Prospective observational study of efficacy of Nd:YAG laser in black tattoo: an experience of cosmetology in rural tertiary care centre

Background: Tattoo is common in rural areas signifying their traditions and beliefs whereas in urban areas tattooing is by choice. Q-switched (QS) lasers represent the gold standard in the treatment of tattoo removal. In this study, we report our experience with the QS Nd:YAG laser device, evaluating its effectiveness in black tattoo in a rural setup. Aim : To study the efficacy of Nd:YAG in increasing energy fluency in the removal of black tattoos. Method : A total of 16 patients with black tattoos were enrolled in this study. The operating settings were taken in increasing energy with fixed spot size and pulse duration starting from a minimum energy of 250 mJ. Patients were given treatment every 4 weeks until the Visual Analogue scale (VAS) score showed good results (50–75%) and were followed up after 6-month of the last treatment session. Patient satisfaction was assessed using a VAS and one dermatologist evaluated the aesthetic outcome based on pictures taken before and after treatment using Tattoo ink lightening (TIL). Results : Out of a total of 16 patients (14 males and 2 females), amateur tattoos were 14 (87.5%) and professional tattoos were 2(12.5%). The mean age of the patients was 24 ± 5.69 years. The most common Fitzpatrick skin type was IV ( n = 12, 75%) followed by V ( n = 3, 18.75%). The mean number of treatment sessions performed was 2.81 ± 1.27. The VAS showed an excellent and good response in 43.75% of patients and 56.25% showed complete removal of the tattoo. TIL showed an excellent and good response in 75% of patients and a clear response in 18.75% of patients. The side effects such as erythema and swelling were seen post-procedure in 100% ( n = 16) of patients and 6% ( n = 1) showed blister and ulcer formation. Conclusions : This is the only study where the effect of increasing energy fluency of Nd: YAG, starting with minimum energy, has been done in the rural Indian population. This study is able to show excellent results. The black tattoo seems to show excellent results with QS 1064 nm ND: YAG laser requiring fewer sessions and causing lesser side effects which decreases the treatment time and also reduces the chances of lost to follow up.