Abstract della lezione
"Tattoo
removal by laser"
Tattoos
are described as a colored pattern of human skin applicated by burning,
cutting, ripping or beatin9. These
rites are common for primitive people as a sign of glory, ornament or
magic protection. The word tattoo derives from the Tahitian word “ta tatau",
which means 'to beat'.
Nowadays
tattooed people are assigned to social fringe groups. The following slice
shows, that this assignment is not always correct.
In
these days it is hard for the young generation to shape an image opposite to
the establishment. The generation conflict has always lead to friction which
has served as a base for social development on both sides. For instant in 1968
the political messages of the student revolt were underlined by the
hippie-look. In contrast to those times the extreme outer appearance of today's
young people is missing any political content.
Not
long ago people of the lower classes were the only to be tattooed. But things
have changed. In the last decade it got more and more common to be tattooed
even in upper class, although an indifferent attitude towards this fashion fad
did not occur.
After
being tattooed and getting established more and more a problem as regards the
tattoo occurs. What to do with the youthful misdeeds? Is there a chance of
getting rid of it? Only seldom a tattoo has to be removed for medical reasons.
Which
methods can be chosen for tattoo removal?
There are several methods described in medical literature but no doubt the
state of the art is the laser-technique.
In
general a difference has to be made between professional and amateurish made
tattoos especially with regards to successful treatment.
A
main difference between this two type of tattoos is the depth of the color
applied to the skin. So to say professional tattoos are harder to remove
because the color was placed deeper in the tissue.
According
to this, different LASER-Systems penetrate into different layers of the skin.
There are special indications for each LASER-System.
It
is not only the depth of the color brought into the skin that is responsible
for the duration of a tattoo but the chemical structure of the color.
There
are a lot of differences between the colors used such as brightness, duration
and toxicology. The side effects vary from simple allergic reaction to
induction of tumor growth. In this context it is very interesting to take a
look at waste management laws.
These
substances worn proudly in skin require a lot of time, energy and manpower to
be disposed.
As
already mentioned different colors with different absorption of light and
different chemical resistance as
regards the removal of the color require LASER-systems with different
wavelengths.
This
chart shows that it is more difficult to remove red and orange colors and
easier to remove green and blue colors. Apart from this, blue chromophors
react to longer wavelengths whereas red colors react to shorter wavelengths.
This is according to the physical laws of absorption.
The
ruby-LASER with its wavelength of 894 nm is the LASER of choice to remove the
colors above mentioned.
The
VERSAPULS-Aesthetic LASER with its different wavelengths,
which is between 532 nm and 1084 nm suits to all used colors.
How
does the QS-Laser tattoo removal work? The main effect is a photo-acoustical
one, which leads to destruction of the tissue capsule around the chromophors.
Additionally, absorption of energy cracks the chromophors and phagocytation via
lymphatic tissue is now possible.
The
QS-Lasers with its short pulse rates allow the usage of the photo-acoustical
effect to remove tattoo. Apart from this there is no thermal lesion of the tissue because of the short energy exposure.
Since
1994 we remove tattoo by using LASER. The number of patients treated in our
institute is growing rapidly because more and more young people are tattooed and
as time goes by more and more established people want to get rid of them.
Traumatic dirt tattoos are relatively seldom.
The
next slices show our concept. EMLA-Ointment or local application of ice leads to
a
sufficient
anesthesia if needed. In most cases it is not necessary to give local anesthesia.
The
application of the LASER-spot should be overlapping. Normally the area treated
needs
4-6
visits. The time between two visits should be 6-8 weeks.
The
applied energies, spot-size and pulse-rates are shown on this chart.
Immediately
after treatment the skin should dry up. Eventually it is necessary to use an
antibiotic ointment. Consequent sun protection for the next 6-8 weeks is
very important.
Side
effect of treatment could be hypo - or hyper-pigmentation, micro-scars,
temporary loss of hair and non-response. It is essential to inform the patient
before the procedure and to have informed consent. Seldom allergic reactions to
the absorbed chromophors can occur. For this reason it is necessary to make a
test before starting tattoo removal.
To
come to an end to remove tattoos by laser is nowadays state of the art.
Artificial
pigmentation, which does not react to
LASER treatment can only be removed by
other
means which lead to scars.