In-Service Exam
Laser - 2001





PHOTO

A 23-year-old man who has the blue-green tattoo shown in the above photograph wishes to undergo tattoo removal. Which of the following is the most appropriate management?

(A) Carbon dioxide laser ablation
(B) Serial excision
(C) Excision and full-thickness skin grafting
(D) Multiple treatments with the Q-switched Nd:YAG laser
(E) Dermabrasion

The correct response is Option D.

The Q-switched Nd:YAG and alexandrite lasers are best used for removal of blue-green tattoo pigments. In contrast, the Nd:YAG laser works best for red, brown, and orange pigments, while the Q-switched ruby laser is used to remove tattoos with violet and purple pigments. Because professional tattoos often extend deep within the dermis, multiple treatments are required.

Because it causes minimal damage to adjacent tissues, the carbon dioxide laser is effective for ablation (skin resurfacing), cutting, and coagulation. Although serial excision can be used in the treatment of traumatic tattoos, scarring is a common sequela. Dermabrasion is recommended for small traumatic tattoos.

References
1. Kilmer SL, Lee MS, Grevelink JM, et al. The Q-switched Nd:YAG laser effectively treats tattoos: a controlled, dose-response study. Arch Dermatol. 1993;129:971.
2. Kurokawa M, Isshiki N, Taira T, et al. The use of microsurgical planing to treat traumatic tattoos. Plast Reconstr Surg. 1994;94:1069.