Original Article

Journal of Investigative Dermatology (1991) 97, 131–136; doi:10.1111/1523-1747.ep12478570

Light and Electron Microscopic Analysis of Tattoos Treated by Q-Switched Ruby Laser

Charles R Taylor, R Rox Anderson, R William Gange, Norman A Michaud and Thomas J Flotte

Wellman Laboratories of Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.

Received 26 April 1990; Accepted 26 February 1991.

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Abstract

Short-pulse laser exposures can be used to alter pigmented structures in tissue by selective photothermolysis. Potential mechanisms of human tattoo pigment lightening with Q-switched ruby laser were explored by light and electron microscopy. Significant variation existed between and within tattoos. Electron microscopy of untreated tattoos revealed membrane-bound pigment granules, predominantly within fibroblasts and macrophages, and occasionally in mast cells. These granules contained pigment particles ranging from 2-in diameter. Immediately after exposure, dose-related injury was observed in cells containing pigment. Some pigment particles were smaller and lamellated. At fluences greater than or equal to 3 J/cm2, dermal vacuoles and homogenization of collagen bundles immediately adjacent to extracellular pigment were occasionally observed. A brisk neutrophilic infiltrate was apparent by 24 h. Eleven days later, the pigment was again intracellular. Half of the biopsies at 150 d revealed a mild persistent lymphocytic infiltrate. There was no fibrosis except for one case of clinical scarring. These findings confirm that short-pulse radiation can be used to selectively disrupt cells containing tattoo pigments. The physical alteration of pigment granules, redistribution, and elimination appear to account for clinical lightening of the tattoos.

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