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Kassirer S, Zachary CB, Marini L, Adatto M, Landau M. Laser tattoo removal strategies: Part II: A review of the methods, techniques, and complications involved in tattoo removal. J Am Acad Dermatol 2024:S0190-9622(24)00970-8. [PMID: 38980249 DOI: 10.1016/j.jaad.2024.05.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 05/11/2024] [Accepted: 05/25/2024] [Indexed: 07/10/2024]
Abstract
The rising global popularity of cosmetic and corrective tattoos has concurrently led to an increased demand for their removal. While in the past, methods like surgical excision, chemical destruction, and dermabrasion were employed, lasers have emerged as a reliable and effective tool for tattoo removal. Increasing technological options and combination treatment strategies have raised the importance of understanding the various approaches to laser tattoo removal along with their respective clinical impact. This CME aims to describe the multifaceted aspects of laser tattoo removal, including the method selection, application principles, and safety considerations. Furthermore, it addresses the factors considered when selecting the most suitable laser to achieve optimal treatment outcomes.
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Affiliation(s)
- Samuel Kassirer
- American Medical Program, Tel Aviv University Faculty of Medicine, Tel Aviv, Israel
| | | | - Leonardo Marini
- Diplomate General Surgery and Dermatology, Medical and Scientific Director, SDC The Skin Doctors Center, Trieste, Italy
| | - Maurice Adatto
- Skinpulse Dermatology & Laser Centre, Geneva, Switzerland
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2
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Jean-Pierre P, Pulumati A, Kasheri E, Hirsch M, Nouri K. Lasers in the management of alopecia: a review of established therapies and advances in treatment. Lasers Med Sci 2024; 39:102. [PMID: 38630348 PMCID: PMC11023987 DOI: 10.1007/s10103-024-04054-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/11/2024] [Indexed: 04/19/2024]
Abstract
Alopecia, also known as hair loss, is a highly prevalent condition affecting millions of men and women in the United States and worldwide, making it one of the most common complaints by patients presenting to a dermatologist. The symptomology on the presentation of alopecia can be highly variable, ranging from diffuse thinning of hair, discrete and localized patches completely absent of hair, or noticing significant shedding when brushing and showering. Although alopecia does not have a direct negative health impact on patients, it is nonetheless a debilitating disease as it can profoundly impact an individual's self-image and psychosocial well-being. There are multiple treatment options available to patients with alopecia, and they are typically tailored to the patient's needs and preferences. The most common of these is the Food and Drug Administration-approved drugs for alopecia, minoxidil, and finasteride. However, both of these are known to be partially efficacious for all patients, so clinicians often use different modalities in conjunction with them, in particular laser-based therapies. This review article will provide a comprehensive assessment of lasers and other light therapies that may be used to manage the two most common types of alopecia: androgenetic alopecia and alopecia areata.
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Affiliation(s)
- Philippe Jean-Pierre
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, 1600 NW 10th Ave, 33136, Miami, FL, USA.
| | - Anika Pulumati
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Eli Kasheri
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, 1600 NW 10th Ave, 33136, Miami, FL, USA
| | - Melanie Hirsch
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, 1600 NW 10th Ave, 33136, Miami, FL, USA
| | - Keyvan Nouri
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, 1600 NW 10th Ave, 33136, Miami, FL, USA
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3
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Wang JV, Bajaj S, Himeles JR, Geronemus RG. Clinical and Optical Coherence Tomography Correlation of Vascular Conditions Treated With a Novel, Variable-Sequenced, Long-Pulsed, 532 and 1,064 nm Laser With Cryogen Spray Cooling. Dermatol Surg 2024; 50:277-281. [PMID: 38085090 PMCID: PMC10903995 DOI: 10.1097/dss.0000000000004057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND Patients frequently seek laser treatment for vascular conditions. More recently, a novel 532 and 1,064 nm laser was developed to offer greater flexibility. OBJECTIVE A prospective clinical trial evaluated the safety and efficacy of a novel, variable-sequenced, long-pulsed, 532 and 1,064 nm laser with cryogen spray cooling (DermaV, Lutronic, South Korea). MATERIALS AND METHODS Subjects with vascular conditions were enrolled for laser treatments. Clinical evaluations and optical coherence tomography (OCT) imaging were performed. RESULTS Thirteen subjects were enrolled. The mean age was 51.3 years, and 92.3% were women. Fitzpatrick skin types I-IV were included. Treatment indications included broken blood vessels, rosacea, port-wine birthmark, and spider angioma. For physician investigator grading, all subjects were graded as improved at both 30-day and 90-day follow-up. Blinded photographic review by 3 independent, blinded physicians had a mean of 89.7% of cases selected correctly with at least 2 of 3 in agreement for 100.0% of cases. Optical coherence tomography imaging showed significant reductions in vessel density ( p = .018) and diameter ( p = .003) of the superficial vascular plexus. No serious adverse events occurred. CONCLUSION A novel, variable-sequenced, long-pulsed, 532 and 1,064 nm laser with cryogen spray cooling can safely and effectively improve vascular conditions and lesions as determined by both clinical and OCT evaluation.
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Affiliation(s)
- Jordan V. Wang
- Laser & Skin Surgery Center of New York, New York, New York
| | - Shirin Bajaj
- Laser & Skin Surgery Center of New York, New York, New York
| | - Jaclyn R. Himeles
- The Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York, New York
| | - Roy G. Geronemus
- Laser & Skin Surgery Center of New York, New York, New York
- The Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York, New York
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4
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Haykal D, Cartier H, Maire C, Mordon S. Picosecond lasers in cosmetic dermatology: where are we now? An overview of types and indications. Lasers Med Sci 2023; 39:8. [PMID: 38110831 DOI: 10.1007/s10103-023-03945-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 12/05/2023] [Indexed: 12/20/2023]
Abstract
Q-switched lasers have undeniably revolutionized the field of laser dermatology since four decades ago. Just as the first-generation laser emits its photonic signal in a few nanoseconds, the picosecond laser delivers pulse widths of at least ten times shorter. These devices offer a powerful tool for treating a wide range of skin conditions with a minimal downtime for visible improvement. For the current study, a literature research was performed on the dermatological applications of picosecond laser. The literature searched on this topic between 1999 and 2023 accessible through various platforms produce a result of 62 articles. The included studies have discussed the application of picosecond laser technology in tattoo removal, treatment of epidermal and dermal pigmentation, and collagen remodeling. After sifting the data from the articles into tables, the results were discussed in detail. The study shows a lot of evidence towards the efficacy of picosecond laser, yet it draws attention to its downsides.
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Affiliation(s)
- Diala Haykal
- Centre Laser Palaiseau, 49 Ter Rue de Paris, 91120, Palaiseau, France.
| | | | | | - Serge Mordon
- Hemerion Therapeutics, Villeneuve d'Ascq, France
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5
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Hernandez L, Mohsin N, Frech FS, Dreyfuss I, Vander Does A, Nouri K. Laser tattoo removal: laser principles and an updated guide for clinicians. Lasers Med Sci 2022; 37:2581-2587. [DOI: 10.1007/s10103-022-03576-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/12/2022] [Indexed: 11/25/2022]
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6
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Du XJ, Zhou HM, Wang Z, Liu J, Wang JF, Li D, Wu TT, Chen B, Zeng WH. Comparative study of 1064 nm nanosecond, 1064 nm picosecond, 755 nm, and 595 nm lasers for tattoo removal: An essential role by macrophage. Lasers Surg Med 2022; 54:737-746. [PMID: 35289435 DOI: 10.1002/lsm.23535] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/26/2022] [Accepted: 02/22/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Tattoo removal is in high demand, and many types of lasers can be used for tattoo removal. Macrophages play an important role in the persistence of tattoos. However, comparative studies of the efficacy of tattoo removal with different lasers versus the relationship between the destruction of pigment particles or recruitment of macrophages after laser treatment are lacking. MATERIALS AND METHODS Tattoo models were established on the rat dorsal surface and randomly treated with 1064 nm nanosecond, 1064 nm picosecond, 755 nm, and 595 nm lasers for one session. Clinical photographic evaluation, melanin index, hematoxylin and eosin staining, identification of macrophages by CD68 staining, and transmission electron microscopy were conducted at different time points. RESULTS Regardless of the pulse duration, all lasers included were effective for the removal of black tattoos, with 1064 nm lasers having the best efficacy, followed by 755 and 595 nm lasers. The diameter of the pigment particles and recruitment of dermal macrophages correlated with the efficacy of tattoo removal. CONCLUSIONS In this study, the 1064 nm lasers were found to be the most effective for black tattoo removal. However, there was no significant difference between the 1064 nm picosecond and the nanosecond lasers. Macrophage recruitment plays an essential role in pigment metabolism during laser-tattoo removal.
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Affiliation(s)
- Xiao-Jie Du
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hong-Mei Zhou
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhao Wang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jing Liu
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jia-Feng Wang
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Dong Li
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Ting-Ting Wu
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Bin Chen
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Wei-Hui Zeng
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Marini L, Marini S, Cutlan J, Hreljac I. Q-S laser micro-drilling and multipass full-beam Q-S laser for tattoo removal - a case series. Lasers Med Sci 2021; 37:1763-1771. [PMID: 34606037 PMCID: PMC8971194 DOI: 10.1007/s10103-021-03431-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/26/2021] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to evaluate the safety and efficacy of a new combined method of Q-S laser-assisted tattoo removal. Ten patients with 13 professional, mostly mono-chromatic black tattoos were recruited. All tattoos received the same Q-S laser treatment sequence. An objective evaluation of tattoo clearing was assessed by careful analysis of a standardized collection of digital images taken from each tattoo, 2 months after each laser session, with the help of a custom-made pigment-fading percentage photographic ruler. The percentages of pigment clearance and side effects were evaluated by 4 independent dermatologists. Patient satisfaction and perceived discomfort during and post-procedure were evaluated according to specific scales. Clinical evaluators confirmed an average photographic pigment clearance of 97% after a median 4.85 treatment sessions. The Frac-Tat® method required 40% fewer sessions compared to those calculated by Kirby-Desai estimates. Photographic assessment of laser-exposed skin quality performed 2 months after tattoo clearing was considered almost comparable with untreated peripheral skin, confirming a very low side effect score. The Frac-Tat QS laser-assisted tattoo removal sequence used in our study showed a high degree of safety and efficiency, clearing exogenous pigments in a relatively few number of sessions. Preliminary ablative photo-acoustic fractional 1064-nm Q-S laser micro-drilling was considered an essential step in optimizing tattoo removal, increasing wavelength-independent micro-columnar clearing of deeper dermal exogenous pigments. Our preliminary observations also confirmed a significant improvement of tattoo procedure-induced micro-textural changes thanks to a tissue remodeling effect induced by the 1064-nm Q-S fractional laser photo-acoustic ablation.
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Affiliation(s)
- Leonardo Marini
- SDC The Skin Doctors Center, via dei Bonomo 5/a, 34126, Trieste, Italy.
| | | | - James Cutlan
- Royal Glamorgan Hospital, Llantrisant, Wales, UK
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8
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Qu Y, Feng X, Liang J, Liu J, Gao D. The Picosecond Laser Effects on Tattoo Removal and Metabolic Pathways. Clin Cosmet Investig Dermatol 2021; 14:1343-1350. [PMID: 34594124 PMCID: PMC8478112 DOI: 10.2147/ccid.s332265] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/16/2021] [Indexed: 11/29/2022]
Abstract
Objective We aimed to investigate picosecond laser effects regarding rat tattoo removals. We systematically detected the metabolic pathways considering tattoo pigment particles in rat models. Materials and Methods We employed fluorescein to mark the tattoo dye and utilized a pattern needle to prepare tattoo on rat so as to establish the tattoo removal effects of picosecond laser methods employing animal models. We applied a picosecond laser to process the tattoo and observed the effects along with metabolic pathways for tattoo removal via pathology and imaging approaches. Results Based on the results of characterization, pathology and fluorescence, we discovered that the picosecond laser could effectively remove the pigment particles on rat skin, part of which would be metabolized out of the body through the circulatory system. After picosecond laser treatment, the fluorescence intensity of the rat skin engraved part was gradually weakened. At 8 h after the treatment, the metabolic organs had weak fluorescence, and there was no fluorescence in the metabolic organs at 12 h and 24 h after the treatment. Conclusion The picosecond laser had perfect tattoo removal effects, which could be utilized as a reference for clinical tattoo removal.
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Affiliation(s)
- Yan Qu
- Department of Dermatology, The Affiliated Hospital of Weifang Medical University, Weifang, Shandong, 261031, People's Republic of China
| | - Xien Feng
- Department of Dermatology, Yantai Yuhuangding Hospital, Yantai, 264003, Shandong, People's Republic of China
| | - Jin'ning Liang
- Department of Dermatology, Yantai Yuhuangding Hospital, Yantai, 264003, Shandong, People's Republic of China
| | - Junru Liu
- Department of Dermatology, Yantai Yuhuangding Hospital Laishan Branch, Yantai, 264003, Shandong, People's Republic of China
| | - Dong Gao
- Department of Dermatology, Yantai Yuhuangding Hospital, Yantai, 264003, Shandong, People's Republic of China
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9
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Bäumler W, Breu C, Philipp B, Haslböck B, Berneburg M, Weiß KT. The efficacy and the adverse reactions of laser-assisted tattoo removal - a prospective split study using nanosecond and picosecond lasers. J Eur Acad Dermatol Venereol 2021; 36:305-312. [PMID: 34543473 DOI: 10.1111/jdv.17674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/10/2021] [Accepted: 08/18/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Laser pulses with nanosecond duration (NSL) have been the golden standard to destroy the pigment particles in skin. It is still controversially discussed whether picosecond pulses (PSL) are superior for tattoo removal. OBJECTIVES To compare the efficacy and the adverse reactions of nanosecond and picosecond laser pulses in a comparative study. METHODS The prospective study included 23 subjects with 30 black or coloured tattoos, which were split into two halves treated with either a new PSL (532, 1064 nm) or standard NSL (694 nm). The lasers were applied at regular time intervals of 4 weeks for up to eight treatments. Tattoo clearance (primary endpoint), pain and adverse reactions (secondary endpoints) were appraised by physicians, blinded observers, and by subjects. The extent and duration of adverse reactions were additionally assessed by using a questionnaire and photo-documentation after each treatment session. RESULTS The tattoo clearance appeared to be more effective for PSL compared to NSL but without statistical significance (P > 0.05). Pretreated tattoos responded better to laser treatments than previously untreated tattoos. Subjects felt significantly less pain with PSL than with NSL (P < 0.001). Transient adverse reactions were statistically less pronounced lasting shorter for PSL as for NSL, especially blistering, pruritus, and burning sensation. Hypopigmentation appeared after NSL treatments only, whereas hyperpigmentation was caused by both lasers. No scarring was detected with either laser. CONCLUSIONS Both laser systems enable acceptable clearance of most tattoos in the present study. PSL cause less collateral skin damage as compared to NSL.
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Affiliation(s)
- W Bäumler
- Department of Dermatology, University of Regensburg, Regensburg, Germany
| | - C Breu
- Department of Dermatology, University of Regensburg, Regensburg, Germany
| | - B Philipp
- Department of Dermatology, University of Regensburg, Regensburg, Germany
| | - B Haslböck
- Department of Dermatology, University of Regensburg, Regensburg, Germany
| | - M Berneburg
- Department of Dermatology, University of Regensburg, Regensburg, Germany
| | - K T Weiß
- Department of Dermatology, University of Regensburg, Regensburg, Germany
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10
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Q-Switched 1064/532 nm Laser with Nanosecond Pulse in Tattoo Treatment: A Double-Center Retrospective Study. Life (Basel) 2021; 11:life11070699. [PMID: 34357071 PMCID: PMC8304052 DOI: 10.3390/life11070699] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/10/2021] [Accepted: 07/15/2021] [Indexed: 11/17/2022] Open
Abstract
Tattoo removal is a well-established procedure in dermatology. Lasers represent the gold standard in the management of this condition nowadays. In this study, we report our experience on the use of a Q-switched nanosecond source. A total of 52 patients were consecutively enrolled in performing tattoo removal at Magna Graecia University of Catanzaro and Tor Vergata University of Rome. Black and blue tattoos were treated with a 1064 nm laser, with a pulse duration of 6 ns and a fluence up to 10 J/cm2, while colored tattoos were treated with sessions of 532 nm laser, with a pulse duration of 6 ns and a fluence up to 5 J/cm2. Up to nine treatments with a minimum interval of 8 weeks between each session were performed. A six-month follow-up visit assessed patient satisfaction (Visual Analogue Scale). Overall clinical result was assessed with a clinical evaluation by two blinded dermatologists using a 5-point scale, comparing pictures before treatment and at follow up. A total of 52 patients were included and analyzed: 30 females (57.7%) and 22 males (42.3%). Mean age was 43.7 ± 12.7 years. According to Fitzpatrick’s skin classification, 16 individuals (30.8%) were type II, 15 (28.8%) were type III, and 21 (40.4%) were type IV. Most of the treated tattoos were carried out by professionals. The mean number of sessions required to obtain a result was 4.6 ± 2.5, and the final tattoo removal rate was 60% or higher, with 51.9% of the patients reporting highest satisfaction scores Q-Switched 1064/532 nm laser may be considered today as the gold-standard treatment for tattoo removal. Our results confirm literature findings of the safety and effectiveness of these devices.
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11
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Modena DAO, Miranda ACG, Grecco C, Liebano RE, Cordeiro RCT. High power Q-switched 1064 nm / 532 nm Nd:YAG Laser in tattoo removal: A systematic review. J COSMET LASER THER 2021; 23:41-48. [PMID: 34668826 DOI: 10.1080/14764172.2021.1988109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Q-switched 1064 nm/532 nm Nd: YAG Lasers present important characteristics which can contribute toward the removal of tattoos, for having the ability to reach only specific targets with minimal damage to the tissue. Despite reports of their clinical benefits, only a few scientific studies demonstrate the efficacy and safety of these types of lasers in the short and long term. To substantiate the effects, benefits, and safety of the application of Q-switched 1064 nm/532 nm Nd: YAG lasers, a systematic review was carried out from September to December of 2019, about the studies which report their use in the removal of tattoos, published in the last 20 years. Randomized clinical trials in humans were considered, as long as they evaluated the efficacy, safety, and benefits of the application of Q-switched 1064 nm/532 nm Nd: YAG lasers in the removal of black and color tattoos in different skin phototypes. One hundred and twenty-two articles were identified after the titles, abstracts were read, and duplicates were removed; six articles were left, which were included in the research (188 individuals). The Q-switched 1064 nm/532 nm Nd: YAG lasers seem promising in the short term, with minimal adverse effects; however, the efficacy and safety in the long term still present limitations. Consequently, future research is necessary, with better methodological standardization applied and with a follow-up for a longer period of evaluation of possible permanent adverse effects, to determine the standardization and safety of the therapy with the lasers Nd: YAG de 1064 nm/532 nm Q-switched.
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Affiliation(s)
- Débora Aparecida Oliveira Modena
- Department of Surgery, Institute of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil.,Gpitas- Ibramed Technology Applied to Health Research Group, Amparo, Brazil.,Ibramed Center for Education and Advanced Training (Cefai), Amparo, Brazil
| | - Ana Carolina Godoy Miranda
- Gpitas- Ibramed Technology Applied to Health Research Group, Amparo, Brazil.,Ibramed Center for Education and Advanced Training (Cefai), Amparo, Brazil.,Department of Tocogynecology, Institute of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil
| | - Clovis Grecco
- Gpitas- Ibramed Technology Applied to Health Research Group, Amparo, Brazil.,Ibramed Center for Education and Advanced Training (Cefai), Amparo, Brazil
| | - Richard Eloin Liebano
- Gpitas- Ibramed Technology Applied to Health Research Group, Amparo, Brazil.,Department of Physiotherapy, Federal University of São Carlos (Ufscar), São Carlos, Brazil
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Pedrelli V, Azzopardi E, Azzopardi E, Tretti Clementoni M. Picosecond laser versus historical responses to Q-switched lasers for tattoo treatment. J COSMET LASER THER 2021; 22:210-214. [PMID: 33594939 DOI: 10.1080/14764172.2021.1886307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BackgroundTattooing is increasingly common among adolescents and young adults. This study explores the clinical efficacy of picosecond laser for the correction of tattoos. Literature suggests that 25-47% of the population have had a tattoo at some point in their life (1). The incidence is slightly higher in adults 18-35 years (22-47%) compared to college students (18-25 years of age(1, 2). Recent surveys report 25% of tattooed adults expressing regret, while 4% of tattooed students had already undergone some form of tattoo-removal procedure (3). A common request for tattoo removal includes poorly executed tattoos, avoidance of stigmatization, trauma, socially inappropriate, and employment. Several procedures have been proposed to remove tattoos including cryosurgery, thermal cautery, or surgical resection (4). A major disadvantage of these methods is that they are all highly operator dependent, and carry a very high risk of residual scarring, residual pigment being left behind "ghosting" (3). In addition, some opt to cover the unwanted tattoo with another design, which results in layered tattoos that are substantially harder to manage. Laser surgery, in skilled hands, is an effective method for tattoo removal and traditionally, this is performed with Quality-Switched Laser, where energy liberatred in the nanosecond range results in a selective photothermal effect (5). Picosecond laser is a more recent innovation that results in energy released in a picosecond timescale (a time interval 1000 times shorter).One potential disavantage of laser therapy for the effacement of cutaneous tattoos is the length of treatment and associated cost, which might dissuade the patient from following through to completion of treatment, limiting potential benefits whilst still being exposed to risk of harm. (5, 6). Recent studies suggest that picosecond laser result in substantially reduced treatment times, whilst achieving an identical or more effective end result (7-9). However, these studies are limited by very small sample size and follow-up.
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Affiliation(s)
| | | | - Ernest Azzopardi
- Laserplast Stl Stp, Milan, Italy.,Swansea Bay University Hospitals Board, NHS, Swansea, Wales, UK.,Dept of Anatomy, University of Malta Faculty of Medicine & Surgery, Tal Qroqq, Malta.,University College London, London, UK
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13
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Kurniadi I, Tabri F, Madjid A, Anwar AI, Widita W. Laser tattoo removal: Fundamental principles and practical approach. Dermatol Ther 2020; 34:e14418. [PMID: 33068020 DOI: 10.1111/dth.14418] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/05/2020] [Accepted: 10/13/2020] [Indexed: 11/28/2022]
Abstract
Tattoos have long become a part of human civilization. However, as the number of people who get tattoos increases, so is the number of people who wish to have their tattoos removed. Compared to other methods, laser-based devices are associated with the best efficacy and least side effects in tattoo removal. Lack of understanding of the fundamental principles of laser and managing its parameters may result in suboptimal result and increased risk of side effects. Recognizing and mastering multiple factors including skin types, nature and color of tattoos, and proper selection of laser parameters such as wavelength, fluence, and pulse, are central in achieving an optimal tattoo removal outcome. This review provides a comprehensive overview on the fundamental principle of laser and practical approaches in tattoo removal.
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Affiliation(s)
- Ivan Kurniadi
- Faculty of Medicine, Department of Dermatology and Venereology, Universitas Hasanuddin, Makassar, South Sulawesi, Indonesia
| | - Farida Tabri
- Faculty of Medicine, Department of Dermatology and Venereology, Universitas Hasanuddin, Makassar, South Sulawesi, Indonesia
| | - Asnawi Madjid
- Faculty of Medicine, Department of Dermatology and Venereology, Universitas Hasanuddin, Makassar, South Sulawesi, Indonesia
| | - Anis Irawan Anwar
- Faculty of Medicine, Department of Dermatology and Venereology, Universitas Hasanuddin, Makassar, South Sulawesi, Indonesia
| | - Widya Widita
- Faculty of Medicine, Department of Dermatology and Venereology, Universitas Hasanuddin, Makassar, South Sulawesi, Indonesia
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14
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Gurnani P, Williams N, Al-Hetheli G, Chukwuma O, Roth R, Fajardo F, Nouri K. Comparing the efficacy and safety of laser treatments in tattoo removal: A systematic review. J Am Acad Dermatol 2020; 87:103-109. [PMID: 32763326 DOI: 10.1016/j.jaad.2020.07.117] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 07/09/2020] [Accepted: 07/18/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Although lasers have been the criterion standard for tattoo removal, selecting the best modality can be challenging because of the varying efficacies and adverse effects. OBJECTIVE To evaluate all lasers used to remove tattoos and assess their efficacies and adverse effects. METHODS Our systematic review searched PubMed, MEDLINE, Embase, Scopus, CINAHL, Cochrane Central Register of Trials, and ClinicalTrials.gov for all laser treatments. The outcomes measured included laser parameters, treatment methods, patient and tattoo characteristics, clearance rate, and adverse effect rate. The quality of the included articles was appraised by using specific assessment tools and given a high, moderate, or low risk of bias. RESULTS Our search led to 3037 studies, with 36 being included in the systematic review (7 randomized controlled trials, 2 nonrandomized controlled trials, and 27 case series). Although quality-switched neodymium-doped yttrium-aluminum-garnet lasers are safe and effective, picosecond lasers have shown superiority with blue, green, and yellow tattoo pigments. Both are safe and effective for black tattoos. LIMITATIONS Variability among studies. CONCLUSIONS Picosecond lasers show superiority when treating blue, green, and yellow tattoos. The R20 and R0 novel techniques can effectively reduce treatment time. Further randomized controlled trials are required to make a more definitive recommendation.
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Affiliation(s)
- Pooja Gurnani
- Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida; Florida International University Herbert Wertheim College of Medicine, Miami, Florida.
| | - Natalie Williams
- Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Ghadah Al-Hetheli
- Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida; Department of Dermatology and Cutaneous Surgery, College of of Medicine, Qassim University, Saudi Arabia
| | - Olivia Chukwuma
- Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Rebecca Roth
- Florida International University Herbert Wertheim College of Medicine, Miami, Florida
| | - Francisco Fajardo
- Florida International University Herbert Wertheim College of Medicine, Miami, Florida
| | - Keyvan Nouri
- Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
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15
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Lee YH, Lee HJ, Kim WS, Lee GY, Choi YJ. Treatment of idiopathic onychodystrophy with a 1064 nm picosecond neodymium-doped:yttrium aluminum garnet laser: A retrospective study. J Cosmet Dermatol 2020; 20:497-505. [PMID: 32593217 DOI: 10.1111/jocd.13580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Laser treatment has emerged as a novel treatment modality for onychodystrophy. Only a few small series have assessed the efficacy of laser treatment in onychodystrophy, most of which were case reports. The therapeutic effect of the 1064 nm neodymium-doped:yttrium aluminum garnet (Nd:YAG) laser for onychodystrophy has been demonstrated. Recently, the picosecond Nd:YAG (PSNY) laser has been introduced to improve various skin disorders. AIMS The aim of this study was to verify the efficacy of a 1064 nm PSNY in management of idiopathic onychodystrophy. METHODS We present a case series of dystrophic nails treated with a PSNY for onychodystrophy improvement. Planimetry using ImageJ software was used to calculate lesion reduction and proximal clear nail growth. Clinical improvement was assessed using a 5-point Global Assessment Scale (GAS). Adverse events were also assessed. RESULTS Twenty-five patients (11 males and 14 females) with a total of 128 nails (94 finger nails and 34 toe nails) were treated. The mean treatment number was 8.7 ± 6.2, and the mean total duration of treatment was 33.4 ± 34.6 weeks. The average proportion of the lesion area decreased significantly (from 65.9% to 46.6%) after PSNY treatment (P < .001). The mean GAS (3.16 ± 1.18) exhibited fair improvement, and there were no serious adverse events. CONCLUSION The 1064 nm PSNY laser can provide fair improvement for onychodystrophy with a good prognosis at least during the follow-up period and optimal cosmetic results in Asian patients.
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Affiliation(s)
- Yun Ho Lee
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Heun Joo Lee
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won-Serk Kim
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ga-Young Lee
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Jun Choi
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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16
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Wu DC, Goldman MP, Wat H, Chan HHL. A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations. Lasers Surg Med 2020; 53:9-49. [PMID: 32282094 DOI: 10.1002/lsm.23244] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVES The use of picosecond laser in dermatology was originally focused on optimizing the removal of unwanted tattoos. Subsequent advances in this technology have broadened its clinical indications to include treatment of benign pigmented lesions, photodamage, melasma, and scar revision. In this systematic review, evidence-based recommendations are developed for the use of picosecond laser in dermatology. STUDY DESIGN/MATERIALS AND METHODS A comprehensive search of the English language literature was performed up to and including November 2019. Relevant citations were individually evaluated, synthesized, and categorized based on the Level of Evidence. With the addition of the authors' combined clinical experience, clinical recommendations were developed. RESULTS After application of inclusion and exclusion criteria, a total of 77 unique studies were evaluated. Treatment of benign pigmented lesions was associated with level I-IV evidence; rejuvenation was associated with level II evidence; melasma was associated with level II evidence; scar revision was associated with level II-III evidence; tattoo removal was associated with level I evidence. CONCLUSION Picosecond laser is a safe and effective treatment modality for an increasing range of dermatologic indications. Further development of this technology is warranted. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
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Affiliation(s)
- Douglas C Wu
- Cosmetic Laser Dermatology, 9339 Genesee Avenue, Suite 300, San Diego, California, 92121
| | - Mitchel P Goldman
- Cosmetic Laser Dermatology, 9339 Genesee Avenue, Suite 300, San Diego, California, 92121
| | - Heidi Wat
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street, Boston, Massachusetts, 02114
| | - Henry H L Chan
- Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street, Boston, Massachusetts, 02114
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17
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[Complications of cosmetic piercings and tattoos in the head and neck region]. HNO 2020; 68:131-140. [PMID: 32020243 DOI: 10.1007/s00106-019-00808-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Piercings and tattoos have gained popularity across all cultural environments during the past century, and one in ten Europeans are now pierced. While tattoos are often restricted to the rest of the body, piercings are common at facial sites such as ears, nose, lips, and tongue. Complications following piercings are not uncommon. Infections can rapidly spread across the auricular cartilage and require antibiotic and often surgical treatment. Mild trauma (i.e., piercing the earlobe) can lead to excessive scar formation due to fibroblast proliferation. Keloids have a particularly high rate of recurrence and are therefore difficult to treat. Due to recent developments in the field of permanent makeup, tattooing techniques are also increasingly applied in the head and neck region. Here, complications such as infection or allergic reactions can occur. Topical medication or laser procedures are the usual therapeutic options.
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18
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Quantitative Monitoring of Tattoo Contrast Variations after 755-nm Laser Treatments in In Vivo Tattoo Models. SENSORS 2020; 20:s20010285. [PMID: 31947903 PMCID: PMC6982791 DOI: 10.3390/s20010285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/25/2019] [Accepted: 12/30/2019] [Indexed: 11/17/2022]
Abstract
Laser lights have been used by dermatologists for tattoo removal through photothermal interactions. However, most clinical studies used a visual scoring method to evaluate the tattoo removal process less objectively, leading to unnecessary treatments. This study aimed to develop a simple and quantitative imaging method to monitor the degree of tattoo removal in in vivo skin models. Sprague Dawley rat models were tattooed with four different concentrations of black inks. Laser treatment was performed weekly on the tattoos using a wavelength of 755 nm over six weeks. Images of non-treated and treated samples were captured using the same method after each treatment. The intensities of the tattoos were measured to estimate the contrast for quantitative comparison. The results demonstrated that the proposed monitoring method quantified the variations in tattoo contrast after the laser treatment. Histological analysis validated the significant removal of tattoo inks, no thermal injury to adjacent tissue, and uniform remodeling of epidermal and dermal layers after multiple treatments. This study demonstrated the potential of the quantitative monitoring technique in assessing the degree of clearance level objectively during laser treatments in clinics.
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19
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Kono T, Chan HHL, Groff WF, Imagawa K, Hanai U, Akamatsu T. Prospective Comparison Study of 532/1064 nm Picosecond Laser vs 532/1064 nm Nanosecond Laser in the Treatment of Professional Tattoos in Asians. Laser Ther 2020; 29:47-52. [PMID: 32903983 DOI: 10.5978/islsm.20-or-07] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 04/15/2020] [Indexed: 11/06/2022]
Abstract
Background and Aims Although, the pulse width should be shorter than the thermal relaxation time of the target, nanosecond laser pulses are not short enough for tattoo removal. Complications are common, such as hyper or hypopigmentation, textural changes, and scarring. Moreover, patients with darker skin types are at a higher risk of complications from tattoo removal using these lasers. Picosecond lasers were developed to overcome the limitation of nanosecond lasers. We did a comparison study of a 532/1064 nm picosecond laser vs a 532/1064 nm nanosecond laser to evaluate the clinical efficacy and complications of multi-color tattoos in Asians. Materials and methods Eleven Asian patients with 37 professional tattoos were enrolled in the study. Each patient was treated with a 532/1064 nm nanosecond laser and a 532/1064 nm picosecond laser. The spot size that was used with each laser was 3 mm. Four treatments were performed, with four week intervals between each treatment. Patients were examined a week after the first treatment and 3 months after the last treatment. Results and Conclusions All patients tolerated the treatments well. The efficacy of the 1064 nm picosecond laser for black tattoos is significantly better than the other studied lasers. The efficacy of the 532 nm picosecond laser is significantly better than the other studied lasers for red tattoos. The efficacy of the 532 nm picosecond laser is significantly better than the 532 nm nanosecond laser and better than the 1064 nm picosecond laser for green tattoos. Mild to moderate post-inflammatory hyperpigmentation was observed in 35.1%, 24.3% 27.0%, and 21.6% of the tattoos treated with the 532 nm nanosecond laser, the 532 nm picosecond laser, the 1064 nm nanosecond laser, and the 1064 nm pico-second laser, respectively. Paradoxical darkening (5.4%) was observed equally with each type of laser. There was no scar formation in any of the tattoos treated. The 532/1064 nm picosecond laser is more effective than the 532/1064 nm nanosecond laser in the treatment of multi-color tattoos in Asians. The 532 nm picosecond laser is more effective than 1064 nm picosecond laser in every tattoo color, with the exception of black. Paradoxical darkening was observed, even the use of picosecond lasers.
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Affiliation(s)
- Taro Kono
- Department of Plastic Surgery, Tokai University, Kanagawa, Japan
| | - Henry H L Chan
- Division of Dermatology, Department of Medicine, University of Hong Kong, Department of Medicine/Therapeutic and Pediatric, Chinese University of Hong Kong
| | | | - Kotaro Imagawa
- Department of Plastic Surgery, Tokai University, Kanagawa, Japan
| | - Ushio Hanai
- Department of Plastic Surgery, Tokai University, Kanagawa, Japan
| | - Tadashi Akamatsu
- Department of Plastic Surgery, Tokai University, Kanagawa, Japan
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20
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Shimojo Y, Nishimura T, Hazama H, Ito N, Awazu K. Picosecond Laser-Induced Photothermal Skin Damage Evaluation by Computational Clinical Trial. Laser Ther 2020; 29:61-72. [PMID: 32903975 DOI: 10.5978/islsm.20-or-08] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 04/23/2020] [Indexed: 01/07/2023]
Abstract
Background and Objectives Computational clinical trial (CCT) in the field of laser medicine promotes clinical application of novel laser devices, because this trial carried out based on numerical modeling of laser-tissue interactions and simulation of a series of treatment process. To confirm the feasibility of the computational clinical trial of skin treatment with a novel picosecond laser, this paper presents an evaluation method of the safety. Study Design/Materials and Methods In this method, the light propagation and thermal diffusion process after ultrashort light pulse irradiation to a numerical skin model is calculated and the safety based on the photothermal damage is evaluated by computational modeling and simulation. As an example, the safety of a novel picosecond laser device was examined by comparing with several laser devices approved for clinical use. Results The ratio of the maximum thermal damage induced by picosecond laser irradiation was 1.2 × 10-2 % at the epidermis, while that caused by approved laser irradiation was 99 % at the capillary vessels. The numerical simulation demonstrated that less thermal damage was observed compared with the approved devices. The results show the safety simulated by photothermal damage calculation was consistent with the reported clinical trials. Conclusions This computational clinical trial shows the feasibility of applying computational clinical trials for the safety evaluation of novel medical laser devices. In contrast to preclinical and clinical tests, the proposed computational method offers regulatory science for appropriately and quickly predicting and evaluating the safety of a novel laser device.
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Affiliation(s)
- Y Shimojo
- Graduate School of Engineering, Osaka University, Suita, Japan
| | - T Nishimura
- Graduate School of Engineering, Osaka University, Suita, Japan
| | - H Hazama
- Graduate School of Engineering, Osaka University, Suita, Japan
| | - N Ito
- Global Center for Medical Engineering and Informatics, Osaka University, Suita, Japan
| | - K Awazu
- Graduate School of Engineering, Osaka University, Suita, Japan.,Global Center for Medical Engineering and Informatics, Osaka University, Suita, Japan.,Graduate School of Frontier Biosciences, Osaka University, Suita, Japan
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21
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Kato H, Doi K, Kanayama K, Araki J, Nakatsukasa S, Chi D, Mori M, Fuse Y, Sakae Y, Uozumi T. Combination of Dual Wavelength Picosecond and Nanosecond Pulse Width Neodymium-Doped Yttrium-Aluminum-Garnet Lasers for Tattoo Removal. Lasers Surg Med 2019; 52:515-522. [PMID: 31729066 DOI: 10.1002/lsm.23181] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES Tattoo removal by laser has been mostly performed using Q-switched laser, which has nanosecond pulse width. In recent years, the efficacy of treatment with picosecond pulse width laser has also been reported. STUDY DESIGN/MATERIALS AND METHODS Using a picosecond-domain, neodymium-doped yttrium-aluminum-garnet laser with a potassium-titanyl-phosphate frequency-doubling crystal, we performed a retrospective clinical study with combination treatment using pulse widths of 750 ps and 2 ns. The number of treatments was compared with the Kirby-Desai score. Tissue changes immediately after laser irradiation at 2 ns and 750 ps were compared using an electron microscope. RESULTS The combination treatment using pulse widths of 2 ns and 750 ps was safe and more effective than the Q-switched neodymium-doped yttrium-aluminum-garnet laser treatment. Tattoo removal was possible with significantly fewer treatment numbers than the Kirby-Desai score, without adverse events. The results from the scanning electron microscope revealed that ink particles irradiated by 750 ps were more dispersed than those by 2 ns. CONCLUSIONS The combination treatment with pulse widths of 2 ns and 750 ps and 1064 nm and 532 nm wavelengths using the neodymium-doped yttrium-aluminum-garnet laser was safe and effective and can be a useful option for tattoo removal. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
| | | | - Koji Kanayama
- Luce Tokyo Aesthetic Clinic, Tokyo, Japan.,Department of Plastic and Reconstructive Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Jun Araki
- Luce Tokyo Aesthetic Clinic, Tokyo, Japan
| | | | - Daekwan Chi
- Department of Plastic Surgery, Jichi Medical University, Tochigi, Japan
| | - Masanori Mori
- Department of Plastic Surgery, Jichi Medical University, Tochigi, Japan
| | - Yuma Fuse
- Luce Tokyo Aesthetic Clinic, Tokyo, Japan
| | - Yuki Sakae
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
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22
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Patel PD, Mohan GC, Bhattacharya T, Patel RA, Tsoukas M. Pediatric Laser Therapy in Pigmented Conditions. Am J Clin Dermatol 2019; 20:647-655. [PMID: 31134589 DOI: 10.1007/s40257-019-00449-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Advances in laser therapy have led to novel therapeutic approaches to common pediatric skin conditions. As a non-invasive alternative to surgical options, laser therapy is efficacious in treating a broad range of conditions, from vascular and pigmented lesions to tattoo and hair removal. This paper reviews the basic mechanics of laser therapy, its role in common pigmented pediatric dermatoses, and special considerations for this unique age group.
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23
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Torbeck RL, Schilling L, Khorasani H, Dover JS, Arndt KA, Saedi N. Evolution of the Picosecond Laser: A Review of Literature. Dermatol Surg 2019; 45:183-194. [DOI: 10.1097/dss.0000000000001697] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Bäumler W, Weiß KT. Laser assisted tattoo removal – state of the art and new developments. Photochem Photobiol Sci 2019; 18:349-358. [DOI: 10.1039/c8pp00416a] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Decorative tattoos including permanent make-up are very popular world-wide. As the trend for tattoo acquisition increases, the demand for tattoo removal will similarly rise. This article highlights the state of the art and new developments in laser assisted tattoo removal.
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Affiliation(s)
- W. Bäumler
- Department of Dermatology
- University of Regensburg
- Germany
| | - K. T. Weiß
- Department of Dermatology
- University of Regensburg
- Germany
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25
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Paasch U, Grunewald S. Update Dermatologische Lasertherapie 2018 I - Epilation, Gefäße und Pigmente. J Dtsch Dermatol Ges 2018; 16:1417-1424. [PMID: 30537330 DOI: 10.1111/ddg.13702_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/09/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Uwe Paasch
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR und Medizinische Fakultät der Universität Leipzig
| | - Sonja Grunewald
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR und Medizinische Fakultät der Universität Leipzig
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26
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Paasch U, Grunewald S. 2018 update on dermatologic laser therapy: Part 1 - epilation, vascular lesions and pigments. J Dtsch Dermatol Ges 2018; 16:1417-1423. [PMID: 30417560 DOI: 10.1111/ddg.13702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/09/2018] [Indexed: 11/27/2022]
Abstract
Technical advances in recent years have led to new dermatologic laser systems, light sources, and treatment concepts. Commonly used wavelengths - generated today with LED-based devices - allow for the combination of various tissue effects and are associated with improved outcomes. Laser hair removal has become more efficient with the use of diode lasers that emit multiple wavelengths simultaneously. In the near future, novel LED-based lasers will also be introduced for the treatment of vascular lesions. Here, too, the combination of different wavelengths promises to be beneficial. Picosecond lasers have led to advances in the field of pigment removal (tattoos).
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Affiliation(s)
- Uwe Paasch
- Department of Dermatology, Venereology and Allergology, Leipzig University Medical Center, and Medical Faculty, Leipzig University, Leipzig, Germany
| | - Sonja Grunewald
- Department of Dermatology, Venereology and Allergology, Leipzig University Medical Center, and Medical Faculty, Leipzig University, Leipzig, Germany
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27
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Huerta Rivera G, López Zaldo JB, Arreola Jauregui IE, Soria Orozco M, Paniagua Santos JE, Vázquez Huerta M. Clearance of facial tattoo with triple-wavelength picosecond laser and fractionated carbon dioxide laser. Dermatol Ther 2018; 32:e12766. [PMID: 30291729 DOI: 10.1111/dth.12766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/22/2018] [Accepted: 09/29/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - Manuel Soria Orozco
- Department of Dermatology, Civil Hospital of Guadalajara, University of Guadalajara, Guadalajara, Jalisco, Mexico
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28
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A split-face, single-blinded, randomized controlled comparison of alexandrite 755-nm picosecond laser versus alexandrite 755-nm nanosecond laser in the treatment of acquired bilateral nevus of Ota–like macules. J Am Acad Dermatol 2018; 79:479-486. [DOI: 10.1016/j.jaad.2017.12.053] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/14/2017] [Accepted: 12/16/2017] [Indexed: 11/18/2022]
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29
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Bernstein EF, Bhawalkar J, Schomacker KT. A novel titanium sapphire picosecond-domain laser safely and effectively removes purple, blue, and green tattoo inks. Lasers Surg Med 2018; 50:704-710. [PMID: 29781161 PMCID: PMC6120457 DOI: 10.1002/lsm.22942] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Green, blue, and purple tattoo pigments are often the colors most resistant to laser removal. Recently, the first ever production picosecond-domain laser with a 785 nm wavelength was developed to improve the rate of clearance of green, blue, and purple tattoo inks. METHODS Twenty-two tattoos from 15 subjects with skin phototypes II-IV were enrolled in the study. A total of four treatments were administered using a single 785 nm picosecond-domain laser wavelength. Blinded assessment of digital, cross-polarized photographs taken approximately 8 weeks following the last treatment was performed using an 11-point clearance scale. RESULTS Fourteen subjects with 21 tattoos completed all study visits. The 21 tattoos contained the following pigments: black (n = 15), green (n = 13), blue (n = 8), yellow (n = 5), purple (n = 4), and red (n = 3). Treatments were performed with a 2-4-mm beam diameter and fluences ranging from 1.1 to 3.1 J/cm2 . Blinded assessment of photographs found 85%, 81%, 74%, 61%, 11%, and 5% clearance from baseline photos for purple, blue, green, black, red, and yellow pigments, respectively. Treatments were well tolerated with typical erythema, edema and one case of pinpoint bleeding. No scarring was noted. CONCLUSION This first study of a new 785 nm picosecond-domain laser demonstrates safe and effective removal of multicolor tattoos. Although clearance was shown for a multitude of colors including black, the 785 nm laser wavelength has special affinity to purple, blue and green tattoo pigments. Lasers Surg. Med. 9999:1-7, 2018. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
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Affiliation(s)
| | - Jayant Bhawalkar
- Syneron‐Candela Corporation530 Boston Post RoadWaylandMassachusetts 01778
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30
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Choi YJ, Kim JY, Nam JH, Lee GY, Kim WS. Clinical Outcome of 1064-nm Picosecond Neodymium–Doped Yttrium Aluminium Garnet Laser for the Treatment of Hypertrophic Scars. J COSMET LASER THER 2018; 21:91-98. [DOI: 10.1080/14764172.2018.1469768] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Young-Jun Choi
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Yup Kim
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae-Hui Nam
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ga-Young Lee
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won-Serk Kim
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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31
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Zhang M, Huang Y, Lin T, Wu Q. Comparison of treatment with an Alexandrite picosecond laser and Nd:YAG nanosecond laser for removing blue-black Chinese eyeliner tattoos. J COSMET LASER THER 2018; 20:415-418. [PMID: 29488808 DOI: 10.1080/14764172.2018.1444773] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objective: To retrospectively evaluate the efficacy of an Alexandrite picosecond laser versus Nd:YAG nanosecond laser for removing blue-black eyeliner tattoos which have existed more than 10 years. Methods: A total of 40 patients were treated with an Alexandrite picosecond laser in our department from August 2015 to July 2017, with a fluence of 1.96-6.37J/cm2, spot size of 2.0-3.6 mm, and pulse width of 750 ps. Another 32 patients were treated with an Nd:YAG nanosecond laser, with a fluence of 2.80-7.00 J/cm2, spot size of 3 mm, and pulse width of 5-20 ns. All analysed patients completed at least one treatment and follow-up. Results: The median number of treatment for all the patients was 1 (range, 1-4). After a single session, no difference was found between the two lasers for the eyeliner removal (p > 0.05). For the people who achieved an excellent response of tattoo clearance, there was still no difference between the two groups (p > 0.05). Transient side effects were observed in two groups, but neither group had significant adverse reactions. Conclusions: To treat blue-black Chinese eyeliner tattoos over 10 years, Alexandrite picosecond laser does not provide better clearance than the Nd:YAG nanosecond laser.
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Affiliation(s)
- Mengli Zhang
- a Department of Cosmetic Laser Surgery , Hospital of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College , Nanjing , China
| | - Yuqing Huang
- a Department of Cosmetic Laser Surgery , Hospital of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College , Nanjing , China
| | - Tong Lin
- a Department of Cosmetic Laser Surgery , Hospital of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College , Nanjing , China
| | - Qiuju Wu
- a Department of Cosmetic Laser Surgery , Hospital of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College , Nanjing , China
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Lorgeou A, Perrillat Y, Gral N, Lagrange S, Lacour JP, Passeron T. Comparison of two picosecond lasers to a nanosecond laser for treating tattoos: a prospective randomized study on 49 patients. J Eur Acad Dermatol Venereol 2017; 32:265-270. [DOI: 10.1111/jdv.14492] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 07/12/2017] [Indexed: 11/29/2022]
Affiliation(s)
- A. Lorgeou
- Department of Dermatology; Université Côte d'Azur; Centre Hospitalier Universitaire Nice; Nice France
| | - Y. Perrillat
- Centre Dermatologique Esthétique et Laser; Grenoble France
| | - N. Gral
- Centre Dermatologique Esthétique et Laser; Grenoble France
| | - S. Lagrange
- Department of Dermatology; Université Côte d'Azur; Centre Hospitalier Universitaire Nice; Nice France
| | - J.-P. Lacour
- Department of Dermatology; Université Côte d'Azur; Centre Hospitalier Universitaire Nice; Nice France
| | - T. Passeron
- Department of Dermatology; Université Côte d'Azur; Centre Hospitalier Universitaire Nice; Nice France
- Université Côte d'Azur. INSERM U1065; tema 12, C3M Nice France
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33
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Ross E. The picosecond revolution and laser tattoo treatments: are shorter pulses really better? Br J Dermatol 2017; 176:299-300. [DOI: 10.1111/bjd.15294] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E.V. Ross
- Laser and Cosmetic Dermatology Scripps Clinic San Diego CA U.S.A
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