Why is Picosure Not Working For My Tattoo?

Question

I've had 3 picosure sessions done and so far my black ink tattoo is not fading. The technician stared at 50% the last 2 sessions and then upped it to 100% but it did nothing to my tattoo. I thought picosure is one of the best lasers and it has a high success rate but I am very discouraged. Can you tell me what might be going on?

Omar Ibrahimi, MD, PhD · Answer

Hi, your post raises a very interesting question. Many times people tend to get caught up in the "what's new" or "what's hot," without truly understanding the science or the research evidence. When it comes to laser tattoo removal, simply having someone treat you with the Picosure is not going to get you the best result. The most important thing is seeing someone who understands the science and physics of laser tattoo removal and also has a mastery of the biology of the skin. Since laser tattoo removal was invented by Harvard dermatologists, seeing a dermatologist with expertise in laser surgery is often your best bet. The laws surrounding laser use vary state to state but your "technician" might be someone who has no formal training in lasers and may not have a background in science or medicine.There have not been any studies that show the PicoSure is superior to current laser technology to treat black tattoo ink. You can read much more about laser tattoo removal here.

Steven F. Weiner, MD · Answer

Although the company reports the Picosure can treat all ink colors, this is not what has been seen clinically. In reality, this laser is best for green inks and fairly poor for all the other colors. What is needed for black inks is a 1064 wavelength with nano and picosecond capabilites. I prefer the Piqo4 laser for this because it has these attributes as well as the highest power of all tattoo lasers.

Hratch Karamanoukian, MD, FACS · Answer

I understand your frustration and in medicine and cosmetic procedures and especially with lasers, it is importnat to know the fundamentals of the laser being used, the energy setting, the limitations and potential side effects. Picosure uses picosecond laser delivery technology and about 10-50,000 faster pulse delivery than nanosecond technology (Alex TriVantage, for example) and as such has been shown to improve clearance of tattoo ink. The nanosecond technology works just as well in most cases, in my professional opinion. Picosure has limitations as to certain colors as it does not do anything for red inks. PicoWay is used for red inks.Picosure works on black ink and also on blues and green ink.

Jeffrey W. Hall, MD · Answer

The clinical trials used for the
PicoSure&trade; laser FDA submission proved that it is the most effective tattoo
removal instrument available.In head to
head comparisons with the best Q-switched lasers the PicoSure&trade; provided
significantly better results in fewer treatments.Furthermore, since its release in April of
2013, the PicoSure&trade; has continued to produce incredible removal results.At Hall Plastic Surgery in Austin, TX we use
the PicoSure&trade; exclusively for tattoo removal and continue to be impressed with
our clinical outcomes.It may be that
your ink is extraordinarily lightfast, which means it is resistant to laser
energy.Some inks incorporate
proprietary ingredients in order to make them resilient and long lasting.In fact, some inks may actually get darker
when exposed to laser energy.Other
factors that affect tattoo removal are the amount of ink, depth of placement,
tattoo location and the patient’s own ability to clear the ink following
treatment.The PicoSure&trade; settings may
need to be adjusted along with the application technique.

Suzanne Kilmer, MD · Answer

If it is a very dark tattoo with lots of ink it
just may be that even though the ink is clearing, you still see the ink that is
there. Also, we have seen that some black inks respond better to QS laser
treatment – you could have them try a QS laser for a session or two and see if that helps.

Why is Picosure Not Working For My Tattoo?

Answers (5)

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