Tattoo removal was one of a handful of procedures that saw a significant increase (+39%) between 2014 and 2015, according to the 2015 annual statistics of the American Society of Aesthetic Plastic surgeons. And so are patient concerns with the possibility of scarring as an unwanted side effect. However, U.S. researchers recently reported a low incidence of hypertrophic scarring and no cases of keloid scarring following tattoo removal with the Q-switched neodymium-doped:yttrium-aluminum-garnet laser.
In a retrospective review of 1,041 charts of patients treated under one study protocol and with more than five treatment sessions, researchers found three of the patients (or 0.28%) treated with the laser had evidence of hypertrophic scarring. These three hypertrophic scars, the researchers write, represented early stage scarring and did not denote extensive or disfiguring lesions. None of the patients studied emerged from their laser tattoo removal treatments with keloids, according to the study.
According to researchers, they used the laser at accurate, protocol-based settings. Treatments were performed at four-week intervals to allow for healing.
While there may be a perception among some patients, even physicians, that hypertrophic scars and keloid formation is associated with tattoo removal, it is more likely a reflection of selecting inappropriate treatment devices, performing aggressive protocols, giving poor post-procedure care or patient confusion about tissue texture changes, dyschromia and these scarring types.
The authors write the incidence of scars they found was lower than even they had anticipated. The study should help providers to better educate patients about what to expect, as well as realistic and theoretical adverse outcomes.
Disclosure: The authors indicated they had no conflicts of interest and no outside funding for the study.