1. Introduction
Tattoos have been a part of costume, expression, and identification in various cultures for centuries. Although tattoos have become more popular in western culture, many people regret their tattoos in later years. (Burris & Kim, 2007)
There are five types of tattoos: amateur, professional, cosmetic, medicinal, and traumatic. (Kuperman-Beade & Levine, 2001). The type, color, and location of the tattoo, as well as the age and skin type of the patient, often dictates the choice of laser wavelength, fluence and spot-size setting, and the number of required treatments. (Jow, Brown, & Goldberg, 2010)
Many different kinds of removal methods have been used throughout the centuries, such as chemical (trichloacetic acid), mechanical (dermabrasion), surgical excision and electrocautery. (Mohammad & Mahmood, 2009)
These destructive methods of removal, which wreaked havoc not only on the tattoo but more prominently on the skin containing that tattoo. (E. F. Bernstein, 2007)
Laser tattoo removal is the current treatment of choice, given its safety and efficacy. It is important to be aware of the mechanisms of laser tattoo removal, as well as their potential short- and long-term effects. (Burris & Kim, 2007)
(Relatively few advances have been made since that time, although there are new promising discoveries on the horizon. (E.F Bernstein, 2006)
2. The lasers most commonly used for tattoo removal have been identified and discussed with regards to their properties of wavelength, chromophore, pulse duration and TRT relevance.
New laser technology has been discussed briefly.
The 4 most common lasers.
Three types of lasers are currently commercially available for tattoo removal: the Q-switched ruby laser (694 nm), the Q-switched alexandrite laser (755 nm) and the Q-switched Nd:YAG laser (532 nm and 1064 nm). Multiple parameters such as tattoo type, color, location, and patient skin type dictate which laser is optimal in each patient. (Jow et al., 2010)
Q-switched (QS) lasers are widely considered the gold standard for tattoo removal, with excellent clinical results, impressive predictability, and a good safety profile. (Barua, 2015)
These include the quality-switched Neodymium : Yttrium Aluminium Garnet laser (QS Nd:YAG, 532 nm and 1064 nm), quality-switched Ruby (QSRL, 694 nm) laser and the quality-switched Alexandrite (QSAlex, 755 nm) laser.5 (Varma & Lee, 2002)
a. The Q-switched ruby laser (QSRL) — the QSRL emits light at a wavelength of 694 nm and has a pulse duration of 28-40 ns. ?
b. The Q-switched alexandrite laser (QSAL) — the QSAL has a near infrared wavelength of 755 nm, pulse duration of 50-100 ns, ?spot size of 2-4 mm, and a repetition rate up to 10 Hz. ?
c. The Q-switched neodymium-doped yttrium aluminum garnet (QS Nd:YAG) laser —emits infrared light ?at 1,064 nm and has a pulse duration of 5-10 ns, spot size of 1.5-8 mm, and a repetition rate up to 10 Hz. The frequency can be doubled and the wavelength can be halved (532 nm) by passing the laser beam through a potassium titanyl phosphate (KTP) crystal. ?(Barua, 2015)