Page 61 - An Introduction to Laser Tattoo Removal

Chapter 2 – Fundamentals of Laser Tattoo Removal v1.0
The mistake we tend to make is looking at the epidermal repair times and assuming it applies to the whole skin! The epidermis can be fully repaired within four weeks, in many people. However, the underlying dermis may require a few months more to reach the same level of repair. Unfortunately, as human beings, we only tend to see what is ‘obvious’ – the epidermis looks ‘fine’, so we think that everything else is too!! This is quite wrong.
The skin repair processes occur in a complex range of timings (see figure 28). The epidermis repair is paramount to minimise any further damage or invasion by bacteria/viruses into the dermis. Removal of ink particles is fairly low in the priorities. In fact, it appears that most of the ink removal process occurs AFTER many other processes are well underway.
When the original research was carried out in Canniesburn Hospital, Glasgow in the early 1980s, the study patients originally returned one week after treatment. The clinicians assessed their tattoos and were asked to return a week later. This process continued until a decision was taken that ‘four weeks’ was sufficient time between repeat laser sessions. This was a mistake!
The clinicians observed fully intact epidermises in their patients and assumed that their skin was ready for another treatment. By repeating the laser treatment, they had ‘reset’ the skin repair clock back to zero. In essence, the patients’ skins were in a permanent state of repair throughout the entire laser treatment program.
Unfortunately, this ‘mistake’ was continued for many years. As time went on, some laser operators reported that a gap of six weeks appeared to yield ‘better’ results. This then became eight weeks.
It now appears that much of the ink removal process may occur around 10 to 16 weeks after the laser treatment, or later. This makes sense since the skin’s main priority is to rebuild the skin’s constituents to ensure functionality. Removing the ink particles is a relatively unimportant part of this process!!
The logical conclusion of this is that fewer treatments may be required, overall, if we leave longer time between repeat sessions, simply because more ink is removed in those gaps.
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Chapter 2 LEVEL A Laser Tattoo Removal
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