Can you double treat a tattoo with the laser?

One of the clinics I will see will or can pass over the tattoo twice the first treatment saying she's never had problem though there's always a risk of scarring. Can this be done with low enough settings?

Doctor Answers 3

R20 method for laser tattoo removal

It is possible to treat a tattoo with multiple lasers passes up to 4 depending on your skin type.  This is called the R20 method and is typically performed with a q switched laser where on a single visit, up to 4 passes are performed 20 minutes apart.  There is certainly risk from laser tattoo removal but for lighter skin this should not be a problems.  There needs to be caution treating ethnic skin such as Asian, African American, South American and Middle Eastern skin as risk is higher for pigment changes and scarring.  With newer picosecond technology, only 1 pass is required


Summit Emergency Medicine Physician
5.0 out of 5 stars 24 reviews

Double Pass when treating Tattoo

It is possible to double treat a tattoo if you wait the appropriate time between treatments - generally 30 minutes but there is no reason to double pass an area during a single treatment.  Please consult an expert in tattoo removal.  Best, Dr. Green

Treating a Tattoo twice in one session

Thanks for your question. Treating a tattoo twice in one session is often referred to as the R20 method because it is necessary to wait 20 minutes or more in between passes.Whether this might be advantageous, or worth the increased risk of scarring and Hypopigmentation  (which can be permanent) is a complex question. With some wavelengths such as 1064, it can be done but it should not be done for the very first session and yes, when done the energy (fluence) needs to be lower. With others it should never be done in my opinion (like 532 or 694). If you go to the website astanzalaser.com there is an excellent blog article there addressing the R20 method which will give you some good information which you can use to ask questions of the laser provider.Best,Lisa Vuich, MD

Lisa Vuich, MD
Nashua Physician
4.7 out of 5 stars 10 reviews

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