Page 100 - An Introduction to Laser Tattoo Removal

Chapter 2 – Fundamentals of Laser Tattoo Removal v1.0
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Fire 3 or 4 shots at an area of the tattoo and wait for a reaction (usually within 2 to 5 minutes, or so)
o Looking for erythema and oedema (reddening and swelling)
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If none is observed within 5 minutes, increase the fluence by 0.5 J/cm2
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Look for a reaction. Repeat above steps in 0.5 J/cm2 steps
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We want to use the absolute ‘minimum’ fluence because most of it is reflected by steam bubbles!
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Once optimum fluence is found, complete the treatment (this optimum fluence should not damage the skin surface!!!). You can overlap the spots by around 25 to 30% with no adverse consequences. The steam bubbles will reflect much of the energy so overlapping has no real effect.
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If you don’t see a response in the skin (reddening and swelling) then the ink is probably not absorbing enough of the laser energy. This might suggest using a different wavelength with a better absorption, in that ink. For example, ‘red’ inks typically absorb the green 532nm Nd:YAG wavelength more efficiently than the fundamental 1064nm wavelength!
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Set the repetition rate to an appropriate level – low for small areas, higher for larger areas – it’s entirely up to you! (The repetition rate – or ‘Hertz’, as it is often referred to – does not affect the treatment outcome)
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Place the laser tip on the skin surface, in a perpendicular fashion
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Fire a couple of shots and stop – ask the patient for their feedback
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If it is too painful, then you may wish to use Mike’s ‘glass slide’ technique! Some people prefer the ‘cold air’ application to reduce the pain sensation
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If they are happy to continue, carry on with the treatment.
ALWAYS be very careful near the eyes and the lips!! Ensure that your patients’ eyes are properly protected with the appropriate safety eyewear.
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You are looking for two clinical endpoints:
o Some reddening (erythema) around the treatment areas
o Some swelling (oedema) about five to ten minutes after the
treatment
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Chapter 2 LEVEL A Laser Tattoo Removal
© The Laser-IPL Guys, 2021