Publications of Faculty of Medicine:Treatment of Tattoos By Q - Switched Ruby Laser: Abstract

Treatment of Tattoos By Q - Switched Ruby Laser
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Before the development of short- Pulsed lasers, all modalities of removing tattoos were limited by scarring. The Q-switched ruby laser (QSRL) was recently shown to effectively remove tattoos without scarring. This study was conducted to determine the efficacy and effects of Q-switched ruby laser in tattoo removal. This study was done on 40 patients with untreated tattoos. Twenty four patients had type IV skin, 6 had type III skin, and 6 had type V skin, while 4 had type II skin. Tattoos were treated by Q-switched ruby laser (694 nm, 5mm spot size and 28 n sec pulse width) Fluences ranged from 6-8 J/cm2. Number of sessions varied from 2-13 sessions. Forty percent of tattoos achieved complete clearance, 30 % achieved high lightening, 15 % achieved moderate lightening, and 10 % achieved mild lightening, while 5 % did not respond to this type of Laser. Hypopigmentation was detected in 45 % of cases, while Hyperpigmentation was detected in 10 % of cases. No scarring was seen in this study. We can conclude that Q-switched ruby laser can be successfully used for removal of different types of tattoos. Hypopigmentation is the major adverse effect of this type of therapy. Introduction Decorative tattoos, an ancient form of body adornment, have not lost their appeal; in fact, the frequency of new tattoo placement is on the rise. Many others have traumatic or iatrogenic tattoos. In addition, cosmetic tattooing has become more popular; eyebrow, eyelid, and lip-liner tattoos are available as well as flesh-toned inks to cover up vascular birthmarks, infraorbital darkening, and unwanted decorative tattoos. Multiple modalities have been employed to remove these tattoos, with traditional methods centered around tissue removal or destruction in the areas of tattoo ink deposition. Topical application of mild acids and gentian violet alone or in combination with dermabrasion or salabrasion0,2), cryosurgery, surgical excision, and infrared coagulatorM are all effective at removing tattoo ink, but the resultant scar may be as undesirable as the tattoo itself Treatment of tattoos with laser was first reported in the Department of Dermatology and venereology, Renha Faculty of Medicine *, and Pluticsurgery Division, General Surgery Department, Faculty or Medicine, Cairo University. •* 1960s by Goldman et al(4) using a normal mode (non Q-switched) ruby laser with poor results. They and others then explored the Q-switched mode, which improved ink removal and cosmetic outcome(5). Selective photothermolysis, localizing thermal damage to specific target by choosing a wave length that is selectively absorbed by the target and a pulse duration that is shorter than the thermal relaxation time (the time for the target to cool), is the basis of the use of new short-pulsed laser therapies to treat tattoosto. Several lasers have been shown to induce selective damage of pigmented cutaneous structures, including the Q-switched ruby laserM (694 nm:28 to 40 nsec), Q-switched Nd: YAG(8) (1064 nm and 532 nm, 10 to 20 nsec), Q-switched alexandriteM (755 nm: 10Onsec), and the pulsed dye (510 nm; 300nsec) lasers('0). This study was conducted to assess the ability of Q-switched ruby laser to remove tattoos.