Which laser is BEST for black ink in regards to tattoo removal? PICO or 1064 Q-SWITCHED?

Question

Some say Pico, some say 1064 Q, but there seems to be no consensus. Is there any CONCLUSIVE evidence of either one being more efficient (in regards to full removal) than the other? Thanks

Anil R. Shah, MD · Answer

Hello,Tattoo removal, if not done correctly, can result in either scarring or ghosting.  Here are some tips:
Find a reputable office with a Pico laser. It produces faster results with less scarring than a nano alone.  Tattoo removal shops are not as reputable as a Doctor. Many of these shops close as quickly as they open, leaving you out of luck on pre-paid packages.Stay out of the sun— sunlight can be harmful to healing in after any laser procedureAvoid infections- This means keep your tattoo area clean (i.e. don’t garden right after a tattoo removal on your arm, etc), don’t pick scabs or blisters if they occur.  Follow our post procedure instructions.  Avoid swimming for 48 hours as water can infect the treated areas.Allow healing between treatment sessions- typically 4-8 weeks.Be healthy- while the tattoo laser breaks up the tattoo particles, your body will actually eliminate the particles. Being healthy will help achieve this process faster and allow for consistent healing. Drink lots of water, get adequate sleep, and eat vitamin enriched foods.In our practice we utilize the currently most powerful Pico laser on the market called the PiQo4 by Lumenis.  The main advantage of a stronger tattoo laser (combining nano and pico wavelengths at greater power) is faster breakup of the tattoo.  The science of tattoo removal is complex but essentially the greater power will photo acoustically break up tattoo particles in smaller pieces. 
Best, 
Anil Shah

Mark Taylor, MD · Answer

Excellent results can be obtained with a good Q-Swtiched ND-YAG, Ruby, or Axelandrite laser depending on the background skin type, location of the tattoo, depth of the ink and settings used.  The Picosecond laser (Picosure from Cynosure) is a very short pulsed alexandrite laser and soon a 532nm and 1064nm picosecond laser will be available from Cutera.   With optimum settings and expert use, all of the best Q-Swtiched and Picosecond lasers should be effective in treating black tattoo ink.

Omar Ibrahimi, MD, PhD · Answer

That is a great question. No one has proved that the picosure laser is better than a very good q-switched laser at removing black ink. The picosure is thought to be a little better at treating blue, green and hard to clear tattoos. Also treatments with the picosure laser tend to be much more expensive than with traditional q-switched lasers (not all q-switched lasers are considered equal though as some have a faster pulsewidth than others).

Which laser is BEST for black ink in regards to tattoo removal? PICO or 1064 Q-SWITCHED?

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