TreaTmenT guide |


treatment guide Tattoo removal


Mario Trelles breaks down the essentials of tattoo removal and the development of new techniques for treatment


designs — some carried out by amateurs, others by professional tattooists — can constitute a true piece of art. however, fashion is transient, and health professionals are now more frequently approached to remove tattoos. Previous techniques used were not particularly successful until lasers entered the therapeutic arena.


F .


Laser devices As lasers are well established for the removal of pigmentation, the purchase of a laser for this purpose can be costly. Therefore, the possibility of counting on a multi-application laser platform, in which different wavelength emissions can be selected, provides the option of a single-unit poly-application appliance as an alternative to the typical situation of having a separate laser device for each specific application3–4


. Within the large availability of laser


devices on the market (e.g. Linline™), many now offer a sophisticated technology that accommodates a range of lasers adapted to a console with built-in programmes for the treatment of cutaneous, vascular and pigment disorders5


Traditional Q-Switch lasers produce


single-pulse widths for a duration of 10–12 nanoseconds (ns). This energy is absorbed ‘in one go’ by the matching colour located at the most external point of the skin. The deeper located pigment


66 ❚ September 2011 | prime-journal.com


ashion and social demand for a modern look have united to entice people to decorate their skin1–2


. Tattoos in a range colours and


remains unaffected, and therefore multiple sessions are needed to eliminate a tattoo. Tattoos of dark, dense colour made up of a considerable amount of ink, or multilayer coloured pigments,


are


especially difficult to eliminate and will require a number


of


t r e a t m e n t sessions6–7


. With


these multiple sessions,


the


reparative tissue process following laser


treatment


different mechanism for pigment elimination (Figures 1–2). The train of pulses, programmed for


operation in a frequency of 1–4 Hz, obtain sequential movement effects reaching


deep Traditional Q-switch


lasers produce single-pulse widths for a duration of 10–12 nanoseconds. This


energy is absorbed ‘in one go’ by the matching colour


located at the most external point of the skin.


leads to reactive fibrosis formation, which prevents light


penetrating to eliminate deep pigment in the following session.


Wavelengths Contrary to this, the pulses of the Linline™ are packed as a block in a carrier pulse, and delivered to the skin as a series of pulses which interact with a


from adequately


pigment. During interaction, the small- width, non-stop pulses of essentially lower energy, are delivered


in


sequence as a train of pulses. Delay time between the block of repeated pulses is of a few microseconds


and energy is absorbed first by the pigment chromophore located more superficially. The elimination of this pigment opens access for the following mini-pulses, contained in the ‘carrier block’, to penetrate and interact with the deeper located colours of the tattoo. Selectivity of laser wavelength


Q-switch energy interaction with pigment progressively increases in


Figure 1 Multilayer tattoo in which a number of colours have been used, making it difficult to eliminate. Observe the positive outcome after three sessions, with elimination of the various pigments


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