Picosecond lasers usher paradigm shift in tattoo removal

Three picosecond laser wavelengths represent a new paradigm for optimal tattoo removal, according to a presentation by New York City-based dermatologist Roy G. Geronemus, M.D., and colleagues at yesterday’s American Society for Laser Medicine & Surgery 2015 annual conference in Kissimmee, Fla.

Dr. Geronemus, clinical professor of dermatology at New York University Medical Center and founder of the university’s laser program, says picosecond lasers offer a faster and more complete response than traditional tattoo removal approaches, such as nanosecond laser technology.

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The dermatologist describes the new paradigm as, “Picosecond at 755 nm for blue and green tattoo removal in one to three sessions; picosecond laser at 532 nm for rapid removal of yellow, red and orange tattoos; and picosecond laser at 1064 nm for tattoos in darker skin types.”

Dr. Geronemus presented a single-center study in which he and colleagues studied multicolor tattoo treatment using a 755 nm wavelength with a pulse width of 500 to 750 ps; 532 nm with a pulse of 450 to 500 ps; or 1064 nm wavelength with a pulse width of 500 to 600ps. A subset of subjects were also treated with a 532 nm nanosecond device. Forty-four subjects, with a total 53 previously untreated tattoos, took part in the study, receiving up to 10 treatments at 1-to 2-month intervals.

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The researchers found the picosecond laser cleared tattoos faster than the nanosecond technology. Red, yellow and orange pigments seemed to respond best to the 532 nm picosecond laser, with 75% to 100% clearance after an average of two treatments in most cases. Seven tattoos containing black ink responded equally well after one to two treatments to the 755 nm and 1064 nm picosecond lasers. One treatment resulted in 75% clearance of the red pigment in nine tattoos. In two of the people studied, the red pigment was gone after three treatments.

Dr. Geronemus presented another study in which he concluded black tattoo ink reduction can be achieved for most skin types with a combination of the 755 nm and 1064 nm picosecond devices, and tattoo treatment with the picosecond laser appears to be safe and well tolerated. Events included mild pain, erythema, edema, transient hypopigmentation, paradoxical darkening, blistering and crust formation. But patients experienced minimal downtime, and physician and patient satisfaction rates were high, according to the study.  

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