Tattoos Can Be Removed in Fewer but Longer Laser Sessions

Murad Alam, MD, MSCI


Journal Watch 

In This Article

Abstract and Introduction


Repeated exposures in one day with intervals between treatments effectively removed most tattoos.


Removal of unwanted tattoos is usually performed with Q-switched lasers. Many treatment sessions are needed (up to 20 for professional tattoos), and the results are often incomplete. These authors studied the efficacy of using four passes in a single treatment session with long intervals between treatments.

Twelve healthy white subjects with a total of 8 professional and 10 amateur tattoos were treated. Each tattoo was divided into two parts, and the parts were randomized to be treated with a single laser pass or by the so-called R20 method of four consecutive passes separated by 20 minutes. All passes were made by the same investigator using a Q-switched alexandrite laser (5.5 J/cm2, 755 nm, 100-nanosecond pulse duration, 3-mm spot size). Patients were followed for 6 months. At 3 months, results on a 5-point measure were significantly better on the R20 sides (P<0.01). In punch biopsy samples, more pigment had been removed from deeper areas with the new technique. Transient side effects included more epidermal injury and purpura on the R20-treated sides, but these did not translate into later adverse effects such as scarring.