Karsai Syrus, Pfirrmann Gudrun, Hammes Stefan, Raulin Christian
Laserklinik Karlsruhe, Karlsruhe, Germany.
Lasers Surg Med. 2008 Feb;40(2):139-45. doi: 10.1002/lsm.20605.
Multiple treatments of resistant tattoos often result in fibrosis and visible textural changes that lessen response to subsequent treatments. The aim of this study is to evaluate the influence of beam profile and spot size on clearance rates and side effects in the setting of resistant tattoos.
STUDY DESIGN/MATERIAL AND METHODS: Thirty-six professional, black tattoos (32 patients) were treated unsuccessfully with a Q-switched Nd:YAG laser (MedLite C3, HoyaConBio Inc., Fremont, CA). Because of therapy resistance all tattoos were re-treated using a new generation Nd:YAG laser (MedLite C6, HoyaConBio Inc.). Maximum energy fluence (E (max)), mean energy fluence, mean spot size, level of clearance, side effects and beam profile (irradiance distribution) of both laser systems were assessed and evaluated in a retrospective study.
All tattoos were previously treated with the C3 laser at 1,064 nm using a mean E(max) of 5.8+/-0.8 J/cm(2) (range 3.8-7.5 J/cm(2)) as compared with a mean E(max) of 6.4+/-1.6 J/cm(2) (range 3.2-9.0 J/cm(2)) during the C6 treatment course. Corresponding spot sizes were larger during C6 treatments as compared with C3 (5.0+/-0.9 and 3.6+/-0.2 mm, respectively). The C6 laser had a "flat top" and homogenous profile regardless of the spot size. For the C3 laser the beam shape was "Gaussian," and the homogeneity was reduced by numerous micro-spikes and micro-nadirs. After the C6 treatment course 33.3% of the tattoos showed clearance of grade 1 (0-25%), 16.7% of grade 2 (26-50%), 16.7% of grade 3 (51-75%), 30.5% of grade 4 (76-95%), 2.8% of grade 5 (96-100%). The total rate of side effects due to C6 treatment was 8.3% in all tattoos (hyperpigmentation 5.6%, hypopigmentation 2.7%, textural changes/scars 0%).
This clinical study documents for the first time the impact of a 1,064-nm Nd:YAG laser with a more homogenous beam profile and a larger spot size on the management of resistant tattoos. Only a few treatment sessions were necessary to achieve an additional clearance with a low rate of side effects.
对抗性纹身进行多次治疗通常会导致纤维化和明显的质地变化，从而降低后续治疗的效果。本研究的目的是评估光束轮廓和光斑大小对抗性纹身清除率及副作用的影响。
研究设计/材料与方法：36个专业黑色纹身（涉及32名患者），用调Q Nd:YAG激光（MedLite C3，HoyaConBio公司，弗里蒙特，加利福尼亚州）治疗未成功。由于治疗抵抗，所有纹身均使用新一代Nd:YAG激光（MedLite C6，HoyaConBio公司）重新治疗。在一项回顾性研究中，评估并评价了两种激光系统的最大能量密度（E(max)）、平均能量密度、平均光斑大小、清除水平、副作用及光束轮廓（辐照度分布）。
所有纹身先前用C3激光在1064nm波长治疗时，平均E(max)为5.8±0.8J/cm²（范围3.8 - 7.5J/cm²），而在C6治疗过程中平均E(max)为6.4±1.6J/cm²（范围3.2 - 9.0J/cm²）。与C3治疗相比，C6治疗期间相应的光斑尺寸更大（分别为5.0±0.9和3.6±0.2mm）。无论光斑大小如何，C6激光具有“平顶”且均匀的轮廓。对于C3激光，光束形状为“高斯”型，并且均匀性因众多微尖峰和微凹而降低。C6治疗疗程后，33.3%的纹身显示为1级清除（0 - 25%），16.7%为2级（26 - 50%），16.7%为3级（51 - 75%），30.5%为4级（76 - 95%），2.8%为5级（96 - 100%）。C6治疗导致的所有纹身副作用总发生率为8.3%（色素沉着过度5.6%，色素沉着不足2.7%，质地变化/瘢痕0%）。
本临床研究首次记录了具有更均匀光束轮廓和更大光斑大小的1064nm Nd:YAG激光在对抗性纹身治疗中的影响。仅需少数几次治疗就能实现额外清除，且副作用发生率较低。
