Traumatic tattoo: use of the variable pulsed erbium:YAG laser

The aim of this study was to evaluate the efficacy and safety of removing traumatic tattoos in the skin by laser. The objective was to achieve selective dermabrasion on the tattoo site without injuries to the surrounding skin, as in the classical mechanical dermabrasion.

Four patients with traumatic tattoos in the face were treated by a variable pulsed erbium:YAG laser. The fluence of the ablative pulses was 5 J/cm(2). The end-point for the treatment was the macroscopic removal of the foreign bodies. Postoperatively, silver sulphadiazine or polyvinylpyrrolidone was applied daily until wound closure occured. Use of a total sun block was mandatory for a period of 6 months. Pre- and post-operative photographs were taken of all cases. The results were evaluated by a panel of four independent observers, who were asked to judge the percentage of tattoo clearance as well as any evidence of pigmentation problems or scarring.

All results were rated from good to excellent. In all patients, a nearly complete clearance of the traumatic tattoo was achieved in one laser session. No scarring, skin atrophy, or hypo- or hyperpigmentation was observed. Furthermore, a high patient satisfaction rate was achieved.

The selective ablation of scar/foreign body tissue is a safe procedure. Compared to results reported with 1064-nm laser treatments, where several laser procedures are necessary, better clearance and scar quality was observed. Compared to mechanical dermabrasion, the procedure is more reliable and causes fewer side effects.