As more and more people are getting tattoos, there is an increasing demand to get them removed.  Whether the tattoo was a mistake from the get go, it didn’t turn out as you expected, or a relationship has changed and you want to remove your “ex” from your skin, the most common way to remove tattoos is with a laser.  The only other option is to surgically excise the tattoo which can realistically be done only for smaller tattoos and it always leaves a scar.

A Q-switched laser is needed to removed tattoos.  What’s unique about this type of laser is that its pulse duration (how long the time is which it fires it energy) is in the nanosecond range.  By making the pulse this short, it makes the energy level of the pulse in the billions of watts.  That huge energy hit to the tattoo causes a shock wave in the tattoo pigment which leads to the pigment breaking up into smaller pieces. Once the particles of the tattoo pigment get pulverized to a certain size, they are small enough for the body to “chew them up” and remove them from the body. Using traditional laser tattoo removal techniques, it takes multiple treatments, 10-15, to get complete tattoo removal.  Often the waiting between treatments is up to 2 months, so it can take a year to 2 to removal a tattoo.

There is a newer technique called the R0 protocol for tattoo removal which will remove tattoos much faster than traditional techniques.  The R0 protocol entails treating the tattoo 4 times in the same day.  There is a liquid placed on the tattoo which removes the frosting which occurs (from heating nitrogen in the skin) so you can immediately proceed to another pass.  Studies show much faster eradication, 1-4 sessions, with no more risks or side effects.

What type of Q-switched laser is the best?  The safest wavelength for treating skin of all colors is the 1064 nm Nd:YAG laser.  There is less pigmentation side effects and less textural changes with the 1064 Q switched laser than with the Alexandrite and Ruby laser.  Sometimes, after treating with this wavelength, residual pigment remains, and that’s when other wavelengths are needed.  You also want to look for a laser that has a “tophat” distribution of its pulse energy.  What this means is that the energy is evenly distributed across the entire spot size to give a uniform treatment.  If this is not the case, the tattoo can be under or over treated in some areas.  The shorter duration of the pulse, the better safety profile, and the better results.  The short pulse allows for less diffusion of the energy to nearby skin so as to leave this skin unaffected.  It also allows for greater energy levels on the treated area.

Top Hat energy distribution of the Spectra laser.  Left=others, Right=Spectra
Top Hat energy distribution of the Spectra laser. Left=others, Right=Spectra

Side effects from Laser Tattoo Removal are:  scarring, hypopigmentation, hyperpigmentation, incomplete tattoo removal, and rare allergic reaction to the dyes of the tattoo.  Darker skin individuals are at higher risks of complications than lighter skin individuals.

The Lutronic Spectra Q-Switched Laser seems to be an ideal laser for tattoo removal.

  1. An extremely short pulse duration which leads to high peak energies
  2. Based on 1064nm Nd:YAG platform
  3. Has multiple other wavelengths for difficult pigment (4)
  4. “Tophat” energy pulse profile
  5. Dual energy generators to prevent loss of energy during prolonged laser firing
Energy output showing the high peak energy of the Spectra laser
Energy output showing the high peak energy of the Spectra laser

Using the Kirby-Desai Scale, you can determine how many treatments it should take to improve the tattoo (within 80% accuracy)  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923953/

For further information about Lutronic Spectra Q-Switched laser tattoo removal, please call our office at 850.622.1214.  

Dr. Steven Weiner is a Board Certified Facial Plastic Surgeon practicing in Santa Rosa Beach, Florida, between Destin and Panama City Beach, Florida. After laying down his scalpel in 2005 he has devoted his practice to Lasers and Injectables.

Blog: http://stevenfweinermd.wordpress.com/

YouTube: http://www.youtube.com/user/StevenFWeinerFacial

Website: http://www.theclinique.net

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