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PubMed1982

[Possibilities for tattoo removal. Report of experiences].

Different motivations are seen in patients with tattoos, which can be seen in a tattooed picture. Two kinds of tattoos can be distinguished: Professional and self-made tattoos. In general, patients with self-made tattoos call for their removal, because the private situation has changed. These tattoos are more difficult in treatment than professional ones, because the colour is located in the whole dermis. The method of treatment depends on size, form and shape of the tattoo. For treatment simple excision of small tattoos, dermabrasion in one or two sessions are recommended. Own experiences and results in 121 patients with tattoos are reported and discussed.

Dermabrasion↗
PubMed1995

Children's and adolescents' awareness of the physical and mental health risks associated with tattooing: a focus group study.

This article explores children's and adolescents' awareness of the physical and mental health risks associated with the increasing practice of tattooing. Twelve focus group discussions on attitudes toward tattoos and beliefs about normative behavior, health beliefs, awareness of the long-term consequences of tattooing, and stigmatization were conducted with 80 volunteers, six to 17 years of age. The videotaped discussions revealed that participants' were knowledgeable about tattoos and the process, and were aware that viral transmission and physical disfigurement were possible results. Generally, attitudes toward tattoos were negative, with almost all participants associating them with illicit type activities. However, a more favorable attitude toward small tattoos was discernible among females during early adolescence. Participants suggested that because of the location of tattoos, they might be embarrassing in some instances, and that because of their permanency, young people might regret having them later in life. Some participants revealed they had removed tattoos using crude implements. These data suggest an urgent need for research on prevention of unsafe use of tattooing and piercing implements.

Adolescent↗
PubMed1996

Evaluation of the Nd/YAG laser for treatment of amateur and professional tattoos.

Two hundred and twenty-one amateur tattoos and 27 professional tattoos were treated with a Nd/YAG laser (lambda 1064 nm and 532 nm). The response was expressed as the percentage area cleared of tattoo. Seventy-nine per cent of amateur black tattoos were > or = 75% clear after one to five treatments (mean 2) at 1064 nm. The response of professional tattoos was slower and less complete. Seventy-four per cent of black professional tattoos were > or = 75% clear after one to 11 treatments (mean 6.3) at 1064 nm. Red tattoos responded well to 532 nm and were > or = 75% clear after one to five treatments. Yellow, orange, blue and green tattoos were resistant to treatment. Side-effects included minor scarring in 1.2% of tattoos and transient pigmentary changes in 77% of patients.

Adolescent↗
PubMed1993

Cosmetic tattoo ink darkening. A complication of Q-switched and pulsed-laser treatment.

BACKGROUND: High-energy, short-pulse lasers, eg, Q-switched lasers, emitting visible and near-infrared light have recently been developed for removing tattoos, with little risk of scarring. The mechanisms of action, and possible adverse effects other than scarring and hypopigmentation, are not fully understood. OBSERVATIONS: We describe five cases of pulsed-laser-induced, immediate, irreversible darkening of cosmetic, white, flesh (skin-color), and pink-red colored tattoos. Irreversible ink darkening can be an insidious complication, because immediate whitening of the skin temporarily obscures the subsequently impressive color change. Among these cases, irreversible ink darkening occurred with Q-switched ruby (694 nm), Q-switched neodymium (Nd):YAG (1064 nm/532 nm), and pulsed green dye (510 nm) lasers. Attempts to remove the darkened ink with further laser treatment failed in two cases, and surgical excision was necessary. In the other three cases, subsequent laser treatments successfully removed the darkened ink. The red cosmetic tattoo ink used in one of the cases was placed in agar in vitro and was converted to a black compound immediately on Q-switched ruby laser exposure. Ferric oxide, a brown-red ingredient commonly used in cosmetic tattoos, was similarly tested and blackened in vitro by Q-switched ruby laser exposures. CONCLUSIONS: Although most tattoos are not darkened by laser treatment, short-pulsed lasers over a wide spectrum can cause immediate darkening of some tattoo inks. Patients should be warned of the potential for irreversible cosmetic tattoo darkening, and test-site exposures should be performed prior to treatment. In some cases, subsequent laser treatments may remove the blackened ink. The mechanism probably involves, at least for some tattoos, reduction of ferric oxide (Fe2O3, "rust") to ferrous oxide (FeO, jet black), but the chemical reaction that is involved remains unknown.

Adult↗
PubMed1999

Use of Q-switched alexandrite laser (755 nm, 100 nsec) for removal of traumatic tattoo of different origins.

BACKGROUND AND OBJECTIVES: Q-switched laser systems have been used for removal of tattoo-related carbon, graphite, and other particles. We assessed elimination of traumatic tattoos of different origin with Q-switched alexandrite laser in nine patients. STUDY DESIGN/MATERIALS AND METHODS: Fluence threshold was determined and a spot test was made. Q-switched alexandrite laser, with a fluence range 4.5-8.0 J/cm(2) (mean, 7.16 +/- 1.18), was used at 4-5-week intervals. Total treatment ranged from 3-12 sessions (mean, 6.1 +/- 3.6 sessions). Double-pulse technique was used in black/black-bluish areas, but single-shot was applied to slate-gray pigment. RESULTS: More than 95% lightening was achieved in five patients after 5.2 +/- 2.3 sessions, and >75% lightening in six subjects after 6.1 +/- 3.1 sessions of treatment. Blacktop, surgical pen, and gravel tattoos presented a better response than gunpowder/fireworks tattoos (>95% vs. 68.7 +/- 23.9% clearance), or tattoos of unknown origin (>95% vs. 62.5 +/- 53% clearance). Epidermal splattering and pinpoint bleeding were observed in one case. No pigmentary alteration or scarring was seen. CONCLUSION: The Q-switched alexandrite laser is a useful system for removal of traumatic tattoos of diverse origin. The best response (>95% clearance) was achieved in blacktop, surgical pen, and gravel tattoos, although an acceptable degree of lightening may be obtained in tattoos due to gunpowder or fireworks.

Adolescent↗
PubMed2000

Q-switch laser and tattoo pigments: first results of the chemical and photophysical analysis of 41 compounds.

BACKGROUND AND OBJECTIVE: In the Western world, there are at least 20-30 million people with tattoos. Improved self-image and social stigmatization are the main reasons for removing tattoos from skin. Q-switched lasers are applied to destroy the tattoo compounds in the skin. The treatment of tattoos containing ink often gives excellent results, whereas the results of treatments for coloured tattoos are not predictable and usually are worse. The chemical structure and the absorption spectra of the tattoo pigments are usually unknown. However, the efficacy of the treatment by using light of different Q-switched lasers (wavelengths 510, 532, 694, 755, 1064 nm) is correlated to both the chemical structure of the tattooed compounds yielding specific absorption spectra and the laser wavelength used. STUDY DESIGN/MATERIALS AND METHODS: A structural and spectroscopic analysis of 41 coloured pigments was performed. RESULTS: The 41 substances were identified, and they consist of 16 individual chemicals of different structured well-known industrial organic pigments. The absorption spectra of the 16 pigments were measured quantitatively. CONCLUSION: The results of the present analysis explain to some extent the outcome of clinical studies regarding laser therapy of coloured tattoos. Because the laser energy used produces a high temperature in the azo or polycyclic pigments, it is necessary to investigate whether that change causes possibly toxic or cancerogenic compounds.

Coloring Agents↗
PubMed2002

Magnetite tattoos.

BACKGROUND AND OBJECTIVES: Tattoo removal is a significant problem. The extraction of magnetite (Fe(3)O(4)) ink tattoos by a magnetic field was investigated, with and without Q-switched laser treatment. STUDY DESIGN/MATERIALS AND METHODS: Magnetite particles (1.4 microm) were used to make mature, black skin tattoos on hairless albino rats. A Q-switched ruby laser (QSRL) 3.5 J/cm(2), 6.5-mm spot size, 40-nanosecond pulse width was used for treatment. Permanent magnets (1.4 T, 6-mm diameter) were tested to extract the magnetite particles, alone and after QSRL. Lightening of treated tattoos was measured from digital photographs, and the amount and distribution of magnetite in skin biopsies was scored blindly. RESULTS: External application of magnets on mature magnetite tattoos without prior QSRL treatment, did not significantly extract, lighten, darken, or change their histologic appearance. A magnetic field applied immediately after QSRL treatment extracted some ink when epidermal injury was present, and caused significant redistribution of magnetite into the upper dermis with vertical banding along magnetic field lines. When applied for 3 weeks following QSRL, magnets caused darkening of tattoos. CONCLUSIONS: Magnetite skin tattoos can be manipulated by external magnets, especially after Q-switched laser treatment. Magnetically-extractable tattoos may be feasible.

Albinism↗
PubMed2002

In vivo study of intradermal focusing for tattoo removal.

Delivery of intradermally focused nanosecond laser pulses with small energy as an alternate technique applicable to clinical procedures in dermatological and plastic surgery is an area of relatively new interest with multiple potential applications. We assessed this approach on common tattoo pigments in dermis in an in vivo study using a wavelength of 1064 nm. Paired micropigs were tattooed with standard blue, black, green and red pigments. The tattoos were allowed to mature and then treated by 12 ns pulses in a focused beam of 11.4 degrees cone angle. Visual observation and histological analysis of biopsies were performed to evaluate results. Significant reduction in pulse energy and collateral damage was achieved with pulse energy ranging between 38 to 63 mJ. Blue and black tattoos were found to respond well from a clinical standpoint. The depth dependence of tissue response and pigment redistributions at 1 hour, 1 week and 1 month after laser treatment was quantitatively analysed through biopsies and a strong relationship was demonstrated between tattoo response and laser-induced dermal vacuolation. The optical absorption coefficients of the four tattoo pigments were measured to be approximately the same and the laser-induced plasma is suggested to be responsible for the pigment redistribution. As we hypothesised, intradermal focusing of nanosecond pulses significantly reduced required pulse energy for tattoo ablation to about 60 mJ or less. These results stimulate a number of additional questions relevant not only to clinical applications but also to the understanding of the fundamental process of laser-pigment interaction in the dermis as it relates to tattoo removal.

Animals↗
PubMed1993

Use of the alexandrite laser (755 nm, 100 nsec) for tattoo pigment removal in an animal model.

BACKGROUND: All previous treatment modalities for the removal of tattoos, with the possible exception of the Q-switched ruby and YAG lasers, result in scarring. OBJECTIVE: The purpose of this study was to investigate the use of a new laser that may remove tattoo pigment without leaving a scar. METHODS: A Yucatan micropig was tattooed by a professional tattoo artist with black, blue, green, and red pigments. These tattoos were then treated with single overlapping pulses with the alexandrite laser (wavelength 755 nm, pulse 100 nsec) and evaluated clinically and histologically. Comparison treatment with an argon laser (wavelength 488 nm, 514 nm, continuous-wave) and flashlamp-pumped dye laser (wavelength 585 nm, pulse 450 microseconds) was performed as well for removal of red tattoo pigment. RESULTS: The alexandrite laser was found to be very effective in removal of professional and amateur black tattoo pigment, moderately effective in removal of blue and green pigment, and minimally effective in removal of red pigment. No scarring was seen clinically or histologically. CONCLUSION: The alexandrite laser shows promise as a treatment modality for tattoo removal without scarring.

Aluminum Oxide↗
PubMed2001

Tattooing and body piercing among adolescent detainees: relationship to alcohol and other drug use.

PURPOSE: The purpose of this preliminary study was to document self-reported tattooing and body piercing behavior among a sample of 860 adolescent detainees. Additionally, the study examined the relationship of alcohol and drug use to tattooing and body piercing--an often overlooked HIV risk behavior. METHODS: Adolescents (N = 860) participating in a substance use and HIV risk reduction intervention were surveyed upon entrance to a Youth Development Campus (YDC). RESULTS: Twenty-nine percent of the sample (N = 245) had at least one tattoo, and more than half (69%) had at least one body piercing. Fifteen percent had two or more tattoos, while 28% had three or more piercings. Although a small percentage of the youth reported knowingly sharing needles for tattoos or piercings (2% and 1.5%, respectively), 21% had tattoos that had been administered unprofessionally and 20% had unprofessionally administered piercings. Marijuana and alcohol were the highest reported substances used in this sample, 62% and 54%, respectively. Alcohol, marijuana, antidepressants, and sedatives were significant correlates of having tattoos. Alcohol was found to be a marginally significant (P = .052) correlate of body piercing. CONCLUSION: The popularity of tattooing and piercing and the risk involved with these activities make them an HIV risk behavior worthy of address. Risk reduction messages to youth should consistently address these behaviors and focus on them as they relate to substance use.

Adolescent↗
PubMed2001

Allergic contact dermatitis to temporary tattoos with positive para-phenylenediamine reactions: report of four cases.

BACKGROUND: In recent years, temporary tattoos instead of permanent tattoos have become popular worldwide. Although contact allergy to temporary henna tattoos appears to be rare in the past, it is progressively more commonly reported. PATIENTS: Four Taiwanese patients of allergic contact dermatitis following application of temporary tattoos were patch tested and they were followed up for 1 year after treatment. RESULTS: All four of the tested patients were positive to paraphenylenediamine. At 1-year follow-up, all four patients still showed various degrees of remnant hyperpigmentation on their previous tattooed areas. CONCLUSION: Temporary tattoos may pose similar risks of allergic reactions associated with permanent tattoos. A high risk of prolonged post-inflammatory hyperpigmentation after allergic contact dermatitis from temporary tattoos should also be alerted, especially in Asian skin type.

Adult↗
PubMed2000

[Tattooing and body piercing--experiences from public health infection surveillance by a public health office].

UNLABELLED: Tattooing and piercing have become increasingly popular in recent years. Both methods involve several medical risks, including transmission of infectious diseases. There are many reports on wound infections as well as transmission of hepatitis and human immunodeficiency viruses etc. According to these facts special hygiene regulations for tattooing and piercing have been published in Germany. Based on these regulations the public health department of the city of Frankfurt am Main, Germany, carried out special hygiene controls in such studios, one a year. Special tattoo or piercing exhibitions were also controlled. Results are reported here. MATERIAL AND METHOD: Studios for tattoos or piercing were informed about hygiene rules and annually controlled from 1995-1999, using a special check list on cleanliness in the studios, disinfection and sterilisation procedures etc. For permission of tattoo and piercing exhibitions special hygiene orders were made mandatory. RESULTS: During 1995-1997 the absolute number of complaints decreased from 20 to 9, in spite of the increasing number of tattoo studios in Frankfurt am Main (from 6 to 10). This was true also of the tattoo and piercing exhibitions. After 1 year without control visits however, an increase of complaints was to be seen in 1999. DISCUSSION: According to our experience tattooists and piercers are interested in good hygiene practice. But our data showing the worsening hygiene data in one year without control visits also demonstrate the necessity of regular controls by the authorities. According to the reports on infectious complications of tattooing and piercing and according to the data reported here hygienic advice and control is an important task of Public Health services.

Communicable Disease Control↗
PubMedDate not supplied

Tattoos: counseling the adolescent.

In Western society, approximately 3% to 5% of the population has at least one decorative tattoo, and the number of new tattoos has increased dramatically over the last decade. Tattooing is becoming increasingly popular among adolescents. Pediatric nurse practitioners (PNPs) are in key positions to counsel preadolescents and adolescents about tattoos. PNPs should be knowledgeable about the care, potential adverse reactions, risks of blood-borne diseases, and removal of tattoos. PNPs should also have an understanding of who gets tattoos, why they get tattoos, and what type of regulations exist related to tattooing in the United States.

Adolescent↗
PubMed1985

Histologic comparison of argon and tunable dye lasers in the treatment of tattoos.

Cosmetic benefit from laser therapy of tattoos may simply be the result of thermal injury and host reparative response which remove pigment by a "slough and bury" mechanism. Tattoo pigment of 4 colors (black, white, red, and blue) was introduced into the skin of guinea pigs and studied histologically at 48 h, 7 days, 4 and 6 weeks, and 3 months. Tattoos of each color were treated with argon laser (488 and 514 nm) and tunable dye laser at 3 different wavelengths (505, 577, and 690 nm). Treated tattoos were biopsied immediately and at 48 h, 7 days, and 3 months. Selective laser absorption by the tattoo pigment was suggested by pigment-related differences in threshold doses for histologic damage. Clinical clearing of tattoo pigment correlated well with the extent of immediate epidermal and dermal necrosis and was as well associated histologically with the deposition of parallel bands of collagen fibers (i.e., scar) between the residual pigment and the overlying epidermis. "Lightening" of tattoos probably depends more on widespread necrosis, subsequent tissue sloughing, and resultant dermal fibrosis than on specific changes in tattoo pigment chemistry, morphology, physical properties, or handling by macrophages.

Animals↗
PubMed1991

Career-oriented women with tattoos.

Almost 50 percent of all tattoos are being done on women, many of whom are counselors, nurses, doctors, lawyers and business managers. Career-oriented women (N = 137) who had tattoos for at least six months were surveyed in a national study. Consequences associated with the unconventional, permanent product--purchase risk (pain, expense, inexperience), possession risk (self, family and general society response) and health risks--were examined. Women obtained tattoos as an expression of individuality. Almost no elements of purchase or health risks were reported, but possession risk occurred. Strong support for the tattoo was expressed by the significant person in the women's life and friends, while mild support was perceived from mothers, siblings and children. Respondents cited a lack of, or negative response from their fathers, physicians, registered nurses and the general public. Misunderstanding of what a tattoo means to the individual and stereotyping of women with tattoos continues. Understanding career-oriented women's experience of seeking tattoos may provide a new gender/cultural perspective which has implications for health care professionals. In addition, nursing may have a role to play in educating tattoo artists about health care risks.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Tattoo application is not associated with an increased risk for chronic viral hepatitis.

OBJECTIVE: Many reports cite tattoo application as an independent risk factor for viral hepatitis. The purpose of this study was to determine whether patients with tattoos are at increased risk for chronic viral hepatitis. METHODS: A total of 212 patients, aged 18-55 yr, who presented to the emergency center and outpatient clinic at a suburban tertiary care hospital participated in the study. Of these, 106 had tattoos and 106 did not. No patient had known liver disease or viral hepatitis. Hepatitis B DNA, hepatitis C RNA, and hepatitis G RNA were measured in the serum using the polymerase chain reaction on stored serum samples. Each participant completed an anonymous questionnaire concerning risk factors for viral hepatitis. RESULTS: Patients with tattoos did not have a higher rate of chronic hepatitis B, C, or G than did a gender-matched group without tattoos. One (0.9%), seven (6.6%), and three patients (2.8%) in the tattoo group were positive for hepatitis B DNA, hepatitis C RNA, and hepatitis G RNA, respectively. Among controls, no patients (0%), three (2.8%), and six (5.6%) patients were positive for hepatitis B DNA, hepatitis C RNA and hepatitis G RNA, respectively (p = 0.815). All infected patients except one in each group reported a risk factor for viral hepatitis. Individuals with tattoos were more likely to have body piercing (p = 0.049; CI = 1.000-1.995), and more than five sexual partners (p = 0.013; CI = 1.073-1.846) than the control group. CONCLUSION: We find no evidence to support the observation that tattoos serve as a risk factor for chronic viral hepatitis.

Adolescent↗
PubMed2003

Treatment of nevus using medical tattooing.

Medical tattooing is used to color skin with a pigment loss. Currently, however, a trial-and-error scheme is employed to obtain the desired color appearance of tattooed skin because prediction of the color appearance is dependent on the experiences of medical doctors. We propose a method for predicting the color appearance of tattooed skin. Two trial dyes are first injected in the area of pigment loss, and the color appearance of a third dye to be injected can be predicted using measured spectrocolorimeter data and mathematical formula. The spectrocolorimeter measures the color appearances of the skin before and after tattooing using the first two dyes, and the mathematical formula calculates the color appearance of the tattooed skin using any third dye. In the derivation of the mathematical formula, light propagation in the skin has been modeled using the modified Lambert-Beer law considering the strong scattering of light by biological tissues. The proposed method was successfully validated by a preliminary tattooing of the skin to an area with pigment loss. Predicting the color appearance of tattooed skin significantly reduces the number of trial-and-error attempts required in the current methods. Medical tattooing using this method can also be applied to treat various skin color abnormalities such as leukoderma, intradermal nevi, and reconstructed nipples.

Colorimetry↗
PubMed2002

Prevalence of body art (body piercing and tattooing) in university undergraduates and incidence of medical complications.

OBJECTIVES: To survey the prevalence of body art (body piercing and tattooing) in university undergraduate students and to determine the incidence of medical complications from these procedures. SUBJECTS AND METHODS: Between February and May 2001, students were offered the opportunity to complete an anonymous, voluntary survey at the beginning of class or organizational meetings. The survey instrument requested information concerning body piercing and tattooing (current or removed) by body site, age, sex, height, weight, body mass index, undergraduate class, athletic status, and the occurrence of medical complications. RESULTS: Four hundred fifty-four (94.4%) of 481 students completed the survey (14.7% of total campus enrollment). The prevalence of body piercing was 51%, and that of tattooing was 23%. The chi2 analysis showed female students were more likely to be pierced than males (P=.002); there was no significant difference in the prevalence of tattooing by sex. Male athletes were more likely to be tattooed than male nonathletes (P=.02). No relationships were shown between piercing/tattooing and age or measures of body somatotype. The incidence of medical complications of piercing was 17%, and these complications included bleeding, tissue trauma, and bacterial infections. Pierced navels were particularly prone to infection. There were no reported medical complications from tattooing. Eighteen percent of piercings (58/315) and 4% of tattoos (6/149) had been removed. CONCLUSIONS: Body art is prevalent among undergraduate university students, and there is a significant incidence of medical complications among students with piercing. Male athletes were significantly more likely to be tattooed than male nonathletes.

Adolescent↗