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Traumatic Tattoos Treated by Q-switched Ruby Laser

Traumatic tattoos occur when pigmented material is implanted into the skin. There are two types of traumatic tattoos: explosive tattoos, which occur when gunpowder granules are impregnated into the skin, and abrasive tattoos, which most often occur from falls on blacktop surfaces in vehicle accidents. Conventional treatments include dermabrasion and carbon dioxide laser, which require removal of the overlying skin and healing by secondary intention. These treatments often lead to scarring and incomplete removal of the tattoo. Recently, the Q-switched ruby laser (694 nm, 15-25 nsec pulse duration) has been used to treat traumatic tatoos.

This study evaluated 12 subjects who were treated with the Q-switched ruby laser at dosages between 6 and 8 J/cm2. Laser treatment created tiny superficial crusts which required 5 to 7 days for complete healing, at which time the foreign pigment returned. Subjects were retreated at 2 month intervals. Eight of the 10 patients with abrasive tattoos had complete clearing after an average of two treatments; the other two patients did not complete the treatments. The two patients with explosive tattoos required two to four treatments for complete clearing. No scarring, atrophy, textural changes or lasting hypopigmentation were reported in any patients.

Comment: This study shows that the Q-switched ruby laser is effective for treating traumatic tattoos. Other short-pulsed lasers also have recently been developed for removal of unwanted cutaneous pigment. The Q-switched ruby, Nd-YAG, alexandrite, and pulsed-dye (510 nm) lasers each produce light at wavelengths well absorbed by melanin and tattoo pigments. They emit light at pulse durations short enough to thermally damage targets less than 1 µm in diameter without damaging surrounding tissue. Each of these lasers is likely to be effective in treating traumatic tattoos; the laser of choice will not be known until a comparative study is performed.

— RL Moy, JS Dover

Published in Journal Watch Dermatology April 1, 1994

Citation(s):

Achauer BM et al. Treatment of traumatic tattoos by Q-switched ruby laser. Plast Reconstr Surg 1993 318 1994-1994.

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