Lasers in tattoo and pigmentation control: role of the PicoSure^® laser system

Figures & data

Table 1 Clinical studies of picosecond laser tattoo removal and novel dermatologic uses

Author(s)	Year	Design	Number and type of subject	Pigment color or target	Clinical end points and patient satisfaction	Adverse effects
Ross et al^Citation6	1998	Intratattoo comparison study	16 patients	Eleven multicolored (black, red, and green); five black only	12/16 tattoos with PS showed significantly more lightening than NS	Pinpoint bleeding, edema, hypopigmentation, scarring in NS
Herd et al^Citation7	1999	Controlled comparison study	Six albino guinea pigs	Black	Greater tattoo clearance within PS-treated areas in two of four surviving guinea pigs (three spots almost total clearance) than NS	None
Ho et al^Citation5	2002	Computer modeling	N/A	Black (graphite tattoo)	Tattoo clearance in 17 patients	N/A
Choudhary^Citation3	2010	Literature review	N/A	N/A	PS identified as the newest development	N/A
Izikson et al^Citation9	2010	Comparison study	Two adult female pigs	India ink and iron oxide	All sites greater pigment lightening with PS compared to Q-switched alexandrite (not significant)-blinded scoring	None
Brauer et al^Citation10	2012	Case series	Ten patients	Blue and green pigment	11/12 tattoos 75% clearance at 1-month follow-up; 12th tattoo required two treatments	Pain (mean pain score for treatment: −1.08 on ten-point scale)
Saedi et al^Citation11	2012	Prospective trial	15 patients	Black and blue	12/15 patients had >75% clearance in one to two treatments; three had 75% in three to four treatments; all 12 patients completed study; 100% satisfaction	Pain (mean pain score: 4.5/10), swelling, postinflammatory hypopigmentation in three of 15, postinflammatory hyperpigmentation in two of 15, blistering
Alabdulrazzaq et al^Citation13	2015	Case series	Six patients	Multicolored tattoos that contain yellow pigment	One subject complete clearance in one treatment; five subjects two to four treatments to achieve 75% clearance	Pain (mean pain score: 1.3/10), edema, erythema, pain, blisters (in three of six), transient hypopigmentation (one of six)
Ho et al^Citation4	2015	Literature review	N/A	N/A	N/A	N/A
Au et al^Citation12	2015	Randomized controlled trial	26 patients	80% blue-black tattoos	81 patients treated with picosecond plus AFR did not experience blistering vs 26 PS alone (statistically significant)	81/95 patients blistered after PS alone; six of 81 did not blister after PS plus AFR
Bernstein et al^Citation14	2015	Prospective clinical study	21 patients	Black (31), green (eight), red (six), blue (two), purple (two), yellow (two)	Overall average clearance 79% in average 6.5 treatments	Edema, erythema; rarely transient pigment alteration

Abbreviations: AFR, ablative fractional resurfacing (CO₂ laser); NS, nanosecond laser; PS, picosecond laser; N/A, not applicable.

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