Acoustic Shock Waves Associated with Lasers to Accelerate Tattoo Removal Procedures: A Real-World Study

The combination of lasers and acoustic shock waves has shown promising results in accelerating tattoo removal.

To assess the effectiveness of treatments combining lasers and shock waves regarding the number of sessions required for successful tattoo removal.

A prospective, observational, real-world, single-center study including adults (>18 years) with ≥one professional tattoo of any color on any body part, excluding the head, partially removed or not. Devices were the QS laser RevLite® SI (Cynosure Lutronic, USA), the picosecond laser PicoWay® (Candela, USA), the CO₂ laser DUOGlide® with a SCAR 3 scanner (DEKA M.E.L.A. srl, Italy), and the GENTLE Pro® shock waves system (Zimmer MedizinSysteme GmbH, Germany). Treatment protocols consisted of QS/picosecond laser passes alternated with shock wave passes (three each) (classic protocol) and one QS/picosecond laser and one shock wave pass, a QS/picosecond second laser pass, and a final fractional CO₂ laser pass (reinforced protocol). Sessions were performed at two-month intervals.

We included 22 patients (68.2% women and 68.2% Fitzpatrick phototype III) with a mean (range) age of 42 (22-68) years and 25 tattoos in total. Most tattoos were black (92.0%) and were removed using the picosecond laser (80.0%) and following the classic (40.0%) and the reinforced (60.0%) protocols in a total of 66 treatment sessions. In 22 tattoos undergoing more than one session, results were good or excellent in 68.2% of them after 2-4 sessions, with no adverse effects.

Acoustic shock wave therapy constitutes a safe adjuvant treatment to accelerate laser-based tattoo removal.