1. What is a Laser?
2. How Do I Know if My Problem Will Respond to the
Nd-YAG, Ruby, or Alexandrite Laser?
3. How Much Pain Will I Actually Experience From This
Procedure?
4. What Are The Risks of the Procedure?
5. Why are Q-Switch Lasers More Expensive Than Other
Treatments for Tattoos
6. What Does the Skin Look Like Following
Treatment?
7. If Wound Care is Necessary, What Will it Consist
of?
8. Where is the Procedure Preformed?
9. Will the Entire Tattoo be Treated at One
Time?
10. Will the Entire Tattoo be Removed with One
Treatment?
11. Are There any Pre-Operative Instructions I Should
Take?
12. Will I be Allowed to Sit in the Sun After -Switch
Laser Surgery
13. Are There Any Long-Term Risks from Laser
Surgery?
14. What Results Can I Expect rom My Procedure?
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The term laser is an acronym for light amplification by stimulated
emission of radiation. Lasers are instruments that convert
electrical energy into light energy for a variety of purposes. In
the treatment of skin problems, different lasers are used for
different purposes. Physicians have used lasers since the 1960’s.
Generalized acceptance has occurred in the last five to ten years
with the advent of more precise lasers. The most recent lasers have
been improved to the point where they now offer significant
advantages over standard techniques in the treatment of a variety
of dermatologic problems that will be discussed below.
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2. HOW DO I KNOW IF MY PROBLEM WILL RESPOND TO THE Nd-YAG, RUBY, OR
ALEXANDRITE LASER?
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Many recent studies have shown remarkable results when these lasers
are used to treat tattoos. The availability of all three
state-of-the-art lasers enables this program to provide treatment of
complex multi-colored tattoos.
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3. HOW MUCH PAIN WILL I ACTUALLY EXPERIENCE FROM THIS PROCEDURE?
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Most patients do not require anesthesia. Occasionally, a topical
anesthetic agent may be used or a sedative for a child. For those
patients who do not require any anesthesia, there is a mild stinging
or burning with each pulse, but this is tolerable. For large
procedures, intravenous sedative anesthesia is available.
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4. WHAT ARE THE RISKS OF THE PROCEDURE?
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The risk of scarring is quite small and probably less than 1%. The
most common side effect is temporary hypopygmentation, which is the
result of the menanin layer absorbing the energy from the first
treatment. Because of hyperpygmentation, the wound has to be
protected from damage from ultraviolet light. Using sunblocks and
covering the site with clothing are recommended. Sunblocks that block
out most of the ultraviolet spectrum are recommended. There is also a
small risk of a wound infection. This is treated with systemic
antibiotics if a crust forms or purulent scabs appear. Finally,
residual hyperpygmentation from a tattoo where there is deeper or
more ink or residual epidermal pigmentation may not absorb all of the
energy and, therefore, may not respond. These may be treated with
other modalities if they persist.
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5. WHY ARE Q-SWITCH LASERS MORE EXPENSIVE THAN OTHER TREATMENTS FOR
TATTOOS?
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The technology of these lasers is much more sophisticated than other
types of treatments. Laser costs, maintenance, service contracts, and
training of personnel all factor into higher cost of the patient’s
treatments.
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6. WHAT DOES THE SKIN LOOK LIKE FOLLOWING TREATMENT?
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The skin immediately turns white, probably from vaporization of the
water in the epidermis. Within five minutes this turns to a gray
color with redness in the surrounding skin. A dressing is used for
the first several days. During this time wearing makeup is not
recommended, but sun protection is strongly recommended.
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7. IF WOUND CARE IS NECESSARY, WHAT WILL IT CONSIST OF?
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If you develop scabs or a crust after treatment, topical antibiotics
will be recommended. Most wounds, however, require simple cleansing
with soap and water or with hydrogen peroxide and application of
Polysporin or Neosporin ointment. Telfa or non-adherent dressings
will be recommended
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8. WHERE IS THE PROCEDURE PERFORMED?
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Currently, the procedure will be performed at the Fairfax County
Health Department, 6245 Leesburg Pike, Falls Church, VA 22044. Some
cases may be referred for specialized treatment of surgical
excision.
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9. WILL THE ENTIRE TATTOO BE TREATED AT ONE TIME?
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Depending on the size of the tattoo, if it is possible, the entire
area will be treated. Occasionally, test sites may be done to
determine the response of your tattoo to the various lasers. If the
test sites are considered successful, treatments will begin at the
follow-up visit. The size of the area treated on each visit also
depends on how the procedure is tolerated and the size of the tattoo.
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10. WILL THE ENTIRE TATTOO BE REMOVED WITH ONE TREATMENT?
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This is rarely the case. Most patients require several treatments to
clear a tattoo or to get the degree of lightening they desire. A
tattoo can be re-treated until the desired improvement is achieved.
Generally, 1-2 months between treatments are required. Tattoos can
take as many as six to ten treatments to clear.
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11. ARE THER ANY PRE-OPERATIVE INSTRUCTIONS I SHOULD TAKE?
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Aspirin and products containing aspirin should be avoided for one
week before laser treatment. If you are taking anticoagulants or have
blood-clotting problems, please let your doctor know. You should
especially avoid excessive sun exposure or tanning for several weeks
or months before treatment. The main reason for this is that melanin
is a competing pigment with tattoo pigment.
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12. WILL I BE ALLOWED TO SIT IN THE SUN AFTER Q-SWITCH LASER SURGERY?
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Your response will be greatly improved if you avoid direct sun
exposure to the treated area for at least two months after treatment.
Once the wound has improved, you may sit in the sun, if you use
sunscreens with SPF #39 or higher on the area in question.
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13. ARE THERE ANY LONG-TERM RISKS FROM LASER SURGERY?
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There is no evidence that these lasers have any untoward long-term
effects. The wave lengths used do not appears to cause any long-term
side effects.
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14. WHAT RESULTS CAN I EXPECT FROM MY PROCEDURE?
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Laser surgery is a spectacular and exciting field, but it has its
limitations. Unknown variables inherent in individual tattoos and
patients make it difficult to predict the final result accuracy. Most
patients are extremely pleased with the final result. Every effort
will be made to achieve an optimum result for you; however, your
doctor cannot guarantee complete success in the treatment of your
tattoo.
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