New Approach in Laser Treatment of Tattoos and Skin Spots
Tattoo is the temporary or permanent placement of colored pigments in the inner layers of the skin. Make-up, medical, aesthetic accessories, traditional purposes can be done depending on the patient’s request, as well as in accidents and firearm injuries, it can develop without the person’s will.
Skin spots can develop on the skin with congenital factors such as Becker Nevus, hormonal factors such as melasma or environmental factors such as sunspots and cause serious aesthetic problems.
Laser treatments, especially Q-switched-switched lasers, are the golden key in the treatment of tattoos and spots. The basic mechanism of action of Q-switched lasers; It is the disintegration effects of strong sound waves formed on the skin with very short application times of a few nanoseconds on the pigments we call chromophore in tattoos and stains. The laser achieves this effect on the skin by “selective photo-damage” (by targeting only the pigments, causing minimal damage to other structures of the skin). With this fragmentation in pigments;
Small pieces of pigment are cleared from the tissue by the body’s immune system. (The cleaning of the immune system in the tissue takes 3 weeks. For this reason, tattoos and stains are applied at least 3 weeks apart.)
Some of the pigment substances are turned into gas forms by laser and are removed from the tissue.
During the shedding of the laser damaged tissue, some of the pigments are removed from the skin.
The above effects of the laser reduce the visibility of the tattoo and blemish even in the first session, and repetitive sessions enable them to be erased.
Laser systems used today with Q switches; Nd:YAG (1064 nm), KTP (532 nm) and 585-650 nm wavelength lasers.
During the application of lasers, the skin on the pigments becomes white with each shot and the pigments fade. This is due to the microdamage of the laser on the skin above the pigments and the edema that develops in the dermis. This change in the skin does not actually reduce the effectiveness of the laser applied at high speed repeatedly.
On the other hand, these high sound waves create large spaces around the pigments. This prevents the laser from reaching the pigments and increases the distribution of the heat to the surrounding tissues, that is, the side effects. This side effect causes uncontrollable pigmentation changes in the skin, allergic reactions, darkening of the pigments and peeling in the epidemic.
Air balloons formed by Q-swiched laser and its negative effect
For this reason, fractional ablative lasers have been used together in recent years to reduce these side effects and increase the efficiency of q-switched lasers. Fractional lasers create micro-damages in the skin at the desired depth. Particularly Fractional CO2 and Erbium YAG lasers are the most effective and reliable lasers used for this purpose.
When Fractional laser is used on the skin area where the tattoo is, micro-damages occur in the areas indicated by the blue arrows. Pigment density decreases in these damaged areas. In addition, gas, pigment and dermal edema are output after Q-switched laser through micro channels. This increases the clinical response and shortens the side effects and recovery time.
The purpose of using fractional ablative lasers in tattoos and spots;
Fractional lasers cause micro-damage to the depths of the skin where the pigments in tattoos and spots are located. With micro-damage, the density of the pigments is reduced.
In A, only the skin and pigments are damaged after Q swiched. Pigmnet and skin damage can be seen with Q-swiched application after fractional laser in B.
Micro-channels opened in the skin with micro-damage allow Q-switched lasers to reach the pigments more.
Micro-channels opened in the skin with micro-damage allow the excess pressure and gases that cause side effects of Q-switched lasers to come out easily.
With the use of fractional ablative laser and then Q swiched laser, it has been determined that the pain is less during laser application, the recovery after laser is faster, the side effects are reduced, the clinical pigments are lost more, and the number of sessions is reduced. It has been determined that the success of treatment increases in multi-colored tattoos. In summary, Q-swiched laser application after Fractional CO2 laser provides higher clinical success.
First, Fractional CO2 laser is applied to the area where the tattoo or stain is.
Fractional laser is applied first.
10-20 minutes after that, Q switched Nd:YAG or KTP laser is applied.
Then Q Switched Nd:YAG laser is used
Results of fractional and Q Switched laser use, last picture on the right, after 3 sessions
