The principal of tattoo removal is destruction of unwanted pigment with minimal collateral damage. This concept is particularly challenging when treating darker skin types as the melanosomes act as competing targets with thc potential to cause epidermal damage. The 1,064-nm wavelength has the least absorption by melanoclyles and is therefore the host choice for laser tattoo removal in darker skin types. There is less risk for hypopigmentation, scarring or textural change. However, the 1,0644-nm wavelength will not treat all tattoo colors. Therefore, one must employ alternate methods for multicolored or densely colored tattoos in dark skin types.
Fractional ablation of tattoos in dark skin types will allow extraction of tattoo pigment particles with minimal risk of scarring or pigmentary change. This concept is particularly useful in dark skin types with in a patient that has demonstrated allergic reaction to the tattoo pigment. For instance, red pigment is the most common known tattoo allergen and can result in a granulomatous reaction. If targeted with a 532-nm wavelength for removal, the pigment can shatter into many smaller particles followed by uptake systemically with the potential for anaphylaxis. To avoid this issue, fractional CO2 laser can be used for sloughing of the pigment through epidermal loss with limited systemic elimination. Non-fractional CO2 laser has limited use in this circumstance as it has significant potential to permanently depigment or scar the skin. This was the case in the patient show below:
Fractional ablation of tattoos in dark skin types will allow extraction of tattoo pigment particles with minimal risk of scarring or pigmentary change. This concept is particularly useful in dark skin types with in a patient that has demonstrated allergic reaction to the tattoo pigment. For instance, red pigment is the most common known tattoo allergen and can result in a granulomatous reaction. If targeted with a 532-nm wavelength for removal, the pigment can shatter into many smaller particles followed by uptake systemically with the potential for anaphylaxis. To avoid this issue, fractional CO2 laser can be used for sloughing of the pigment through epidermal loss with limited systemic elimination. Non-fractional CO2 laser has limited use in this circumstance as it has significant potential to permanently depigment or scar the skin. This was the case in the patient show below:
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a) Noted depigmentation after CO2 laser treatment for tattoo removal b) Noted depigmentation of prior treated area, accomplished with fractional CO2 laser treatment |
Laser tattoo removal for a skin complexion.
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