#laser #tattoo removal treatment

Q-Switched Nd: YAG Laser

The Q-Switched Nd: YAG Laser is a type of laser developed to remove blue, brown, black and possibly other colours of tattoo pigments and certain brown pigment patches and birthmarks from the skin. Although laser sugery is effective in most cases, no guarantee can be made that a specific patient will benefit from the treatment.

Treatment is done in stages. Initially a test dose may be done to determine the energy settings of the laser. Once this dose is determined, the entire tattoo or pigmentation will be treated. The tattoo or pigmentation will be re-examined and re-treated if necessary in two months or longer intervals until either the entire pigment is removed. In some unpredictable cases, laser will not be efficient to remove the pigment.

The number of sessions varies depending on the lesion, size, location, colour, patient's age and duration of the tattoo. Most likely a total of 3-7 visits or more will be necessary.

Instructions for Skin Care after Q-Switched Nd: YAG Laser Treatment

1. Keep the treated area dry for 24 hours following the Q-Switched Nd: YAG Laser treatment.
2. Remove the dressing after 24 hours.
3. If it is difficult to remove the dressing, soak it in saline solution (salt water) to loosen.
4. Clean the wound and the edges with cotton balls with a cleansing solution.
5. Dry the wound carefully.
6. Apply antibiotic ointment with cotton applicators. 
7. Cover the wound with non-stick dressing (eg. Melolin). This will prevent the dressing from sticking in the wound. Hold the dressing with tape.
8. Apply antibiotic ointment to the treated area twice a day for 7 days or until the surface is totally healed.
9. Showers are allowed but do not rub the area with towels because the area is extremely delicate while any crusting is present.
10. You may experience some discomfort after the Q-Switched Nd: YAG Laser treatment. For adults take two tablets of paracetamol (eg. Panadol) every six hours when needed for pain (if you are not allergic to it).
11. If swelling occurs, an ice pack wrapped in a soft cloth can be applied.

Precautions to take following your Laser Treatment

1. Avoid direct exposure to the sun. Use a sunblock.
2. Do not rub, scratch or pick at the treated area. A protective dressing should be applied if the area is irritated by clothing or jewellery.
3. Do not apply make-up until the crusts disappear. (Usually 4 to 10 days)
4. Avoid swimming and contact sports while crusts are present.
5. If the treated area shows signs of infection (tenderness, redness, swelling or pus), notify your doctor immediately.

What are the Side Effects and Possible Complications of Laser Surgery?

• Pain: prevented with the correct use of a topical anesthetic cream before the procedure.

• Healing Wound: laser surgery may cause a superficial burn on the surface of the skin which takes several days to heal. This may result in swelling, weeping and crusting of the treated area. This usually takes 4 to 10 days to heal.

• Pigmentary Changes: in most patients the treated area loses pigmentation (hypopigmentation) and becomes lighter in colour than the surrounding skin temporarily. This type of reaction tends to gradually fade away and return to normal over a period of 2-4 weeks. With repeated treatments the pigment loss may become more persistent and take time to heal, up to 6 to 8 months. There is some risk of permanent loss of pigmentation in the area of treatment, leaving a white shape similar to the original tattoo or pigment lesion being treated, but this is rare and usually avoidable by an adequate healing care. There is also a risk of increased pigmentation (post-inflammatory hyperpigmentation) as a healing reaction. However, this type of change is very rare. In such cases, the increased pigment usually fades away over a 2-6 month period.

• Scarring: to minimize the chances of scarring, it is important that the patient follows the post-laser instructions carefully.

• Persistence of Tattoo or Pigment: some tattoo inks are located too deep in the skin to be removed completely in spite of repeated treatments and may leave vague spots of colour remaining after treatment. Green tattoos don't respond to this treatment. In all cases, it may not be possible to completely remove the tattoo entirely.