A prototype picosecond-domain Nd:YAG laser was safe and effective at removing multicolor decorative tattoos in a preliminary study, achieving 79% removal in an average of 6.5 treatments, according to a report published in Lasers in Surgery and Medicine.
Nanosecond-domain Q-switched lasers have been the standard tools for tattoo removal for decades, but a new class of the device that generates picosecond-domain pulses was developed to remove tattoos more efficiently. In this prospective study, a prototype device (PicoWay, Syneron-Candela Corporation) was used to remove 31 multicolor tattoos on 21 patients aged 19-55 years (average age, 32 years), according to Dr. Eric F. Bernstein of Main Line Center for Laser Surgery, Ardmore, Pa., and his associates.
Annie Fulton
Multicolored tattoos are increasingly popular; the need for effective removal modalities is likely to grow as well.
All the tattoos were previously untreated and measured no more than 10 cm by 10 cm in area. All were treated through a hydrogel dressing to protect the epidermis and minimize scarring. Treatment sessions were done at 6- to 10-week intervals until the tattoos were cleared or demonstrated a lack of further improvement, for a maximum of 7 treatments.
Three physicians blinded to treatment conditions assessed digital photographs of the treated areas taken at two fixed focal lengths before each treatment session, at 6-10 weeks following each treatment, and at 12 weeks after the final treatment session. This panel of physicians assessed the photographs, which were presented in a randomized order, grading them on percentage improvement for overall clearance and for clearance of each color contained within a given tattoo. The photographs had been taken with a cross-polarized flash, which enhances the view of the tattoo beyond what is normally seen by the naked eye.
Overall, the panel judged that the new device produced 79% clearance after an average of 6.5 treatments. Clearance scores were 92% for black ink, 85% for yellow ink, 80% for red ink, 78% for purple ink, 65% for green ink, and 43% for blue ink. Black and red inks were removed the most effectively, as expected; green and blue inks were more difficult to remove, also as expected. However, the 85% clearance of yellow ink, usually the most difficult color to remove, in an average of four sessions was “surprising and encouraging,” Dr. Bernstein and his associates said.
“It was hoped that picosecond-domain lasers would be ‘color blind’ and remove all colors equally; however, we found this not to be the case,” they noted (Lasers Surg Med. 2015;47[7]:542-8).
Regarding the safety of the new device, purpura was noted immediately after one treatment in one patient but completely resolved by the next session. Mild pinpoint bleeding developed immediately after 14% of sessions, almost always with attendant edema and erythema; all of these effects resolved with time. No immediate blistering was observed in any patient. At 3-month follow-up, no scarring and no moderate to severe pigmentary alterations were noted. Mild hypopigmentation occurred in red or yellow portions of two tattoos, and mild hyperpigmentation occurred in black areas of five tattoos.
“The true benefits of picosecond-domain devices for tattoo removal and other applications should become more apparent as these devices are used more frequently in clinical practice,” the investigators added.
This study was funded by Syneron-Candela Corporation, maker of the prototype picosecond-domain laser tested here. Dr. Bernstein reported serving as a consultant for Syneron-Candela, and two of his associates are employees of the company.