Tattoo Removal – Body decoration has evolved throughout the world at many sites independently of one another and has been used for beautification, religious expression, healing, and as a form of punishment. Surgical excision effectively removes the entire tattoo, but replaces it with a linear surgical scar. It is preferable in patients having allergic reactions as laser removal in this situation may lead to ­anaphylactic reactions.

The wide range of colors that is present in today’s tattoos often requires the use of all three available types of Q-switched lasers to effect their removal.  Photo acoustic destruction of a tattoo particle with Q-switched laser results in breakdown of tattoo particles into smaller fragments which are eliminated through the epidermis,removed by vascular or lymphatic systems or become re-phagocytosed by mononuclear cells. Type of laser for tattoo removal depends on the color of pigment in the tattoo.

LASERS FOR TATTOOS

Lasers have also been used to remove tattoos by heating and tissue destruction since the 1970s.,21 Argon laser destroys tissue by nonselective heating and emits a blue or green continuous laser beam at 488 or 514 nm. Black tattoos absorb this laser light, but because this laser is not pulsed, nonspecific heating and tissue destruction takes place. Thermal energy spreads from the tattoo granules to the surrounding skin, Photothermolysis describes the ability to remove targets from within skin or other tissues without damaging the surrounding tissue.

These targets can be anything that take up laser energy such as blood vessels, melanin pigment or tattoo particles.  Small particles such as tattoo granules should be treated with pulses in the nanosecond domain.  Tattoos treated with millisecond lasers or intense pulsed light (IPL) devices that emit millisecond-domain pulses result in ­incomplete removal of tattoos and with significant ­scarring.

 Side Effects of Laser

Treatment for Tattoo Removal – Immediate reactions:

Post treatment bleeding, blistering, secondary infection, local hyperesthesia Allergic, granulomatous, lichenoid and photoallergic reactions (Mercury in red ink causes allergic reactions, cadmium in yellow ink causes photoallergic reaction.) Pigmentary changes such as hypo and hyperpigmentation Pigment darkening in decorative tattoos containing ferric oxide, titanium dioxide and zinc oxide

 Delayed side effects:

Failure to remove complete pigment, textural changes, atrophy, keloids, hypertrophic scars Fragments of fireworks or gunpowder if present may explode upon exposure to nanosecond laser pulses leaving pox-like scars.