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Consider 3-week treatment intervals for laser tattoo removal


 

AT THE AACS ANNUAL MEETING

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NEW ORLEANS – Laser tattoo removal using a 3-week interval between treatments may be feasible for most patients, based on data from a pilot study conducted by Dr. Robert Burke.

The demand for tattoo removal has increased along with tattoo prevalence in the United States, Dr. Burke said at the annual meeting of the American Academy of Cosmetic Surgery. The treatment protocol for laser tattoo removal depends on the patient’s skin type, as well as on the type and density of inks used, said Dr. Burke, founder and director of the Michigan Center for Cosmetic Surgery in Ann Arbor.

Dr. Robert Burke

Some methods have been tested to accelerate the laser tattoo removal process, but have resulted in skin damage such as scarring and hypopigmentation, he added.

No standard recommendation currently exists for time intervals between laser tattoo removal treatments, Dr. Burke said. Intervals of 3, 4, 6, and 8 weeks or longer have been recommended. “It has been speculated that 3-week intervals can interfere with macrophage activity, but long-term studies have shown no clinical or other interference whether you treat at 3, 4, 6, or 8 weeks,” he said.

Previous recommendations were based mainly on tissue reactions observed with older lasers; this thermal damage was likely because of laser beam irregularities and nonuniform energy application in round beam lasers, he added.

Laser tattoo removal involves selective photothermolysis, Dr. Burke noted, and the laser light can destroy the target without damaging the surrounding tissue only if the thermal relaxation time (defined as the time necessary for the target to cool 50% through diffusion of heat to surrounding tissues) is greater than the pulse duration. “Fluence sufficient to reach a damaging temperature in target chromophores without damaging surrounding tissue structures is the critical element of selective photothermolysis,” he explained.

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