Avanti X-23 Laser Tattoo Removal
Tattoo removal has been performed with various tools during the history of tattooing. While tattoos were once considered permanent, it is now possible to remove them with treatments, fully or partially.
Before the development of laser tattoo removal methods, commons techniques included dermabrasion, TCA (Trichloroacetic acid, an acid that removes the top layers of skin, reaching as deep as the layer in which the tattoo ink resides), salabrasion (scrubbing the skin with salt), cryosurgery and excision which is sometimes still used along with skin grafts for larger tattoos. Some early forms of tattoo removal included the injection or application of wine, lime, garlic or pigeon excrement. Tattoo removal by laser was performed withcontinuous-wave lasers initially, and later with Q-switched lasers, which became commercially available in the early 1990s. Today, "laser tattoo removal" usually refers to the non-invasive removal of tattoo pigments using Q-switched lasers. Typically, black and darker-colored inks can be removed more completely.
Tattoo removal is most commonly performed using lasers that break down the ink particles in the tattoo. The broken-down ink is then absorbed by the body, mimicking the natural fading that time or sun exposure would create. All tattoo pigments have specific light absorption spectra. A tattoo laser must be capable of emitting adequate energy within the given absorption spectrum of the pigment to provide an effective treatment. Certain tattoo pigments, such as yellows, greens and fluorescent inks are more challenging to treat than darker blacks and blues, because they have absorption spectra that fall outside or on the edge of the emission spectra available in the tattoo removal laser. Recent pastel coloured inks contain high concentrations of titanium dioxide which is highly reflective. Consequently, such inks are difficult to remove since they reflect a significant amount of the incident light energy out of the skin.
Widely considered the gold standard treatment modality to remove a tattoo, laser tattoo removal requires repeat visits. The newer Q-switched lasers are said by the National Institutes of Health to result in scarring only rarely and are usually used only after a topical anesthetic has been applied. Areas with thin skin will be more likely to scar than thicker-skinned areas. There are several types of Q-switched lasers, and each is effective at removing a different range of the color spectrum. Lasers developed after 2006 provide multiple wavelengths and can successfully treat a much broader range of tattoo pigments than previous individual Q-switched lasers. Unfortunately the dye systems used to change the wavelength result in significant power reduction such that the use of multiple separate specific wavelength lasers remains the gold standard.
The energy density (fluence), expressed as joules/cm2, is determined prior to each treatment as well as the spot size and repetition rate (hertz). To mitigate pain the preferred method is simply to cool the area during treatment with a medical-grade chiller/cooler and to use a topical anesthetic. During the treatment process the laser beam passes harmlessly through the skin, targeting only the ink resting in a liquid state within. While it is possible to see immediate results, in most cases the fading occurs gradually over the 7–8 week healing period between treatments.