Paradoxical darkening and removal of pink tattoo ink

Abstract

It is widely accepted that Q-switched lasers are the gold-standard treatment for the resolution of unwanted tattoo ink. Although much safer than other tattoo removal modalities, the treatment of tattoo ink with Q-switched devices may be associated with long-term adverse effects including undesired pigmentary alterations such as tattoo ink darkening. Darkening of tattoo ink is most often reported in cosmetic, flesh-toned, white, peach, and pink tattoos. In this paper, we briefly review a case of pink tattoo ink that initially darkened paradoxically but eventually resolved with continued Q-switched laser treatments.

Laser tattoo removal: A clinical update

“…Such paradoxical darkening has been successfully treated with further QS laser treatments, sometimes requiring up to 20 sessions. [ 29 30 ] Ablative laser resurfacing with pulsed CO 2 and erbium-doped YAG lasers have also been successfully used in cosmetic tattoos. [ 31 32 ]…”

Complementary and Alternative Medicine for Vitiligo

“…Pigments used for diluting colors are often left in the skin for a long time. In the case of titanium dioxide, patients can experience paradoxical darkening, which is cosmetically undesirable, although dermatologists have successfully treated this with the Q-switch laser (Kirby et al, 2010). The common problem with micropigmentation is dissatisfaction with shape and tone.…”

“…Magnetic responsive dyes in tattoo can cause cutaneous reactions when patients undergo MRI testing. (De Cuyper, 2008;FDA, 2011;Kirby 2010).…”

Rising Concern over Cosmetic Tattoos

“…Red ink absorbs the 532-nm Nd: YAG laser, and the red and infrared wavelengths of the 755-nm alexandrite and 1,064-nm Nd:YAG lasers are each effective for the treatment of black, blue, and green inks. 51 To preclude paradoxical darkening, alternative treatments may include pulsed CO 2 52 and erbium-doped YAG lasers, 53 which have been shown to be effective in vaporizing red, pink, and flesh-colored cosmetic tattoos. 50 Chemical reduction of ferric oxide to ferrous oxide is thought to be responsible for the potentially permanent darkening of tattoos.…”

“…Nevertheless, it is possible to treat the paradoxical darkening with continued QS laser treatments. 51 To preclude paradoxical darkening, alternative treatments may include pulsed CO 2 52 and erbium-doped YAG lasers, 53 which have been shown to be effective in vaporizing red, pink, and flesh-colored cosmetic tattoos. Newer techniques for tattoo removal involve combinations of QS pigment-specific (red and infrared) lasers with ablative fractional laser resurfacing, which have been reported to enhance the rate of pigment clearance and decrease risk of vesiculation.…”