Q-S laser micro-drilling and multipass full-beam Q-S laser for tattoo removal — a case series

Abstract

The purpose of this study was to evaluate the safety and efficacy of a new combined method of Q-S laser-assisted tattoo removal. Ten patients with 13 professional, mostly mono-chromatic black tattoos were recruited. All tattoos received the same Q-S laser treatment sequence. An objective evaluation of tattoo clearing was assessed by careful analysis of a standardized collection of digital images taken from each tattoo, 2 months after each laser session, with the help of a custom-made pigment-fading percentage photographic ruler. The percentages of pigment clearance and side effects were evaluated by 4 independent dermatologists. Patient satisfaction and perceived discomfort during and post-procedure were evaluated according to specific scales. Clinical evaluators confirmed an average photographic pigment clearance of 97% after a median 4.85 treatment sessions. The Frac-Tat® method required 40% fewer sessions compared to those calculated by Kirby-Desai estimates. Photographic assessment of laser-exposed skin quality performed 2 months after tattoo clearing was considered almost comparable with untreated peripheral skin, confirming a very low side effect score. The Frac-Tat QS laser-assisted tattoo removal sequence used in our study showed a high degree of safety and efficiency, clearing exogenous pigments in a relatively few number of sessions. Preliminary ablative photo-acoustic fractional 1064-nm Q-S laser micro-drilling was considered an essential step in optimizing tattoo removal, increasing wavelength-independent micro-columnar clearing of deeper dermal exogenous pigments. Our preliminary observations also confirmed a significant improvement of tattoo procedure-induced micro-textural changes thanks to a tissue remodeling effect induced by the 1064-nm Q-S fractional laser photo-acoustic ablation.

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

“…Professional tattoo removal with a sequence of three 1064-nm QS nanosecond-picosecond laser passes per session – one fractional mode, followed by two full-beam mode passes at 5-minute intervals, has shown to be an effective and safe treatment protocol to achieve almost full removal of dark and red tattoo inks in fewer sessions than single QS laser pass-per-session treatments [ 4 ]. According to the Kirby-Desai tattoo removal scale, which estimates the number of expected laser treatments required to achieve complete tattoo removal according to specific parameters such as patients skin phototype, tattoo anatomical location, colour, amount of ink, presence of scarring and/or tattoo layering, the approximate number of QS laser treatments to obtain complete tattoo fading in this clinical case would have been 11 [ 6 ].…”

“…However, overall outcome is significantly affected by post-treatment skin care regimes. An example of adaptive three stage post-laser skin repair protocol was described by L. Marini et al in 2022 [ 4 ]. One of the most-important aims in effective post-treatment wound healing protocols includes the prevention of pathologic scarring, skin textural chromatic modifications and reduction of post-inflammatory hyperpigmentation.…”

“…However, literature confirms that not all patients respond equally well to QS laser tattoo removal procedures stressing the importance of a preliminary analysis of several clinical variables [ 3 ]. Individual photo-genetic skin types, specific tattoo characteristics such as ink chemical composition, colour intensity and distribution, age and anatomical location deeply influence QS laser parameters and post-treatment aftercare [ 3 , 4 ]. Khunger et al (2015) categorised post laser-assisted tattoo removal adverse results into immediate and delayed complications [ 3 ].…”

Immune Response in Laser Tattoo Removal: A Systematic Review

“…The seventh study conducted by Marini et al offers a comprehensive case series examining the application of QS laser micro-drilling and multipass full-beam QS laser in the context of tattoo removal 18 . The research, undertaken by Vander Bent, reveals that ablative CO2 laser treatment has the potential to alleviate itching, burning sensations, and the overall impact on daily life for tattoo allergy patients.…”