Kilmer 1993  Title: The Q-switched Nd:YAG laser effectively
treats tattoos. A controlled, dose-response study.
Author: Kilmer SL, Lee MS, Grevelink JM, Flotte
TJ, Anderson RR
Journal: Arch Dermatol 1993 Aug;129(8):971-8
PMID: 8352621, UI: 93356572
Affiliated institution: Department
of Dermatology, Harvard Medical School, Boston.
Cited in:
BACKGROUND AND DESIGN: The Q-switched ruby laser was recently
shown to remove tattoos without scarring. The Q-switched neodymium:
yttrium aluminum garnet (Nd:YAG) laser, which targets black ink
with a longer wavelength that has less absorption by melanin,
should effectively treat tattoos with fewer pigmentary alterations.
A prospective, blinded, controlled study was conducted to assess
the ability of the Q-switched Nd:YAG laser (1064 nm, 10 ns, 5
Hz) to remove tattoos. Twenty-five patients with 39 blue-black
or multicolored tattoos (14 previously untreated, 25 Q-switched
ruby laser-resistant) were exposed in randomly derived quadrants
with 6, 8, 10, or 12 J/cm2 at 3 to 4 week intervals for a total
of four treatment sessions.
RESULTS: An excellent response (> 75% ink removal) was seen
in 77% of the black tattoos and more than 95% of the black ink
cleared in 11 (28%) of 39 tattoos at 10 to 12 J/cm2 after four
treatment sessions. Colored inks were not as effectively removed.
Response was related to fluence with greatest improvement noted
in the quadrants treated with 10 and 12 J/cm2. No significant
side effects, including pigmentary changes or scarring, were noted.
Histopathologic examination demonstrated persistence of tattoo
ink in clinically clear areas and confirmed the absence of fibrosis
and granulomatous changes.
CONCLUSION: The Q-switched Nd:YAG laser (1064 nm) effectively
treats black tattoos with an excellent cosmetic outcome. Bright
colors were minimally responsive to treatment. Higher doses were
more effective and equally well tolerated.
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