Could there be a slower physiological healing process in vegan individuals?

The article “Comparing Tattoo Removal Responses in Vegan and Omnivore Patients” by Fusano et al. investigates the clinical outcomes of Q‐switched laser tattoo removal in vegans and omnivores. The study reveals that vegans required more laser sessions, exhibited poorer clinical responses, and experienced extended healing periods compared to omnivores. When well‐planned vegetarian diets offer numerous health benefits. Unfortunately, the study does not assess the diets of the groups, nor does it address factors like hydration levels and prior skincare regimens, limiting the interpretation of results.

vegans required more laser sessions, exhibited poorer clinical responses, and experienced extended healing periods compared to omnivores.When well-planned vegetarian diets offer numerous health benefits.Unfortunately, the study does not assess the diets of the groups, nor does it address factors like hydration levels and prior skincare regimens, limiting the interpretation of results.

Dear Editor,
We read the article "Laser removal of tattoos in vegan and omnivore patients" by Fusano et al. 1 with great interest.The authors of the study compared the clinical response of tattoo removal between omnivore and vegan patients treated with Q-switched laser (QSL), and found results that vegans needed more laser sessions to achieve the best outcome, showed worse clinical responses and needed more days for complete healing compared to omnivores.
In the scientific community, vegetarian diets-which may include products of animal origin (such as ovolactovegetarian, lactovegetarian, and ovovegetarian) or completely exclude products of animal origin (strict vegetarian diet, also known as vegan diet)-when well-planned, are appropriate for individuals during all stages of the life cycle.Such diets can provide adequate amounts of all macronutrients and micronutrients, except for vitamin B12.These diets are associated with excellent cardiovascular markers, 2 lower body composition indices, 3 and consequently, reduced inflammatory markers when compared to omnivores. 4These benefits arise from the high consumption of plant foods, which are rich in vitamins, minerals, phytochemicals, and antioxidants.
However, these diets have recently been impacted by industrialization, leading to an increased consumption of ultra-processed foods among adherents. 5These foods do not provide the aforementioned health benefits and can contribute to an inflammatory response.
Regrettably, the present article did not assess the diets of the two groups.The authors did not utilize evaluation methods such as a food frequency questionnaire (FFQ) or a 24-h recall.This absence of information represents a study limitation since an individual's nutritional status and diet play a crucial role in the inflammatory responses associated with the treatment.By possessing the capability to quantify the constituents of the diet, researchers would gain insights into whether disparities exist in food consumption between the two groups, which could substantiate the observed results.This is evidenced in the study by Shah et al., 4 where vegans demonstrated higher fiber consumption and lower intake of saturated fat and dietary cholesterol compared to omnivores, leading to a reduction in inflammation.
Other limitations in the study concern the patients' hydration levels, which were not disclosed, and could potentially influence the results.Additionally, the authors did not account for the patients' previous treatments and skincare regimens before the intervention.
A possible hypothesis for the observed results is a slower physiological healing process in vegetarian individuals.Similar trends are seen in other physiological processes; for example, numerous studies demonstrate that vegetarians tend to have lower blood pressure levels compared to omnivores.This difference might be linked to a decelerated aging process, potentially contributing to greater longevity among vegetarians. 6 conclusion, the findings of the article seem to be influenced by unaddressed factors such as diet, hydration, inflammatory response, and prior skin care.As a result, the authors' conclusion appears premature.We trust that these considerations can foster reflection and contribute to the advancement of research in this field, as well as aid in the standardization of future studies.

CO N FLI C T O F I NTER E S T S TATEM ENT
The authors report no conflict of interest.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.© 2023 The Authors.Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.