Is the R20 method safe and effective for tattoo removal?

Question

I have a black ink tattoo of just lettering. It is new and I'm waiting 8 weeks before I begin laser removal. I am wondering if the r20 method done with a nd yag laser would be quicker to remove this than just one pass each time and if I choose this method, is the risk of permanent scarring significantly higher than if I went with the one pass with the q switch or the picosure?

Joel Schlessinger, MD · Answer

There are always going to be risks of scarring with tattoo treatments, but they do increase with the r20 method so that is always something to think about.  I am so happy to have it in our practice, however, as it dramatically decreases the time to improvement and the chances of complete clearance as well.  We use the Q-switched Alex laser and find it is the best results.  I am not really sure that the ND YAG is a good choice.  The Picosure should be as good as the Q Switched Alex but the costs will be significantly more as well.  The main thing that it offers is quicker resolution without the r20 method, but not sure it is worth that much more cost.  Good luck!

Phillip Bekhor, MBBS, FACD · Answer

R20 which essentially involves multiple Switched laser treatment of the same area of tattoo in a single session.  The initial reports seemed promising in terms of speeding up the fading process, however this has not been universally confirmed and there is some disagreement as to how beneficial it really is.  In my experience  benefits are inconsistent and minimal at best.  The process. in experienced hands, would be regarded as safe.Since then however, technology has moved on, with the development of picosecond lasers which have a higher chance of speeding up the removal process.  Those seeking state of the art tattoo removal would be best advised to have treatment with picosecond systems such as the well established Picosure laser laser (black and green/blue inks) or the newer Enlighten and Picoway systems (black and red pigment").

Steven F. Weiner, MD · Answer

Yes, I think that the R20 protocol is a good choice for you.  I have no experience with the pico lasers and whether it is safe for those lasers, but for QS lasers, particularly the 1064 wavelength, it is a great option.  I would say that even though 4 passes are done in one sitting, it is equivalent to about 2-2.5 regular treatments, in my experience.  An even faster treatment is using the R0 protocol, where the doctor applies a substance to the skin after the first pass and allows for treatment immediately following this.  No 20 minute wait and is equivalent to R20 results.

Is the R20 method safe and effective for tattoo removal?

Answers (3)

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