Page 162 - Mike Murphy's Blog Posts

As can be clearly seen in figure 2, leaving a longer interval means that subsequent treatments occur further down the ‘removal curves’, meaning that much more ink may be removed between treatments. Note that the ‘ink removal curves’ – the purple lines are identical in figures 5 and 6.
While the above figures are only my idea of what is happening in the skin, they appear to confirm that leaving longer intervals between laser treatment sessions is probably a good idea. Certainly, my own clinical experience has shown that this is the case. In one patient, I left more than year between two sessions – the amount of ink ‘lost’ was very significant.
Summary
Every time we hit a tattoo with laser energy, we generate trauma around those ink particles. The skin responds by going into repair mode. To maximise the amount of ink removed between laser sessions, we must allow the skin to do its job to the best of its ability. This means that we need to leave sufficient time for the natural skin repair processes to occur before introducing new ‘trauma’ around the ink (with another laser session).
If we don’t leave enough time then, we are not allowing for a good clearance of the ink, plus we restart the whole repair process. In essence, we will keep the skin in a state of permanent repair!
Figure 6 indicates that a longer interval between laser sessions allows for more ink clearance. While I have no real clinical evidence to back this claim, there does appear to be plenty of anecdotal evidence from various sources which support it. I am keen to collect as much information on this as possible – if you have seen similar results with long intervals between laser sessions, please let me know.
Below are before and after photos of a treatment I carried out on a young sportsman, using a Q-switched Nd:YAG laser at 1064nm and around 5 J/cm2. The final photo shows the result after only four sessions. The shortest interval between session was 9 months, while the longest was 21 months. Such long intervals clearly allowed his skin repair processes to essentially ‘complete’ before subsequent laser treatments. They also appear to have allowed for maximal ink clearance.
Mike’s Blog Posts 162