Therapeutic outcome of tattoo removal with a Q-switched Nd:YAG laser in Thai students - Comparison of two rural regions within a tattoo removal program

Abstract

Objective: To review the results of laser tattoo removal in Thai students of Saraburi province. Material and methods: This is a retrospective review study of the students participating in our tattoo removal program at Saraburi province, Thailand. The laser used was a 1064 nm Q-switched Nd:YAG laser (spot size, 3 mm; pulse duration, 6 ns, fluencies, 1.25-12 J/cm 2). A maximum of 5 laser treatments per student was performed at 2-month intervals. The data collected included age and sex of the students and information regarding the tattoos (how long the tattoo had existed, person who performed the tattoo procedure, method and price of tattooing, number of tattoo figures, complications during and after tattoo procedure including cleaning methods of tattoo needle) and the laser procedure (laser parameters, pain level during laser removal assessed by pain score sheet, treatment results, complications, side effects). Correlations were analyzed between the person who did the tattoo and complications after laser tattoo removal procedure, the age of tattoo and results of laser treatment and complications. Results: The 78 students involved were aged between 10 years 4 months and 21 years. The mean time of tattoo existence was 2.3 ± 1.4 years. The majority of the students were tattooed by amateur practitioners and by hand. The costs of tattoo procedure ranged between 0 and 1800 Thai Bahts. A clinical clearance of 76-100% was achieved in 41.6% of the treated tattoos. Observed side effects were textural changes, hyperpigmentation, hypopigmentation, and scarring which occurred in 11.4%, 8.8%, 5.1%, and 5.9% of the cases, respectively. There was no statistically significant correlation between the person who did the tattoo, or the age of tattoo to the complications or side effects after laser tattoo removal. Conclusion: In a rural area of Thailand, more male Thai students chose to have a tattoo than female students. Nearly all of the students did the tattoo themselves or had it done by friends. The students did not initially know or had not realized the possible medical complications or social consequences of having a tattoo. From our study (students in the rural area and dark skin prototype), the lower applied laser fluencies caused a lower rate of scarring. More laser sessions may be required to achieve standard clinical clearance.