Efficacy of the Q-switched Neodymium: Yttrium Aluminum Garnet Laser in the Treatment of Blue-black Amateur and Professional Tattoos

Abstract

Background: Q-switched neodymium: yttrium aluminum garnet (Nd: YAG) laser at a wavelength of 1064 nm primarily targets dermal melanin and black tattoo ink. Recent studies have shown that this laser is effective in treating black tattoos. There are few studies conducted in India for the same.

Aim: The aim was to assess the effectiveness of Q-switched Nd: YAG laser (QSNYL) in the treatment of blue-black tattoos following 3 treatment sessions.

Materials and methods: This study, a prospective interventional study included a total of 12 blue-black tattoos. Following informed consent for the procedure, as well as for photographs, a questionnaire was administered, and improvement perceived by the patient was recorded. In addition, global assessment score (GAS) by a blinded physician was also recorded. Photographs were taken at baseline and at every follow-up. Each patient underwent three treatment sessions with 1064 nm QSNYL at 4-6 weekly intervals. Fluences ranged from 1.8 to 9 J/cm(2). The follow-up was done monthly for 4 months from the first treatment session. The response was assessed by patient assessment (PA) and GAS by comparing photographs.

Results: After three treatment sessions, although no patient achieved clearance, most patients showed good response with few adverse effects. An average of 64.1% (GAS) and 54.2% (PA) improvement was observed in 12 tattoos. Tattoos more than 10-year-old showed quicker clearing than those less than 10-year-old. Amateur tattoos also showed a better response in comparison to professional tattoos.

Conclusion: Totally, 1064 nm QSNYL is safe and effective for lightening blue-black tattoos in pigmented Indian skin. All patients achieved near complete clearance following the continuation of treatment (an average of six sessions) although this was spaced at longer intervals.

Keywords: Blue-black tattoos; Q-switched neodymium:yttrium aluminum garnet laser; pigmented skin.

Figure 1

(a) Tattoo over forehead - before treatment (b) Tattoo forehead after laser treatment

Figure 2

(a) Tattoo dorsum of hand - before laser treatment (b) Tattoo dorsum of hand - after laser treatment

Figure 3

(a) Tattoo forearm- before laser (b) Tattoo forearm - after laser

Figure 4

(a) Professional tattoo dorsum of hand - before laser (b) Professional tattoo dorsum of hand - after laser

Figure 5

Blister formation over double tattooed area following laser treatment