Same-day, repetitive Q-switch laser treatments boost tattoo clearance, but with diminishing returns

Kissimmee, Fla. - Repetitive same-day treatment with a nanosecond pulse, Q-switched laser increases tattoo ink clearance and is safe, but the magnitude of improvement does not appear to increase linearly with the number of treatments, reported Suzanne L. Kilmer, M.D., at LASER 2012, the 32nd annual meeting of the American Society for Laser Medicine and Surgery.

Dr. Kilmer presented results from a study she did with her fellow, Omar Ibrahimi, M.D., Ph.D., that investigated the efficacy and safety of repetitive laser treatments for 26 tattoos in 17 patients. Fifteen tattoos were divided into four quadrants that received one, two, three, or four same-day laser treatments, and 11 were bisected and received one or four same-day treatments.

The treatments were performed with either a Q-switched alexandrite (755 nm) or one of several Nd:YAG lasers (532 nm and 1,064 nm); same-day repeat treatments were performed after a minimum wait time of 20 minutes.

All patients returned for a one-month follow-up visit, and 14 patients (20 tattoos) were evaluated one month after a second treatment session performed in the same manner as the first.

Study results
At the first follow-up, tattoo ink clearance rates for areas treated with one, two, three, and four laser exposures were 39, 50, 55, and 59 percent, respectively. Corresponding rates for patients who were treated again at a second visit were 63, 69, 74, and 78 percent, respectively.

All treatments were well-tolerated. The amount of swelling and petechia increased along with the number of treatments performed, but surprisingly, the treatment discomfort decreased, says Dr. Kilmer, associate clinical professor, University of California, Davis, and director, Laser & Skin Surgery Center of Northern California, Sacramento.

“Patients seemed to find the post-treatment sequelae an acceptable trade-off for the possibility of gaining better tattoo clearance faster, and increasing the number of same-day treatments did not increase the measurable risk of post-treatment textural or pigmentary changes. In fact, no hypopigmentation or scarring was noted in any tattoo,” she says.

“Weighing the benefits and downsides of performing repeat treatments, my practical recommendation would be to perform just two treatments per visit unless the patient has a particular reason to achieve greater clearance sooner,” Dr. Kilmer says.

Disclosures: Dr. Kilmer reports no relevant financial interests.

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