AT LASER 2016
BOSTON (FRONTLINE MEDICAL NEWS) – For the removal of unwanted tattoos, particularly those made up of more than one color, a multispectral laser system of 755 nm, 532 nm or 1,064 nm with a picosecond pulse duration has been found to be safe, fast, and highly effective, without leaving any residual scarring.
“Q-switch lasers with nanosecond pulse rates have been the gold standard of treating unwanted tattoos for years; however, they’re not without their limitations,” said Dr. Bradley Bloom , who presented the results of a prospective, single center study at the annual meeting of the American Society for Laser Medicine and Surgery.
Over the past several years, fewer than 60% of patients achieve complete clearance despite numerous treatments for tattoo removal, explained Dr. Bloom, of Skin Laser and Surgery Specialists of NY & NJ in New York City. “These limitations include the need for many treatments, and the difficulty in clearing green, blue, and yellow inks,” but these challenges could be alleviated by using picosecond lasers with short pulse durations, he said.
The study involved 44 individuals with a total of 53 noncosmetic tattoos. All tattoos were photographed at baseline and before each treatment; the subjects received anywhere between 1 and 10 treatments. Photographs were taken 2 months after the final treatment. Individuals were treated every 6 weeks, plus or minus 2 weeks, with either a 532-nm, 755-nm, or a 1,064-nm laser with a 450-500 picosecond, 500-750 picosecond, and 500-600 picosecond pulse duration, respectively (0.5-6 J per square centimeter, and 1-10 millimeters).
The majority (84%) of the treated tattoos were made up of several different ink colors, including black, red, orange, yellow, green, blue, pink, and white.
“The results we saw with the 532-nm [laser] were over 75% clearance of red, orange, and yellow [inks] with just an average of two treatments,” said Dr. Bloom, adding that these data compare favorably against historical data.
Patients who received at least four treatments reached 75% improvement in tattoo visibility with the 532-nm laser. In addition, 82% of those treated with at least four treatments with the 1,064-nm laser improved by at least 50% and 85% of those treated at least four times with the 755-nm laser treatment improved by at least 50%.
Investigators noted that both wavelength and pulse duration were critical variables in determining the efficacy of the treatment on a given tattoo. For example, 532 nm was found to be “extremely useful” in clearing red, orange, and yellow inks, while the 755-nm laser was found to be the most effective on blue and green inks.
For black inks, both the 755-nm and 1,064-nm were found to be effective, but Dr. Bloom advised that “greater caution [is] required” when using the former on darker skin types.
Some patients did see “mild hypopigmentation” which improved with time, Dr. Bloom said. In addition, a patient who had a biopsy after receiving 10 laser treatments revealed no evidence of fibrosis or scar formation, which “underscores the safety of this device.”
For handling multicolor tattoos, Dr. Bloom suggested dividing the tattoos based on which colors are dominant so that they can be targeted with the laser best suited to remove that color.
Cynosure, maker of the multispectral laser system, supported in the study. Dr. Bloom disclosed advisory, consulting, and financial ties to Aerolase and Cutera