Treatment of Gunpowder Traumatic Tattoo by Q-Switched Nd:YAG Laser: An Unusual Adverse Effect

Abstract

We hypothesize that the rapid transfer of high-energy pulses to powder particles creates microexplosions of these fragments resulting in cavitation and provoking transepidermal holes and subsequent scars. This adverse effect was only produced if the tattoo resulted from gun powder being shot at a short distance from the skin.

Treatment of traumatic tattoo with the Q‐switched Nd:YAG laser

“…However, pox-like scars due to microexplosion of tattoo fragments and spreading of pigments were reported for gun-shot wounds with a high density of gunpowder exposed to this type of laser irradiation (12). Bomb explosion resulted in diffused and low pigment load tattoos on the face of our case, which responded significantly to the treatment without any adverse effects.…”

Treatment of Gunpowder Tattoos with a High-Speed Diamond Drill

“…Established methods for treatment of this unusual type of injury are brush debridement; dermabrasion; carbon dioxide, erbium, or Q-switched neodymium-doped yttrium aluminum garnet lasers; or minipunch technique for deeper lesions. [1][2][3][4][5][6] The treatment should be performed within the first 24 hours after the trauma, when inflammation, edema, and exudation are prominent, although delayed treatments with a successful outcome have been described. 5 In large lesions containing a great amount of pigment or when the pigment has deeply penetrated into the skin, multiple sessions with combined treatment options may be necessary.…”

Treatment of Fireworks Tattoos with the Q-Switched Ruby Laser

“…Unfortunately, a test site may not predict how the rest of the treated area will respond. The rapid transfer of high‐energy pulses to powder particles can create microexplosions of these fragments, resulting in cavitation and provoking transepidermal holes and subsequent pox‐like scars 9,10 …”