Fast Five Quiz: Tattoos

Brett Sloan, MD


September 10, 2020

In general dermatology, liquid nitrogen (-196 °C) is commonly used to destroy superficial cutaneous lesions, but it is not useful in tattoo removal because the nonspecific destruction leads to prolonged healing and unpredictable results.

The 532-nm picosecond laser has demonstrated an ability to effectively clear yellow ink, a color that was notoriously difficult to remove using previous Q-switched devices. Although at first glance, the data appear to be conflicting regarding the true difference between picosecond and nanosecond lasers for tattoo removal. However, when both devices are used optimally, the picosecond lasers appear to be more effective when all tattoo colors are taken into account and when more treatment sessions are conducted.

The QSRL is effective in removing tattoos with minimal scarring, although multiple treatment sessions are required. The QSRL effectively removes black, blue-black, and green ink, although green ink can be difficult despite reflectance spectra predictions that it will respond at 694 nm. Other colors respond poorly to the QSRL.

The Q-switched Nd:YAG laser is effective in removing black ink, creating rare textural changes and almost no hypopigmentation. These improvements are attributable to the longer wavelength, higher fluence, and shorter pulse width.

Read more about tattoo lasers.

This Fast Five Quiz was excerpted and adapted from the Medscape Drugs & Diseases articles Tattoo Reactions, Tattoo Skin Reactions, and Tattoo Lasers.

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