R20 with Ruby Laser or Picosure for Black Tattoo?

Question

I went to a doctor's office for removal of a black tattoo. The doctor said he prefers to do R20 with the Ruby because this laser goes deeper in the skin and this will work better than the Picosure (they have both lasers). This seems to contradict other things I have read. I have had a few treatments and my results have not been as drastic as I had hoped. Can you please let me know if you think the R20 with Ruby approach makes sense or if I should ask to switch to the Picosure? 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

Harold J. Kaplan, MD · Answer

Hi Flower.  Irrespective of what machine is being used, we would be opting for the 1064 wavelength when treating black ink.  We do not prefer the R20 method as it can lead to more trauma and a higher risk of scarring.  This should have been a simple treatment with the Picosure 1064 wavelength, but perhaps the machine was not working correctly so they decided to switch you for the treatment.  Best to check back with them.

Sean A. Simon, MD · Answer

The Picosure should be a very good option for the removal of a black tattoo as in your case, perhaps you can request at least a session or two with that laser.  Good luck.

Evan Sorokin, MD · Answer

There is no study comparing the R20 to the PicoSure that I know of.  Thus, it is really impossible to say definitively that one is better than they other.  That being said for black tattoos I believe the PicoSure works better than any other tattoo laser available.  The PicoSure is VERY GOOD at removing black tattoos.

R20 with Ruby Laser or Picosure for Black Tattoo?

Answers (4)

Answer: No data to prove

Answer: No data to prove

Recommended reading

Everything you need to know about Tattoo Removal

Our mission is to create a world where every investment in modern beauty is Worth It.

R20 with Ruby Laser or Picosure for Black Tattoo?

Answers (4)

Answer: No data to prove

Answer: No data to prove

Browse related questions

Recommended reading

Everything you need to know about Tattoo Removal

Our mission is to create a world where every investment in modern beauty is Worth It.