Laser Treatment of Accidental Tattoos: Experience at a Tertiary Referral Center

Abstract

Background: To date, information on laser treatment of accidental tattoos is limited. Objectives: This study analyzes the efficacy and safety of quality-switched ruby, quality-switched Nd:YAG and picosecond lasers in the treatment of accidental hyperpigmentation in a larger patient cohort. To date, there is limited information on laser therapy of accidental hyperpigmentation. Methods: We conducted a retrospective systematic single-center analysis on 70 patients, which presented with accidental hyperpigmentation at the Dermatology Department of the University Hospital of Zurich between 2008 and 2017. Patients with accidental tattoos due to road injuries, explosives or other traumas and iatrogenic measures were included. We analyzed the data including laser parameters such as wavelength, energy density, spot size and intervals between the sessions. Also, the number of sessions performed and the overall success were registered. Results: We treated 38 patients by quality-switched nano- and/or picosecond laser therapy and completed the treatment in 28 cases within a mean number of 3–5 laser sessions. No complications occurred. Conclusion: We demonstrate the validity and safety of quality-switched and picosecond lasers in the treatment of accidental hyperpigmentation. Using a combination of different wavelengths and pulse lengths on the same lesion and gradually increasing the fluence in the course of the laser treatment is recommendable to increase efficacy. We observed a tendency towards faster elimination of facial accidental tattoos and/or originating from road injuries compared to tattoos located on the extremities and those caused by explosions, piercings or iatrogenic measures or consisting of metal pigment particles.

Successful Removal of 17 Tattoos Self-Administered Using Black Eyeliner Ink with Quality-Switched Neodymium-Doped Yttrium Aluminum Garnet 1,064-nm Laser: A Case Report

“…In the case of our patient, within 7–10 treatment sessions, the pigment, which was mainly composed of black carbon, on the cheek, the proximal legs, and the neck completely disappeared, while the pigment on the finger and ankles was a bit more resistant. These results are in line with previously described factors influencing the treatment response of tattoos [ 11 , 12 ]. First, amateur tattoos are known to respond faster to laser treatment than professional tattoos due to their superficial location in the skin and their uneven application with less pigment [ 13 ].…”

“…Furthermore, the location of the tattoo influences the response to laser treatment. Tattoos on the proximal extremities as well as the face and neck area clear in fewer sessions than tattoos on the distal extremities due to better lymphatic supply and transport [ 9 , 11 , 12 ]. As also seen in our patient, tattoos with fibrosis induced by a poor injection technique, patient constitution, or inflammation are more difficult to remove.…”

Tattoos in Psychodermatology

“…Accidental tattoos are caused by persistent depositing of exogenous pigment particles, such as metal salts or carbon, in the dermal or subcutaneous layers of the skin due to traumas, iatrogenic causes, and chronic intake of some drugs [47]. These tattoos can be reminders of past events and can remain anywhere unintentionally.…”