Is a lot of bleeding after fourth Q-Switched Nd:YAG session normal?

Question

I went to a different dermatologist for my 4th session. The technician used Medlite with 1024 wavelength (I have light-medium Asian skin). The laser didn't hurt much, unlike the other times. Afterwards, my tattoo looked bad, very red and bleeding. It bled a lot for 4-5 hours, but the technician said it is normal. 12 hours later, it was still bleeding a bit all over. I am so worried I will scar or hyperpigment. Is the bleeding indeed normal? My tattoo never bled this much before.

Jason Emer, MD · Answer

Bleeding is sometimes okay after laser tattoo removal it just depends the tattoo, depth, and type of treatment.  Please trust your physician.  Best, Dr. Emer.

Michele S. Green, MD · Answer

The mediate laser doesn't typically bleed afterward in the way that you are describing and Asian skin is very sensitive and needs the correct laser.  I would to the physician for examination and local wound care.  Please consult an expert.  Best, Dr. Green

Jared Mallalieu, DO · Answer

Sorry to hear about your recovery. The goal of laser tattoo removal is to use enough energy to break down the ink, but to do it without injuring the skin (making it bleed or blister). As the ink becomes less dense, higher laser settings are needed. Sometimes you may notice some bleeding, bruising etc. Good wound care is very important to prevent scarring. On the rare instance we might see this after treatment, my office has the patients use antibiotic ointment 3 times a day. Avoid sun until it's healed as well. Good luck, Dr. M

Hardik Soni, MD · Answer

Bleeding can occur as it is secondary to rupture of the capillaries in the skin. It usually indicated the energy may be too high especially if there is a significant amount.  The skin will heal. Just use a bland ointment such as Aquaphor.  While hyperpigmentation or hypopigmentation is a potential risk after any laser based procedures, permanent changes are the exception rather than the rule.Best of luckDr Soni

Steven F. Weiner, MD · Answer

Bleeding is not normal after this procedure. It means the skin has been broken. Proper wound care must be done to prevent pigmentation and scarring problems. Make sure the provider sees this and offers wound care. Aquaphor +/- Biafine might be needed.

Is a lot of bleeding after fourth Q-Switched Nd:YAG session normal?

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