Page 115 - An Introduction to Laser Tattoo Removal

Chapter 2 – Fundamentals of Laser Tattoo Removal v1.0
The R20 and R0 Techniques
The R20 technique was developed by a group of clinical researchers trying to reduce the number of treatments required to remove tattoos fully. They did this by repeating the treatment at twenty minute intervals, to give the white frosting appearance time to disappear.
Their initial results seem to indicate that more pigment may be removed using this technique in one treatment sitting.
This technique was ‘improved’ by the addition of a topical perfluorocarbon, which caused the highly reflective steam bubbles to dissipate much more quickly than normal. This technique is known as the R0 technique.
Both techniques appear to improve the rate of ink clearance, due to multiple treatments in any one sitting.
The R20MTM Technique
A more recent application of the above ‘R’ techniques includes the application of an ablative erbium:YAG laser over the treatment area, to create ‘holes’. These holes, theoretically, allow the steam bubbles to dissipate more rapidly than usual.
This is followed by three to five passes with a conventional Q-switched Nd:YAG laser. As with the R0 technique, perfluorocarbons are added to the treatment area to further enhance bubble reduction between passes.
The combination of erbium laser, PFCs and the Nd:YAG laser appears to reduce the total number of repeat treatments significantly.
Microneedling and Laser Tattoo Removal
This book chapter is about laser tattoo removal. However, we were contacted by an experienced laser operator with the following message:
Hi Mike. I started tattoo removal about 8 years ago. My husband bought a Fotona
QXMax for our clinic and I was taught how to use it. I had no idea what to expect.
The recommendation was treatments every 8 weeks for several treatments. They
cited the Kirby Desai scale.
Anyway, we were new to all laser treatments back then. We had a Cutera Excel V
vascular laser before the Fotona. Nigel and I went to lots of conferences and at one of them I was listening to a doctor talk about pre- drilling the tattoo with, I
think, a fractional erbium. So, I asked about it. I thought perhaps microneedling
might work as it is a ‘cold’ treatment - by which I mean no added heat which I
thought might be a good thing.
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Chapter 2 LEVEL A Laser Tattoo Removal
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