERIALS AND METHODS: This was a case series of four patients who presented with undesirable SMP. Following induction of adequate cutaneous anesthesia, a 1064 nm picosecond Nd:YAG laser was applied to all surface areas with SMP. Post-operative care consisted of 1% dimethicone ointment applied twice daily to the affected areas for 3-7 days. Patients were evaluated after 3-4 weeks and additional treatment sessions were undertaken if necessary. RESULTS: Clearance of SMP was achieved within 1-3 treatment sessions in all cases. There were no unexpected adverse events. CONCLUSION: Picosecond Nd:YAG laser is an excellent treatment option for undesirable SMP. It is safe and effective and typically requires fewer treatment sessions than traditional tattoo removal. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Successful Treatment of Cosmetic Oral Mucosal Tattoos Using QS 694-nm Ruby Laser and 755-nm Alexandrite Picosecond Laser.

BACKGROUND AND OBJECTIVES: Q-switched (QS) and picosecond lasers can effectively and safely remove unwanted tattoo pigments. Cosmetic mucosal tattoos are rare and there are only a handful of cases of successful laser tattoo removal, all with QS 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser. STUDY DESIGN/MATERIALS AND METHODS: A 19-year-old Fitzpatrick skin-type II female presented for treatment of a 6-month-old, black tattoo on the mucosal surface of her lower lip. She underwent six treatment sessions with a QS 694-nm ruby laser on months 0, 1, 3, 5, 7, and 12. A 30-year-old Fitzpatrick skin-type IV male presented for treatment of a 10-year-old black tattoo on his left buccal mucosa. He underwent one treatment with 755-nm alexandrite picosecond lasers. RESULTS: One month after last treatment, both patients demonstrated marked improvement to the treatment area without scarring or dyspigmentation. CONCLUSIONS: Given the excellent results seen in the patients presented here, the authors recommend that lasers should be the first-line treatment for the removal of unwanted cosmetic mucosal tattoos, which are typically easier to remove than cutaneous tattoos and can be accomplished with various wavelengths in the picosecond and nanosecond domains. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Comparative Evaluation of 15 Laser and Perfluorodecalin Combinations for Tattoo Removal.

BACKGROUND AND OBJECTIVES: We present a case of laser tattoo removal treated with 15 different combinations using picosecond 1064 nm, picosecond 755 nm, nanosecond 755 nm, and a fractionated CO2 laser, both with and without a perfluorodecalin (PFD) patch to ascertain the most effective approach. STUDY DESIGN/MATERIALS AND METHODS: A single lower extremity black tattoo was divided into 15 treatment sections allowing for testing of various laser and PFD combinations. Sectioned treatment was conducted until a treatment superiority was noted. RESULTS: After two sessions using sectioned combination treatments with a 4-week interval clinically significant results were produced. CONCLUSIONS: The combination of picosecond 1064 nm, picosecond 755 nm, and a fractionated CO2 laser without the PFD patch showed superior clinical improvement over the other combinations. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Increased Tattoo Fading in a Single Laser Tattoo Removal Session Enabled by a Rapid Acoustic Pulse Device: A Prospective Clinical Trial.

BACKGROUND AND OBJECTIVES: The ability to provide improved tattoo fading using multiple laser passes in a single office laser tattoo removal session is limited. In part, this is due to the loss of laser effectiveness caused by epidermal and dermal vacuole "whitening" generated during the initial laser pass at the tattoo site. The Rapid Acoustic Pulse (RAP) device generates acoustic shock wave pulses that clear epidermal and dermal vacuoles to enable multiple laser passes in a single office laser tattoo removal session. The objectives of this study were to determine if the RAP device, when used as an accessory to the 1064 nm Nd:YAG Q-switched (QS) laser can enable delivery of multiple laser passes in a single office laser tattoo removal session, and therefore result in increased tattoo fading compared to the clinical standard single-pass QS laser tattoo removal session. STUDY DESIGN/MATERIALS AND METHODS: The RAP device was evaluated in a single-center (SkinCare Physicians), prospective, IRB approved study. A total of 32 black ink tattoos, from 21 participants, were divided into three zones and treated with either multiple QS laser passes, each followed by 1 minute of RAP device application (Laser + RAP) in zone one and single-pass QS laser treatment (Laser-Only) in zone two, separated by an untreated control zone. The treatment sites were assessed for the number of laser passes and adverse events immediately, 6 weeks, and 12 weeks following the treatment session. Photographs of the treatment sites were assessed for percent fading at 12 weeks post-treatment by three blinded reviewers. RESULTS: When the RAP device was applied as an accessory to the QS laser in a multi-pass laser tattoo removal treatment, an average of 4.2 laser passes were delivered in a single session, with no unexpected or serious RAP device-related adverse events. At the 12-week follow-up, tattoos treated with Laser + RAP showed a statistically significant increase in average fading (44.2%) compared with tattoos treated with Laser-Only (24.8%) (P < 0.01). Additionally, a significantly higher overall proportion of tattoos treated with Laser + RAP (37.5%) had a response of >50% fading compared with tattoos treated with QS Laser-Only (9.4%) (P < 0.01) as well as a response of >75% fading from Laser + RAP treatment (21.9%) compared with Laser-Only treatment (3.1%) (P < 0.05). CONCLUSIONS: The RAP device, applied as an accessory to the 1064 nm Nd:YAG QS laser, safely enables multiple QS laser treatments in a single office laser tattoo removal session by clearing the whitening caused by the previous QS laser pass. Enabling multiple QS laser passes results in a statistically significant increase in tattoo fading in a single office laser tattoo removal session compared to the clinical standard single-pass QS laser tattoo removal session. © 2019 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

Combination of Dual Wavelength Picosecond and Nanosecond Pulse Width Neodymium-Doped Yttrium-Aluminum-Garnet Lasers for Tattoo Removal.

BACKGROUND AND OBJECTIVES: Tattoo removal by laser has been mostly performed using Q-switched laser, which has nanosecond pulse width. In recent years, the efficacy of treatment with picosecond pulse width laser has also been reported. STUDY DESIGN/MATERIALS AND METHODS: Using a picosecond-domain, neodymium-doped yttrium-aluminum-garnet laser with a potassium-titanyl-phosphate frequency-doubling crystal, we performed a retrospective clinical study with combination treatment using pulse widths of 750 ps and 2 ns. The number of treatments was compared with the Kirby-Desai score. Tissue changes immediately after laser irradiation at 2 ns and 750 ps were compared using an electron microscope. RESULTS: The combination treatment using pulse widths of 2 ns and 750 ps was safe and more effective than the Q-switched neodymium-doped yttrium-aluminum-garnet laser treatment. Tattoo removal was possible with significantly fewer treatment numbers than the Kirby-Desai score, without adverse events. The results from the scanning electron microscope revealed that ink particles irradiated by 750 ps were more dispersed than those by 2 ns. CONCLUSIONS: The combination treatment with pulse widths of 2 ns and 750 ps and 1064 nm and 532 nm wavelengths using the neodymium-doped yttrium-aluminum-garnet laser was safe and effective and can be a useful option for tattoo removal. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Perfluorodecalin-infused patch in picosecond and Q-switched laser-assisted tattoo removal: Safety in Fitzpatrick IV-VI skin types.

BACKGROUND: 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. STUDY DESIGN/MATERIALS AND METHOD: 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. RESULTS: 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. CONCLUSION: 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.