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. |
