2 sessions done with a Q-switched ruby laser because black ink turned brown. Is hypopigmentation permanent? (photos)

I use a Q Ruby almost daily in my tattoo removal practice and notice this "ghosting" you are describing in even my lighter skin patients. What I normally do is give it a rest and hold off the next session for a few months. I space in lighter skin patients every 6 weeks so maybe I would tell this patient to return in 12 or 14 and to expose the area to a bit of sun.

The doctor may consider returning to the YAG . 

There was a study where the hypo pigmented areas were exposed to UVB light and the melanin returned.

Thanks for your question. Transient hypopigmentation in the course of laser tattoo removal can certainly occur and it is rarely permanent. Usually over the course of a couple of months, with a little bit of sun exposure (do not burn though!) the melanocytes in the area will recover and the skin returns to normal pigmentation. Best,Lisa Vuich, MD