Red-brown tattoos are usually treated with a frequency-doubled Q-switched (QS) neodymium:yttrium-aluminum-garnet Nd:YAG laser (532 nm), because red and pink pigments show maximum absorption between 500 and 570 nm. Using a QS laser for red-brown tattoo removal has sometimes led to paradoxical darkening of the tattoo pigments, and this darkened grey-black colour may be difficult to remove. A woman with red-brown cosmetic tattoos on her eyebrows was treated using a QS Nd:YAG laser (1064 nm) initially with low fluence and subsequently with increasing fluences at 6-weekly intervals. After the first treatment, a slight darkening of the tattoo pigments was seen, but this faded and complete clearance was achieved after five treatments. There was no downtime during every treatment and there were no scars, pigmentary alterations or textural changes.
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Lee et al. (2009) studied this question.
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