Four a Day
A new tattoo treatment regimen, consisting of four QS laser treatments on the same day was first introduced by Dora Kossida, MD, at the Advances and Controversies in Laser and Aesthetic Surgery 3rd International Conference held in Innsbruck, Austria in September 2010. Dr. Kossida developed the technique while working with R. Rox Anderson, MD, and Dieter Manstein, MD, at the Wellman Center for Photomedicine at Massachusetts General Hospital in Boston.
“They limited the initial study to simple black ink tattoos,” says Dr. Fitzpatrick, “and found that doing four treatments on the same day removed greater than 75% of the ink without scarring. I’ve had similar responses to the treatment regimen in my practice, even with multicolor tattoos. We do a treatment with the appropriate laser(s), wait until the tissue whitening clears—usually about 30 minutes—do a second treatment, then a third and a fourth. One patient with a multicolor tattoo that included red, black and yellow inks showed 90% clearance when treated with this regimen. That kind of result with no scarring prompted us to begin a study of the regimen with a large patient base. In one of the study groups we will do three QS laser treatments followed by a fractional CO2 treatment to see if adding the fractional treatment will improve clearance and/or minimize scarring. The study is just starting so we won’t have results for a year or so.”
Why would consecutive treatments make such a difference? “Studies have repeatedly shown that higher fluencies are more effective,” explains Dr. Fitzpatrick. “But when we go too high, we run the risk of scarring. We think multiple treatments in the same day allow you to sequentially reach deeper layers with each treatment.”
These photos were taken before and six weeks after two sessions of four treatments with the QS ruby laser. (Photos courtesy of Richard FItzpatrick, MD)
