Page 160 - Blog Posts v1

Figure 3: The various stages of wound repair can take months to complete in a healthy person. If a person has medical issues (such as diabetes, peripheral neuropathy, PVD, cancer etc) then the timeline of these processes may be significantly longer. In addition, the timeline increases with age, obesity, smoking and a whole range of other issues.
A laser treatment of a tattoo is essentially a traumatic event, from the perspective of the skin. There is thermal and physical damage as the absorbed laser energy results in rapid heating of the ink particles leading to steam formation, physical expansion of the local tissues (due to tissue water boiling) and a little thermal damage which can result in very localized scar tissue formation. This occurs every time the tattoo is treated. Consequently, the total amount of scar tissue builds up with each treatment. This suggests that fewer treatments will ultimately generate a better overall outcome.
Figure 4: The main activities in each phase
The main purpose of the skin repair process is to repair the damage to the skin and remove any perceived ‘threats’ such as bacteria, toxins and viruses – the actual removal of shattered ink particles is probably a fairly low priority in the overall process, if it not perceived as a threat!
It struck me that we were treating patients too frequently! At four and six week intervals we were creating new trauma around the ink particles, before the skin repair process had even neared completion!
It also occurred to me that the majority of ink removal had probably not been completed either. Anecdotal evidence clearly suggested that leaving longer periods between treatments resulted in more clearance of the ink.
So, I thought about this and figured out a mathematical approach...
Mike’s Blog Posts 160