Removal of tattoos

Il Laser Q - Switched è oggi lo strumento + utilizzato in tutto il mondo per eliminare i tatuaggi.

Formerly, tattoos were removed by skin abrasion techniques using salt, milling processes, chemical burning or electrocoagulation, inevitably resulting in permanent scarring and often incomplete removal of the pigment. Surgical tattoo removal introduced an alternative technique, but still left unsightly scars.

Argon lasers were used from 1980, but the CO2 used also resulted in incomplete removal of pigment and left scars due to inadequate selectivity.

Tattoo removal is now done with Q-Switched lasers; these machines impart a laser pulse of very short duration (nanoseconds, ie a few billionths of a second). These pulses destroy the cells that contain the pigment granules, breaking them down into smaller fragments (10 to 100) which over the course of a few days or weeks are absorbed by macrophages in the body and eliminated.

A number of treatments with roughly a month between sessions ensures progressive, natural disappearance of the tattoo. The pulses of very short duration avoid overheating of the skin and eliminate the formation of scars (selective photothermolysis).

Neodymium - Yag Q-Switched lasers emit a choice of 4 rays of different wavelengths, each designed for removal of specific colours:

  • 1064 nm (nanometers) for black, brown and dark blue
  • 532 nm for red, orange and purple
  • 585 for blue
  • 650 for green and yellow

    The process

    • Local anesthesia with anesthetic cream applied in occlusion for 1 hour before the session, on the area to be treated.
    • Duration: dependent on the size of the tattoo to be removed: an area of ​​4cm2 takes about ten minutes.
    • A number of sessions is required, with a gap of approximately one month between sessions. The number of sessions depends on several factors:
      • type of tattoo: professional tattoos are usuallymore difficult to remove because the pigment is injected to a greater depth and is denser.
      • colour of tattoo: the green and especially yellow pigments often used in multicoloured tattoos are the most difficult to remove.
      • age of tattoo: older tattoos are easier to remove than more recent ones, as some of the pigment will already have been eliminated by the body.
      • the final number of sessions required to remove the tattoo cannot be predicted beforehand. Simpler cases may require between 2 and 4 sessions. More difficult cases may require 8 or 12.

    Contraindications

    • Patients with olive-toned, black or dark skin as there is a high risk of changes in the pigmentation.
    • Patients with a tendency to hypertrophic or keloid scars
    • Existing skin infections
    • Summer
    • Cosmetic tattoos (eyebrows, lips, areola, scar camouflage, etc.) with pink, brown or orange colours. These tattoos often contain zinc and titanium oxide that turn black when treated with QS laser.

    After treatment

    • Discomfort or burning sensation in the treated area within 24 hours
    • Crusting and blisters in the first 3-10 days
    • A dressing with antibiotic ointment - Fucidin H cream - is applied to the treated area morning and evening until it is healed, within 3 - 10 days
    • Erythema (reddening of the skin) for 2 weeks
    • Do not expose the treated area to sunlight for 1 month and always use sun block 50+

    Complications

    Skin infections:

    • Herpes simplex virus: anyone suffering from recurrent herpes should take antiviral medication prior to the treatment: Famvir 500 - 3 tablets taken at the same time
    • Bacterial infections: antibiotic ointments to be used following the treatment

     

    Infections may occur as with any skin trauma.

    Persistent erythema, discolouration (hypo- or hyperpigmentation of the treated skin): this can occur in the first few weeks after treatment from direct exposure to excessive cold, heat or sunlight.

    Follow up

    Even in the most successful cases there may be a faint residue of the tattoo when the treatment is finished, a kind of shadow that we call a "ghost tattoo". This may remain for several years or permanently.

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