Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Treatment of cosmetic tattoos with nonablative fractional laser in an animal model: A novel method with histopathologic evidence†
Article first published online: 8 FEB 2013
Copyright © 2013 Wiley Periodicals, Inc.
Lasers in Surgery and Medicine
Special Issue: Dermatology and Plastic Surgery
Volume 45, Issue 2, pages 116–122, February 2013
How to Cite
Wang, C.-C., Huang, C.-L., Lee, S.-C., Sue, Y.-M. and Leu, F.-J. (2013), Treatment of cosmetic tattoos with nonablative fractional laser in an animal model: A novel method with histopathologic evidence. Lasers Surg. Med., 45: 116–122. doi: 10.1002/lsm.22086
- Issue published online: 25 FEB 2013
- Article first published online: 8 FEB 2013
- Manuscript Accepted: 21 SEP 2012
- Cardinal Tien Hospital. Grant Number: CTH-100-1-2A07
- cosmetic tattoo;
- fractional photothermolysis;
- nonablative fractional laser;
- transepidermal elimination
Background and Objective
Cosmetic tattoos are difficult to treat using Q-switched lasers. We introduce a novel method for the treatment of cosmetic tattoos using a nonablative fractional laser and investigate the underlying pathophysiological mechanisms in an animal model.
Study Design/Materials and Methods
Ten rats were tattooed on their backs with white and flesh-colored pigments. One-half of each tattoo was treated with a 1,550-nm, erbium:glass fractional laser system with energy settings of 17 mJ and 169 MTZ/cm2 × 2 passes for five sessions at 1-month intervals. The untreated half of each tattoo served as the control. An independent physician reviewed the photographs and scored the clinical response. Serial skin samples were obtained at baseline and at various times after laser treatment. These tissue sections were stained with hematoxylin and eosin, and immunostained for types I, III, and IV collagen; laminin; fibronectin; and α-smooth muscle actin.
White tattoos showed excellent responses in two rats and good responses in eight rats, whereas flesh-colored tattoos showed excellent responses in four rats and good responses in six rats (P = 0.001 in both cases compared with baseline). Both tattoos exhibited a similar clearance rate (P > 0.05) and histological reactions. Microscopic epidermal necrotic debris (MEND) containing tattoo pigments and collagen fibrils appeared on day 1, increased on day 2, and was exfoliated after 5 days. The dermal–epidermal junction lost integrity 30 minutes after treatment, but recovered completely on day 3. The expression of fibronectin and collagen-III, which play key roles in wound healing, increased around the microscopic treatment zone on days 1–5 and 4–7, respectively. A few myofibroblasts appeared on days 4–7.
Nonablative fractional lasers (NAFLs) successfully remove cosmetic tattoos by transepidermal elimination of tattoo pigments through the disrupted dermal–epidermal junction. This action is facilitated by the wound healing process. Lasers Surg. Med. 45: 116–122, 2013. © 2013 Wiley Periodicals, Inc.