TreaTmenT guide | References
1. Pers M, von Herbst T. Tatovering af umyndige. Ugeskr Laeger 1965; 127: 973–7
2. Goldstein N, Sewell M.
Tattoos in different cultures. J Dermatol Surg Oncol 1979; 5(11): 857–64
3. Trelles MA. Cosmetic laser surgery: current procedures and developments to come. In: Taylor S. ed, Private Hospital Healthcare Europe. London: Campden Publishing Ltd, 2003
4. Vélez M, Serra M, Trelles MA, Pérez-Peña P. Estado Actual Del Láser Quirúrgico En España. S.E.L.M.Q. Boletin Informativo 2001; 1: 9–15
5. Multifunctional laser
complex Multiline. France: Linline.
www.linline.com (accessed 4August 2011)
6. Dixon J. Laser treatment of
decorative tattoos. In: Arndt KA, Noe JM, Rosen S. eds, Cutaneous Laser therapy: Principles and methods. New York: John Wiley and Sons, 1983
7. Kilmer SL, Anderson RR. efficacy during treatment, and the
train of pulses acts layer after layer, fragmenting the tattoo. During ‘continuous’ exposure of tissue to pulse after pulse, minimal acoustic waves are produced, which are not heard during treatment.
Although micro-
haemorrhaging occurs internally, the visual perception is not of bleeding and skin fragmentation, but of a progressive change in the skin colour, which becomes greyish, so that cleaning of the
pigment is produced with minimal damage to the epidermis. Under these circumstances, treatment with an absence of thermal lesions in neighbouring structures occurs and therefore, the speed of skin recovery is not compromised. Sessions can be carried out within shorter periods of time (Figure 3).
Results In order to obtain consistent results with a complete removal of the tattoo and keep the skin quality and texture in good condition, laser sessions should be performed with a delay time of 3–6 months, giving the micro-haematomas a chance to completely resolve. This technique of treatment, being
different from conventional Q-Switch lasers, needs a training period, particularly to recognise when to stop pulses on the same spot, and how to programme pulse repetition rate. The train of pulses penetrates and
68 ❚
Figure 2 This tattoo, black in colour, was easy to remove; but as can be appreciated, a mixture of pigments was used turning the original colour reddish in colour owing to oxidation by a photochemical process which occurred during treatment. However, further sessions achieved success
destroys pigment layers with
quasi-non-audible photo-acoustic waves rebounding inside the tissue. This should be recognised, in order to stop pulsing the laser, when external changes in the skin appear and to avoid tissue collateral damage. On the other hand, for this advanced
technology the manufacturer should consider producing a larger changeable beam diameter, together with a longer focal distance. The solution to this in particular, will entail maintaining the effective high fluence necessary for treatment in a larger beam diameter.
Mario A. Trelles Aesthetic and Plastic Surgeon, Instituto Médico Vilafortuny, Tarragona, Spain
Clincal use of the Q-switched ruby and the Q-switched Nd:YAG (1064 nm and 532 nm) lasers for treatment of tattoos. J Dermatol Surg Oncol 1993; 19(4): 330–8
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Figure 3 Monochromatic tattoo on the forearm. Few sessions make it possible to eliminate without changes to the texture of the skin
September 2011 |
prime-journal.com
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