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PubMed1992

[Forum: dermopigmentation or medical tattooing. In practice ... how to perform medical tattooing?].

Dermopigmentation is now part of the therapeutic armamentarium of plastic surgeons. In good indications and when applied according to a few simple rules, every surgeon can obtained reliable and reproducible results with medical dermography. This therapeutic procedure is performed on an outpatient basis, usually in several sessions; subsequent revisions are always possible provided certain basic errors are avoided. The authors describe each step of this technique.

Alopecia↗
PubMed1996

Skin reflectance-guided laser selections for treatment of decorative tattoos.

BACKGROUND AND DESIGN: A fundamental idea of laser treatment of tattoos is that the wavelength must be well absorbed by the tattoo color. In this study, absorption by different tattoo colors was therefore measured in vivo by skin reflectance to establish optimal laser wavelengths for different tattoo colors. Spectral reflectance by tattooed skin and by normal, uninvolved skin was measured in 10-nm steps in a wavelength range from 300 to 800 nm on eight human volunteers with a total of 13 tattoos, which consisted of 14 different tattoo colors. Wavelength ranges for maximal absorption were established. RESULTS: We found that tattoos absorbed maximally in the following ranges: red tattoos, from 505 to 560 nm (green spectrum); green tattoos, from 630 to 730 nm (red spectrum); and a blue-green tattoo, in two ranges from 400 to 450 nm and from 505 to 560 nm (blue-purple and green spectrums, respectively). Yellow tattoos absorbed maximally from 450 to 510 nm (blue-green spectrum), purple tattoos-absorbed maximally from 550 to 640 nm (green-yellow-orange-red spectrum), blue tattoos absorbed maximally from 620 to 730 nm (red spectrum), and orange tattoos absorbed maximally from 500 to 525 nm (green spectrum). Black and gray absorbed broadly in the visible spectrum, but these colors were most effective from 600 to 800 nm. Optimal and suboptimal laser wavelengths are proposed. CONCLUSIONS: We recommend that wavelength ranges should be established for maximal tattoo absorption before laser treatment of decorative tattoos to select the most optimal laser wavelength present.

Adult↗
PubMedDate not supplied

Adolescent pregnancy, tattooing, and risk taking.

PURPOSE: To determine pregnant adolescents' interest in tattooing and identify additional risk-taking behaviors practiced by tattooed pregnant adolescents. DESIGN: A descriptive study with a convenience sample of 41 pregnant adolescents was conducted. The majority of participants were 16 to 17 years of age, 7 to 9 months gestation, single, in the 10th to 11th grades, and primarily White. A subgroup of five participants were tattooed. Participants completed the 71-item Armstrong Tattoo (AT) questionnaire. Descriptive statistics were used to describe the sample and evaluate responses. RESULTS: The majority of adolescents expressed interest in becoming tattooed; 48% expressed fear (disease, pain) as a deterrent to becoming tattooed. All tattooed participants had received tattoos prior to pregnancy. Decisions to become tattooed were made rapidly at 14 to 16 years of age, and all tattooed participants were impregnated by tattooed males. Most tattooed participants perceived themselves as risk takers, and all denied additional health problems (infection, blood-borne disease) related to the tattooing process. CLINICAL IMPLICATIONS: Proactive, preventive health education regarding maternal/fetal risks related to amateur and professional tattooing during pregnancy is needed. Pregnant adolescents aged 14 to 16 years who are dating a tattooed male may be at greater risk for impulsively deciding to become tattooed.

Adolescent↗
PubMed2000

Tattoos: their relationship to trauma, psychopathology, and other myths.

OBJECTIVE: The purpose of this study was to examine the relationship between tattoos and reason for presentation to a community hospital emergency department (ED): injury, illness, or a psychiatric/chemical dependency problem. In addition, to assess contemporary beliefs about tattoos, ED staff and patients were surveyed about their attitudes toward and personal experience with tattoos. Demographic characteristics of participants also were evaluated relative to tattoos. METHODS: All patients seen in the ED during two 24-hour periods in winter 1999 were surveyed about tattoos in a personal interview. Hospital staff who regularly interact with ED patients were asked the same questions. Data were collected on 294 patients and 289 staff members. Diagnoses were recorded for all patients, then coded as an injury, illness, or psychiatric/chemical dependency complaint. RESULTS: In the 16-35 years age group, 35% of patients and 19% of staff had tattoos. In the 36-50 years age group, 28% of patients and 11% of staff had tattoos, and the 51-65 group had similar percentages: 6% of patients and 5% of staff had tattoos. Having a tattoo was not related to presenting complaint. Age was a significant predictor of attitudes regarding tattoos: Younger people had a more positive attitude. Significantly more smokers (31%) than nonsmokers (13%) had tattoos. Education was negatively related to having a tattoo. Gender was not significantly related to having a tattoo or to the number of tattoos a person had. CONCLUSION: A surprisingly large percentage of young patients presenting to the ED had tattoos. No relationship was found between having a tattoo and nature of chief complaint.

Adolescent↗
PubMed2004

Efficacy of laser treatment of tattoos using lasers emitting wavelengths of 532 nm, 755 nm and 1064 nm.

BACKGROUND: Multifunctional laser devices can be used to treat tattoos successfully. OBJECTIVES: To report the efficacy of laser treatment in professional, amateur, accidental and permanent make-up tattoos from our own experience and to compare it with the literature. METHODS: We retrospectively studied 74 consecutive patients with professional, amateur, make-up and accidental tattoos between June 1998 and November 2000. Patients were treated with a Q-switched Nd:YAG laser (wavelengths of 532 nm and 1064 nm), a Q-switched alexandrite laser (755 nm) and a variable pulse Nd:YAG laser (532 nm). RESULTS: Fourteen patients (19%) achieved a complete response (>95% lightening of treated tattoos), 23 (31%) an excellent response (76-95% lightening) and 21 (28%) a good response (51-75% lightening). Sixteen patients (22%) showed only a slight improvement (< or =50% lightening). Make-up tattoos and blue-black professional tattoos were most successfully treated. Multicoloured professional tattoos needed more treatments (mean +/- SD 5.7 +/- 5.4) in comparison with single-colour tattoos (3.5 +/- 2.0). The amateur tattoos needed fewer treatments (2.8 +/- 1.1) in comparison with professional tattoos. With accidental tattoos the results depended on the particles which had penetrated the skin. In contrast to literature reports, newer tattoos showed a trend to better treatment results than older tattoos. CONCLUSIONS: Using modern Q-switched lasers, tattoos are removed successfully with minimal risk of scarring and permanent pigmentary alterations. Even multicoloured tattoos can be treated successfully and with a low rate of side-effects.

Adolescent↗
PubMed1996

Motivation for tattoo removal.

BACKGROUND AND DESIGN: Motivational issues surrounding tattoo removal are important to understand because tattooing is flourishing, thus creating many requests for tattoo removal. A descriptive study and a 67-item survey were used to examine characteristics of tattooed patients seeking laser therapy for tattoo removal. The setting was the Laser Dermatology Center, Massachusetts General Hospital in Boston, a large metropolitan ambulatory clinic. Patients queried were 64 tattooed males and 41 tattooed females between the ages of 17 and 62 years with a wide variety of vocational and professional occupations. We assessed risk factors surrounding tattooing decisions and experiences that might later influence their motivation to have the tattoos removed by laser therapy. RESULTS: Motivation, treatment, and cost, in terms of money, pain, and risk of disfigurement all entered into the decision making to have the tattoos removed. Strong elements of purchase and possession risks were documented as well as an improved sense of self and maturity. The patient's maturation was in contrast to the notion of a waiting room filled with ill-behaved stereotypical tattooed individuals. Most participants impulsively obtained their tattoos for internal expectations of self-identity at an early age and were still internally motivated to dissociate from the past and improve self-identity. CONCLUSIONS: Poor decision making and subsequent personal regret seem to be frequent motivations for tattoo removal, thus viable methods and accessibility to tattoo removal programs are important. In addition, educational programs for adolescents about tattooing to reduce risks and promote dissuasion should be implemented.

Adolescent↗
PubMed2001

Laser removal of tattoos.

Tattoos are placed for different reasons. A technique for tattoo removal which produces selective removal of each tattoo pigment, with minimal risk of scarring, is needed. Nonspecific methods have a high incidence of scarring, textural, and pigmentary alterations compared with the use of Q-switched lasers. With new advances in Q-switched laser technology, tattoo removal can be achieved with minimal risk of scarring and permanent pigmentary alteration. There are five types of tattoos: amateur, professional, cosmetic, medicinal, and traumatic. Amateur tattoos require less treatment sessions than professional multicolored tattoos. Other factors to consider when evaluating tattoos for removal are: location, age and the skin type of the patient. Treatment should begin by obtaining a pre-operative history. Since treatment with the Q-switched lasers is painful, use of a local injection with lidocaine or topical anaesthesia cream may be used prior to laser treatment. Topical broad-spectrum antibacterial ointment is applied immediately following the procedure. Three types of lasers are currently used for tattoo removal: Q-switched ruby laser (694 nm), Q-switched Nd:YAG laser (532 nm, 1064 nm), and Q-switched alexandrite laser (755 nm). The Q-switched ruby and alexandrite lasers are useful for removing black, blue and green pigments. The Q-switched 532 nm Nd:YAG laser can be used to remove red pigments and the 1064 nm Nd:YAG laser is used for removal of black and blue pigments. The most common adverse effects following laser tattoo treatment with the Q-switched ruby laser include textural change, scarring, and pigmentary alteration. Transient hypopigmentation and textural changes have been reported in up to 50 and 12%, respectively, of patients treated with the Q-switched alexandrite laser. Hyperpigmentation and textural changes are infrequent adverse effects of the Q-switched Nd:YAG laser and the incidence of hypopigmentary changes is much lower than with the ruby laser. The development of localized and generalized allergic reactions is an unusual complication following tattoo removal with the Q-switched ruby and Nd:YAG lasers. Since many wavelengths are needed to treat multicolored tattoos, not one laser system can be used alone to remove all the available inks and combination of inks. While laser tattoo removal is not perfect, we have come a long way since the advent of Q-switched lasers. Current research is focusing on newer picosecond lasers, which may be more successful than the Q-switched lasers in the removal of the new vibrant tattoo links.

Humans↗
PubMed2002

Tattoo-associated dermatoses: a case report and review of the literature.

BACKGROUND: Tattoos are increasingly popular in today's society, especially with the advent of laser tattoo removal. As a result, observed reactions within tattoos are likely to become more abundant. Three main classes of tattoo-associated dermopathies can be distinguished in the English literature: allergic/granulomatous/lichenoid, inoculation/infection, and coincidental lesions. Injury to the dermis, such as during placement of a tattoo, can also flare a Koebner response in patients with active susceptible disease. OBJECTIVE: This case report and review of the English literature provides a quick reference to tattoo reactions, techniques available for removal of tattoos, and disorders other than tattoos known to exhibit the Koebner response. METHODS: The English literature was reviewed via MEDLINE citations from 1966 to December 2001 to delineate articles involving tattoo reactions and Koebner reactions significant to dermatology. CONCLUSION: Numerous conditions have been documented in association with tattoos and the process of tattoo application. Awareness and identification of dermatoses associated with tattoos, tattoo removal options, and conditions associated with the Koebner response are important to both the dermatologist and dermatologic surgeon.

Adult↗