Fluence settings on Enlighten by Cutera?

Question

I have had 3 tattoo removal sessions so far. 1 at one location. And then the last two at a new place. They are using Enlighten by Cutera on my all black tattoos. The first 2 sessions the fluence was at 1.5 and the 3rd session the fluence wasat 1.8. The tattoos are not fading as fast as I would expect using this laser and I am curious if the fluence is not high enough. My skin has been handling the treatments with no issues at all. Its almost as if within a day I forget I even had it done.

Barbara Padilla, MD · Answer

For black ink tattoos, I use the 1064 wavelength,  2 ns and generally start with 1.7 joules with a 5 mm spot size. They can increase the joules by 0.1 or 0.2 for the next treatment session depending on the skin reaction.  When the tattoo starts lightening up (and it will), they should switch to 750 ps and adjust the energy and spot size accordingly.

Lisa Jenks, MD · Answer

I assume that they are on a wavelength of 1064, using nanoseconds and a spot size of 3 or 4.  If that is the case, in my opinion, they should be using a higher fluence.  You should have scabbing, oozing and redness for 5-7 days after each treatment.

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