Comparison of Two Q-Switched Lasers and a Short-Pulse Erbium-Doped Yttrium Aluminum Garnet Laser for Treatment of Cosmetic Tattoos Containing Titanium and Iron in an Animal Model

Cosmetic tattoos contain titanium and ferric oxide and darken through reduction after Q-switched laser irradiation. The optimal treatment for removing these pigments remains unknown.To compare the effects of two Q-switched lasers and a short-pulse erbium-doped yttrium aluminum garnet (SP Er:YAG) laser to remove cosmetic tattoos in an animal model.Rats were tattooed using white, flesh-colored, and brown inks (4 bands of each color) on their backs. For each color, one band was left untreated, and one each was treated with a Q-switched neodymium-doped YAG laser, a Q-switched alexandrite laser, and a SP Er:YAG laser every 3 weeks until the pigments were clear.The two Q-switched lasers were equally effective; all three pigments darkened initially and then resolved gradually. Up to 20, 18, and 10 sessions were required to remove white, flesh-colored, and brown tattoos, respectively. Only six sessions were required with the SP Er:YAG laser. Minimal scarring was observed with all lasers. Skin biopsies confirmed pigment granule fragmentation after Q-switched laser treatment and a decrease in the amount of pigment after SP Er:YAG laser treatment.The SP Er:YAG laser was superior to the Q-switched lasers for removing cosmetic tattoos.