Tattoo removal by Q-switched Nd:YAG laser: an objective evaluation using histometry

Background: Tattoos have played an important role in various human cultures for thousands of years. The creation of high power, short pulse Q-switched lasers (QS) has provided a tool for considerable therapeutic advances in tattoo removal. Objective: The aim of the study is to correlate the clinical efficacy of QS Nd: YAG laser for tattoo removal with histological as well as histometric findings. Patients and Methods: QS Nd: YAG laser was used for blue tattoo removal in 12 Egyptian patients. Sessions were done every 2 months for about 6-10 sessions (average 7). Skin phototypes of patients ranged from phototype III to V. Photographs were taken before and after every treatment session. Skin biopsies were taken from the patients before treatment and after six sessions to perform histological and histometric analysis. Results: Eight patients (66.7%) showed excellent response and four patients (33.3%) good response. No textural change or scarring was observed in any patient. Histological examination confirmed the clinical response. Haematoxylin and Eosin (H&E) stained sections showed a significant decrease or almost complete disappearance of the tattoo pigment. Meanwhile, histometric study objectively confirmed a significant decrease in ink particle surface area after treatment. Conclusion: QS Nd: YAG laser effectively treats tattoos in dark-skinned Egyptian patients with excellent cosmetic outcome and minimal side effects. The histopathologic and histometric findings significantly correlated with the clinical response.