Comparative study of the efficacy of Q-switched neodymium-doped yttrium aluminum garnet laser alone versus ultra-pulse carbon dioxide laser along with Q-switched neodymium-doped yttrium aluminum garnet laser in patients with black tattoo

Objectives: The objectives of the study is to evaluate the efficacy of QS neodymium-doped yttrium aluminum garnet (Nd:YAG) laser alone versus in combination with ultra-pulse carbon dioxide (CO 2 ) laser along with QS Nd:YAG laser in patients of black tattoo. Material and Methods: Fifty patients having black tattoo were consecutively assigned into two groups, namely group A and group B. Group A was treated with QS Nd:YAG laser (1064 nm) alone, and Group B underwent combination of fixed dose of ultra-pulse CO 2 followed by increasing energy dose QS Nd:YAG laser (1064 nm), at 6-week interval till complete clearance or for a maximum of 6 sittings. After each sitting, percentage of improvement was evaluated using Visual Analog Scale (VAS) based on the assessment of the patient, whereas tattoo ink lightening (TIL) was calculated by evaluating the response in serial digital photographs and grading system for TIL. Results: Combination laser (group B) had greater improvement in mean VAS score and mean TIL score in the past three noted visits as compared to 1 st 1 - session ( P = 0.0001). The number of sessions required was lesser in comparison to Kirby-Desai score. Conclusion: For both professional and amateur tattoos, combination of ultrapulse CO 2 laser and QS Nd:YAG laser is more effective in comparison to QS Nd:YAG laser alone.