Q-Switched 1064-nm Laser Versus Picosecond 1064-nm Laser in Tattoo Removal

BACKGROUNDLaser tattoo removal is becoming more popular, with the Q-switched (QS) 1064-nm nanosecond laser considered the traditional standard. While the picosecond (PS) 1064-nm laser offers an alternative for optimizing treatment protocols, comparative data regarding its relative efficacy remain limited and inconsistent.

AIMThis study aims to evaluate and compare the clinical efficacy and safety profiles of QS 1064-nm laser and PS 1064-nm laser for tattoo removal.

METHODSA retrospective analysis was conducted on 130 patients with tattoos between January 2015 and September 2024 in a hospital. Participants received either QS 1064-nm laser (n = 57) or PS 1064-nm laser (n = 73) therapy. Efficacy was measured utilizing a four-grade clearance scale (poor to excellent), and adverse effects were recorded.

RESULTSThe PS 1064-nm laser achieved significantly higher excellent clearance (78.1% vs. 54.4%, p = 0.029) and required fewer median sessions (3 vs. 4, p = 0.020). Although the overall effectiveness rate (> 50% clearance) was higher for the PS 1064-nm laser (94.52%) than for the QS 1064-nm laser (85.96%), this trend did not reach statistical significance (p = 0.094). After adjusting for baseline color imbalance (p = 0.061), a subgroup analysis of blue/black tattoos (n = 108) showed PS 1064-nm laser had significantly greater excellent clearance (80% vs. 55.8%, p = 0.007), with comparable overall effectiveness (93.9% vs. 88.4%, p = 0.314). Both treatments maintained excellent safety performance; reported side effects were limited to transient erythema/edema, with no severe complications reported.

CONCLUSIONThe PS 1064-nm laser showed comparable overall effectiveness to the QS 1064-nm laser, with advantages in excellent clearance and fewer sessions. Limitations include predominantly blue/black tattoos and a 3-month follow-up, necessitating prospective validation.

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