Recurring Mistakes in Tattoo Removal

In the Western world, more than 10% of the population have at least 1 tattoo. If the tattoo is removed, the tattoo pigment particles in the skin can be selectively destroyed by means of selective photothermolysis. This treatment requires laser pulses of short durations (nanoseconds) and high intensities. We report on 12 patients who received treatments with improper treatment parameters. In all patients, we diagnosed hypo- or hyperpigmentations and scar formation at the treatment site. In particular, the pulse duration of the light sources or lasers applied were considerably longer than those required by the principles of selective photothermolysis. The light intensities of those devices are normally not sufficient to destroy the pigment particles. Instead of destruction, the pigment particles in the skin are heated up and the heat is conducted to the adjacent tissue causing unspecific tissue injury. Lasers or intense pulsed light sources with millisecond pulses and low light intensities are clearly not suitable to be applied for tattoo removal.