Clinical use of the Q-switched ruby and the Q-switched Nd:YAG (1064 nm and 532 nm) lasers for treatment of tattoos.

BACKGROUND: The desire to remove tattoos has probably been around as long as their existence. Recent technological advances in lasers have finally made it possible to remove tattoos without leaving an equally undesirable scar.

OBJECTIVE: The purpose of this article is to review the use of the Q-switched ruby (694 nm) and the Q-switched Nd:YAG (532 and 1064 nm) lasers for effective removal of tattoo ink, with cosmetically appealing results.

RESULTS: The Q-switched ruby laser (694 nm) effectively removes blue-black and green ink, may treat other colors less efficiently, and is frequently associated with transient pigmentary changes, including rare depigmentation. The Q-switched Nd:YAG laser at 1064 nm quickly removes black ink, as well as other colors less efficiently; pigmentary changes are much less frequent, correlating with its lower absorption by melanin. The 532-nm wavelength treats red ink effectively, but also leads to temporary hypopigmentation. Transient textural changes may be noted at all three wavelengths discussed, but scarring is rare.

CONCLUSIONS: Q-switched lasers can remove tattoos without residual scarring. Efficacy of ink removal is dependent on the wavelength used for the targeted pigment.