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Tattoo ink darkening of a yellow tattoo after Q-switched laser treatment.

The popularity of tattoos is burgeoning with 20-30 million tattooed individuals in the Western World. Requests for removal can be expected to rise concurrently with increased applications. Laser removal of tattoos is potentially a more cosmetically acceptable method of removing tattoos than surgical excision or dermabrasion. Nevertheless, complications and side-effects can result from laser treatment and include scarring, hypopigmentation, hyperpigmentation, partial removal, infection, bleeding and tattoo ink darkening. The latter has been reported for flesh-toned and red tattoos. Such a complication has never been reported for the laser treatment of a yellow tattoo in the dermatological literature. We describe a case of tattoo ink darkening of a yellow tattoo after treatment with the 532 nm quality-switched Neodymium : Ytrrium-Aluminium Garnet laser to highlight clinicopathological features. The mechanism by which some tattoos darken after laser treatment is not clearly understood. We review darkening of tattoos after laser treatment to raise awareness of this important complication. This paper will help to facilitate discussions with the patient and in obtaining informed consent prior to commencing treatment. Tattoo ink darkening of a yellow tattoo adds to the growing list of complications resulting from attempts at tattoo removal.

Color↗

Tattooing and risk for transfusion-transmitted diseases: the role of the type, number and design of the tattoos, and the conditions in which they were performed.

Tattoos have been shown to be associated with transfusion-transmitted diseases (TTDs), particularly hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. Very little is known about the association between different categories of tattoos and TTDs. In a cross-sectional study in Brazil, we studied 182 individuals with tattoos and assessed the odds of testing positive for a TTD according to tattoo type, number, design and performance conditions. Major findings were significant associations between an increasing number of tattoos and HBV infection (odds ratio (OR) of 2.04 for two tattoos and 3.48 for > or = 3 tattoos), having a non-professional tattoo and testing positive for at least one TTD (OR = 3.25), and having > or = 3 tattoos and testing positive for at least one TTD (OR = 2.98). We suggest that non-professional tattoos and number of tattoos should be assessed as potential deferral criteria in screening blood donors.

Adolescent↗

Tattoos and tattooing. Part I: History and methodology.

Most medical examiners and pathologists who routinely perform autopsies identify tattoos on a daily basis. However, these dermagraphics generally are given only cursory inspection and description, if at all, although many pathologists photograph particularly unique, unusual, or bizarre examples. From a medicolegal perspective, these permanent skin designs are most often used as identification markers, especially in cases of unknown or questionable identity. The majority of pathologists and other physicians are not familiar with the way in which tattoos are applied, much less the history of this unusual art or the various aspects of tattoos that may provide even more complete information as to how, where, why, and when the tattoos were done. This article, the first of three parts, provides a brief but comprehensive history of tattooing from both the worldwide and Western perspectives, describes how professional tattooing is done, and illustrates the machines involved and the various constituents of the inks that are currently used. The second and third articles will explore the gross and histopathology of tattoos, methods of tattoo removal, medical applications and complications associated with tattoos, psychology and psychopathology of tattoos, and the importance of tattoos in forensic medicine.

Europe↗

The Q-switched neodymium:YAG laser and tattoos: a microscopic analysis of laser-tattoo interactions.

The Nd:YAG laser effectively removes or lightens amateur and professional tattoos. The biomechanics of the removal of tattoo particles at the cellular level are incompletely understood. We examined biopsies obtained from 35 amateur and professional tattoos (including coloured tattoos), treated on three or more occasions with the Nd:YAG laser. Biopsies taken immediately after laser treatment showed vacuolation with complete clearance of tattoo particles in the most superficial layers of the dermis, as assessed by light and electron microscopy. We propose that the 'disappearance' of the tattoo particle arises from the formation of atomic species and gaseous products, which are rapidly dissolved in the extracellular fluid. Residual fragmented particles that are commonly found in the mid- and lower dermis are rephagocytosed. The interaction between the Nd:YAG laser and black tattoo particles at 1064 nm, and red tattoo particles at 532 nm, appears to be specific, as there was little evidence of thermal damage to adjacent cells or stromal collagen.

Humans↗

Tattoos and tattooing. Part II: Gross pathology, histopathology, medical complications, and applications.

Tattooing involves piercing the skin with needles bearing various pigments, to cause the permanent imprint of a design. The body responds to these incursions in specific and predictable ways, with initial sloughing of the overlying epidermis, variable dermal inflammation, and gradual assimilation of the pigment into macrophages. Eventually, much of the pigment is carried to the regional draining lymph nodes, with a residue staying within macrophages localized to dermal perivascular regions. The age of tattoos may be estimated, both grossly and microscopically. Tattooing can result in a variety of relatively uncommon complications and adverse reactions to the pigment, and certain infectious diseases may be inadvertently transmitted through tattooing when the instruments are inadequately sterilized, or when poor technique is used. This article, the second of three, describes the gross and microscopic pathology of both fresh and healed tattoos, and discusses the various complications (infectious and otherwise) that can occur. Tattooing has specific applications in both dermatology and plastic and reconstructive surgery, and these are also discussed.

Humans↗

[Significance of a single tattoo in dyssocial probands. Statistical comparison of socially maladjustment, male delinquents with and without tattoos].

Although tattooing is not confined to the circle of sociopaths and delinquents, it is widely known, that criminal offenders always had heightened tendencies towards this kind of body ornamentation. The author makes an attempt to clarify the significance of a single tattoo in a sample of male delinquents by comparing the tattooed and the non-tattooed individuals. In spite of the popular prejudice, the results of this trial show, that delinquents with one tattoo stem from comparatively more favourable familiar backgrounds, are less loaded with mental disorders and delinquency among blood relatives, show better scholastic and professional accomplishments. However, tendencies toward addictive and delinquent behavior were comparable in the two groups.

Adult↗

[Forum: dermopigmentation or medical tattooing. History of tattooing].

Tattooing has been performed all over the world since prehistoric times, as indicated by numerous ancient relics. The significance of tattoos has differed at times and in different civilisations (means of communication, social identification mark, religious origin). Today, it is performed by real artists who have inspired its medical applications. Medical dermopigmentation was initially used in the context of breast reconstruction (nipple areola complex) and, with subsequent refinements, its indications have been extended to the treatment of residual scars and to the permanent make-up.

Esthetics↗

[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↗