The picosecond lasers, Q-Switched Nd: YAG and Alexandrite are pigment lasers developed to remove black, red and other colours of tattoo pigment, certain brown growths and birthmarks from the skin. Picosecond lasers are a new generation of pigment lasers that treat superficial pigmentation such as freckles and lentigines; deeper pigmentation such as Hori’s and Ota Naevus as well as green, sky blue and black tattoos. These lasers operate in the ultrashort picosecond domain and complement other lasers and light devices (e.g. Q-switched Nd:YAG laser, intense pulsed light device) in the treatment of pigmented lesions.
Repeated laser treatments are often necessary depending on the indication. The tattoo or pigmentation will be treated at intervals of two months or longer until either the pigment is removed or further improvement is deemed unlikely.
Solar lentigo (sun spot) on the cheek
Nevus of Ota (pigmented birthmark) on the cheek
he number of treatment sessions generally required are as follows:
The above information serves only as a general guide. There is no guarantee that the pigmentation/ tattoo will be totally removed at the end of the treatment sessions.
* With the Q – Switched Alexandrite Laser
Treatment of the pigmented skin lesions is usually done in stages under topical anaesthesia, which is often applied for about 1 hour before the procedure.
Your doctor will precisely target the pigmented lesion to be removed with the laser. When the laser hits the skin, you may feel a pricking pain, somewhat like a rubber band snapping on the skin. The pain is usually bearable and short-lived. An icepack can be used to minimise the pain immediately after the procedure.
Pigment laser treatment often causes mild damage to the superficial layer of the skin (epidermis). This appears as redness and swelling soon after the laser procedure and lasts for several hours.
You may experience some burning discomfort for several hours after the laser treatment. Pain and discomfort can be relieved by taking painkillers (e.g. 2 tablets of paracetamol) and by using an ice- pack.
The laser wound should be cleansed gently with sterile normal saline solution. Prescribed antibiotic ointment should then be applied to the treated areas twice daily for 5-7 days or until the surface wound is totally healed.
Showers are permitted but gently pat the area dry and avoid further injury to the healing skin.
Over the next 5-7 days, superficial scabs which form over the treated areas will fall off by themselves. It is important not to pick at the scabs as this may result in infection and scarring.
If the laser is used to treat a deeper pigmentation using a deeper penetrating laser wavelength, superficial pin-point bleeding on the surface of the skin may result instead of superficial scabs. This will take 3-5 days to heal.
Do not rub, scratch or pick at the treated area.
Do not apply make-up and avoid swimming and contact sports until the scabs disappears (usually 5-7 days).
If the treated area shows signs of infection (tenderness, redness, swelling or pus), consult your doctor or nurse-in-charge, Laser Suites, National Skin Centre for further advice and management.
Over the next 3-6 months, avoid direct exposure to the sun and use a broad spectrum sunscreen daily to reduce the risk or severity of post-laser hyperpigmentation.
When performed by a trained dermatologist, pigment laser treatment is a very safe procedure with minimal risk of permanent scarring. In most people, the treated area loses its pigment (hypopigmentation) and becomes lighter in colour than the surrounding skin temporarily. The skin colour usually returns to normal over the next 2-4 weeks.
Increased pigmentation (hyperpigmentation) may occur after the lasered skin has healed (post-inflammatory hyperpigmentation). It is usually seen 2-4 weeks after the laser treatment and is often made worse if skin is exposed to the sun. This post-laser reaction is temporary but may take 4-6 months to gradually fade. Your doctor may prescribe a skin lightening cream to help clear this post-laser pigmentation faster.
Scarring is a very rare occurrence from pigment laser treatment. It may result from skin infections following the laser treatment. Textural changes with hypopigmentation may appear after laser tattoo removal. This is usually transient but may rarely be permanent. It is important for patients to report to their doctor immediately if there is prolonged pain, redness, tenderness and oozing of the laser-treated skin. To minimise the chances of scarring, it is important that you follow the post-laser skincare instructions carefully.
Some tattoo ink or pigment is located too deep in the skin to be removed completely in spite of repeated treatments. Vague spots of colour may remain after treatment. There may be some ink colours that change colour or darken in response to the laser and others that simply will not respond to this laser. It may not be possible to completely remove all tattoo and skin pigmentations with this laser. If this situation arises, there may be other treatment alternatives available.