What laser is best for getting rid of black Ink? (Photo)

Question

Hello I have two tattoos on my wrists that I regret greatly and I'm looking for the fastest and most effective way to get rid of them. Before I jump the ship on the picosure laser I've been reading online that apparently it's not as effective with black as the usual YAG laser is this true? I've attached a picture of one of the tattoos so you can get an idea (Note there is another same shape and size on the other wrist)

Raffy Karamanoukian, MD, FACS · Answer

The dark black inks are suitable for laser tattoo removal. Your approach is excellent as more and more of our patients are opting for laser tattoo lightening to modify and possibly revise their tattoos. Best, Dr. Karamanoukian Los Angeles

Hratch Karamanoukian, MD, FACS · Answer

Picosure can be used to clear the dark ink. Picosure has been shown to clear blue green ink.Picosure does does not clear red ink.PicoWay is a picosecond laser that targets red ink. 532 nm Q switched Nd YAG lasers target red inks. We use the Alex TriVantage laser that has 755 nm, 532 nm and 1064 nm lasers.

Bruce E. Katz, MD · Answer

Thank you for posting a picture of your tattoo.
I recommend learning more about the Picosure laser for permanent tattoo
removal. This new laser will remove the tattoo without causing harm to the
surrounding area. Consult with your surgeon to decide if this is best for you.

Danny Soares, MD · Answer

Most available q-switched lasers in current use are effective for removal of black tattoos. This is because black pigment absorbs all laser frequencies. The next question then becomes which laser can remove black pigment and simultaneously minimize side effects such as pigmentation changes. This is an important detail because, especially in patients with darker skin, there is an intrinsic risk of pigmentation changes with laser tattoo removal. The Nd:YAG laser is known to be best for targeting dark tattoo ink while minimizing damage to melanocytes; this is because melanin, your skin pigment, absorbs more weakly at the Nd:YAG laser's wavelength that other commonly-used lasers. Despite these truths, the studies that have been performed over decades, overall, show that the Ruby (e.g. Astanza Eternity) and Alexandrite (e.g. Picosure) lasers are more capable of removing dark inks in fewer treatments than the Nd:YAG (e.g. Picoway), but do have more potential for scarring. The new-generation lasers (e.g. Picosure), offering picosecond pulse durations, are less likely to cause scarring because of decreased collateral damage to skin structures. From the appearance of the tattoo in the photo, I believe that the picosure laser will probably address your tattoo best. The major reasons to use the Nd:YAG would be for a red tattoo or if you had darker skin. Your provider should be able to guide you through this process and occasionally, multiple laser types may be necessary for complete clearance of professional multi-colored tattoos. Best of luck!

Omar Ibrahimi, MD, PhD · Answer

Your question about what laser is best for tattoo removal is a good one. I will advise you that an even more important question you should be asking is how well trained is the person operating the laser. These lasers were invented by Harvard dermatologists and there is a tremendous amount of physics one must understand to effectively and efficiently treat tattoos. There is no convincing evidence that the Picosure laser is better than the standard Q switched Nd:YAG laser for black ink. For some colors, such as green or blue, it is probably better. Make sure you see someone with expertise which is more important than which brand of laser they use.

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