Cosmetic Eyebrow Tattoo Removal Using a Q-Switched Ruby Laser: A Case Report

Tattoos are created by the deposition of exogenous pigment into the dermis and were historically considered permanent; however, advances in laser technology have made their removal increasingly feasible. Q-switched (QS) laser systems remain the standard of care for tattoo removal, operating through selective photothermolysis. Despite their effectiveness, laser tattoo removal may be associated with transient or persistent adverse effects. Here, we report the case of a 38-year-old woman who presented with a bilateral cosmetic eyebrow tattoo exhibiting blue-green discoloration and an unnatural appearance, refractory to seven prior laser treatments performed elsewhere. The patient was treated with five sessions of a QS 694 nm ruby laser between March and August 2024, resulting in progressive pigment lightening. Transient erythema and edema were observed, as well as a reduction in eyebrow hair density, which was managed with adjunctive topical therapy containing 5% minoxidil, tretinoin, phytantriol, and vitamin E. This case highlights the effectiveness of the QS ruby laser for eyebrow tattoo removal and emphasizes eyebrow hair density reduction as a potential adverse effect that should be addressed during patient counseling and informed consent.