Page 73 - An Introduction to Laser Tattoo Removal

Chapter 2 – Fundamentals of Laser Tattoo Removal v1.0
The ‘consensus’ out there, based on clinical evidence
There currently exists a significant number of clinical study reports in the scientific literature, where picosecond lasers have been compared directly with nanosecond lasers. In addition, there are other papers which report only picosecond laser experiences.
Overall, the consensus is that picosecond lasers are marginally ‘better’ than nanosecond devices in terms of ink clearance rates in certain cases with lower pain sensations and slightly less blistering and epidermal damage.
However, there is a debate on just ‘how much’ better picosecond lasers are, compared with the older Q-switched lasers. Consequently, there are now a few papers which have compared the results of many of the above studies. A report by Torbeck2 et.al. (2019) concludes “Picosecond laser published data do show improved patient- and physician-rated results in comparison with nanosecond lasers. However, in the head to head studies by Pinto and colleagues (not sponsored by any company) there was no significant difference between the two.”
A review by Reiter3 et.al. (2016) states “There is sparse evidence that picosecond lasers are more effective than their nanosecond counterparts for mainly black and blue ink tattoo removal, with minor side effects.”
The study by Choi1 et.al. (2018) into the effectiveness of picosecond lasers on a range tattoo ink colours concluded that “wavelength is more influential than pulse duration for the removal of each colored ink. Regardless of the pulse duration, the 532nm laser was the most effective in clearing red, orange, and yellow colored inks and was mildly effective in removing green and black colored inks.” Mike wrote a blog post on this study’s results.
Finally, a comparative study on 49 patients by Lorgeou found that the picosecond laser appeared to be significantly better than nanosecond lasers on black ink. However, their results with ‘polychromic’ (coloured) tattoos were much less significant.
1: Choi M.S., et.al. “Effects of picosecond laser on the multi-colored tattoo removal using Hartley guinea pig: A preliminary study.” PLoS ONE 13(9): e0203370. https://doi.org/10.1371/journal.pone.0203370
2: Torbeck R.L., et.al. “Evolution of the Picosecond Laser: A Review of Literature.” Dermatologic Surgery: February 2019 - Volume 45 - Issue 2 - p 183-194
3: Reiter O., et.al. “Picosecond lasers for tattoo removal: a systematic review.” Lasers in Surgery and Medicine, 31, 1397–1405 (2016)
4: Aurélie Lorgeou et.al. “Comparison of two picosecond lasers to a nanosecond laser for treating tattoos: a prospective randomized study on 49 patients.” Journal of The European Academy of Dermatology and Venerology Volume32, Issue2 February 2018, Pages 265-270
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Chapter 2 LEVEL A Laser Tattoo Removal
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