Key considerations for ensuring optimal laser tattoo removal outcomes include skin type, nature and color of tattoos, and careful selection of laser parameters, according to a comprehensive, literature-based overview of laser tattoo removal published in Dermatologic Therapy.
Considerations for Laser Tattoo Removal
In their paper, dermatology experts from the Universitas Hasanuddin in Indonesia indicate that there are several considerations involved in laser parameters with laser tattoo removal. These parameters include pulse width, fluence, spot size, and repetition rate. In terms of pulse width, the researchers wrote that a minimum of nanosecond pulse is necessary to achieve an optimal tattoo removal with a laser approach.
They also noted that high fluence of energy density is needed in laser tattoo removal of faded tattoos “or when the amount of target chromophore is less while low fluence is used in tattoos with intense color or layered tattoos.” According to the study authors, it is recommended to choose the lowest fluence that is effective for achieving immediate whitening. Clinicians can increase fluence in subsequent sessions as the density of the ink decreases.
For recommendation on spot size, the investigators wrote that a larger spot size is associated with greater photon preservation and increased dermal penetration, ultimately reducing the risk for epidermal injury. In regard to repetition rate, the writers of the paper note that a high rate of repetition is employed in broad and flat lesions to reduce the duration of therapy, whereas low repetition rates are used in cases that need high levels of precision.
Before removal, experts agree that clinicians should first determine whether a tattoo was created by a professional tattoo artist or an amateur artist. This may help gauge differences in ink composition, depth, and density. These factors may predict the number of therapies needed, with professional tattoos often requiring more sessions compared with amateur varieties.
In addition, the age of the tattoo should be determined before intervention, as older tattoos may require fewer sessions due to ink fading. The number of colors in a tattoo should also be determined, as tattoos with more than 1 color may require the use of more than 1 wavelength. Clinicians should also identify whether the patient developed an allergy during the making of the tattoo, as the allergy may recur during laser tattoo removal.