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Treatment of cosmetic tattoos with nonablative fractional laser in an animal model: A novel method with histopathologic evidence

Authors

  • Chia-Chen Wang MD,

    1. Department of Dermatology, Cardinal Tien Hospital, New Taipei City 231, Taiwan
    2. School of Medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan
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  • Chuen-Lin Huang PhD,

    1. Department of Medical Research, Cardinal Tien Hospital, New Taipei City 231, Taiwan
    2. Department of Physiology and Biophysics, Graduate Institute of Physiology, National Defense Medical Center, Taipei 114, Taiwan
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  • Shao-Chen Lee PhD,

    1. School of Medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan
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  • Yuh-Mou Sue MD,

    1. School of Medicine, Taipei Medical University, Taipei 110, Taiwan
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  • Fur-Jiang Leu MD, PhD

    Corresponding author
    1. School of Medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan
    2. Department of Pathology, Cardinal Tien Hospital, New Taipei City 231, Taiwan
    • Department of Pathology, Cardinal Tien Hospital, 362 Chung Cheng Rd., Hsin Tien District, New Taipei City 231, Taiwan.
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  • Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Abstract

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.

Results

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.

Conclusion

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.

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