Hyperpigmentation depends on the kind of skin the patient has. Skin types IV, V and VI are more likely to suffer from this skin problem, irrespective of the wavelengths used in the laser procedure.
Applying a sunscreen with a high SPF and hydroquinone twice a day will help in resolving the problem of hyperpigmentation, within a period of a couple of months. In some patients, the recovery could take longer.
Transient changes in the skin’s texture might also occur as one of the side effects. Textural changes are noted very occasionally and are usually resolved within a span of a few months. Permanent changes in the skin’s texture will rarely be seen.
If you are going for this method and are highly likely to have pigment or skin texture changes, the treatment intervals should be longer.
Sometimes, a blister is noticed after the tattoo is removed. A blister or a crust is formed post tattoo removal on the area that is treated through radiation. Using Q-switched lasers could very rarely, lead to the development of a large bulla (a large blister). But if you follow precautionary measures, it might help in minimizing the chances of developing a bulla and other negative side effects.
It is strongly recommended NOT to manipulate with this skin change. If the blister is removed early, it may increase the chances of developing a scar. A patient with a medical history of hypertrophic scarring, needs to be warned of his increased chances of scarring. Steps like elevating, resting and applying intermittent icing post removal, will minimize the chances of a bulla. Here’s one thing to remember – make sure that your surgeon contemplates the use of a cooling device, during the entire procedure.
Other side effects reported are allergic reactions resulting due to Q-switched laser tattoo removal. Although very rare, when yellow cadmium sulfide is used to brighten up red ink or yellow ink of a tattoo, it may cause a photo allergic reaction.
The treatment of such an photo allergic side effect includes strict avoidance of direct exposure to sunlight, administration of an intralesional steroid injection and in some cases, surgical removal as well! Sometimes, oral antihistamines and anti-inflammatory steroids can be used to treat the allergic reaction to the tattoo ink.
Although, tattoo removal by this procedure has been declared as a gold standard removal method and is very safe, there are certain complications that may occur during the procedure and although extremely rare, they include –
• Hypopigmentation: Chances of discoloration of the patient’s skin (hypopigmentation – white spots or hyperpigmentation – dark spots).
• Paradoxical Darkening: There are extremely narrow chances of paradoxical darkening, in which the tattoo gets darker instead of getting lighter.
• Presence of Toxins: Sometimes, in a tattoo design, few color pigments like yellow #7, are known to break down into toxic and poisonous chemicals in the body on exposure to light. The chances of this occurrence is more, if these tattoos are exposed to UV light or laser removal, which might result in degradation of the products and these toxic substances may migrate to the patient’s kidneys and liver.
• Tissue Damage: Q-switched laser method for tattoo removal can rupture your blood vessels, though a rare occurrence. It may also rupture aerosolized tissue, that requires a plastic shield or a conic device, so as to protect the laser operator from coming in contact with the blood and tissue.
An ugly tattoo is better than a large layer of pigmented or allergic skin. So, do a thorough research if you are planning to get your tattoo removed, and consult a certified surgeon who is experienced in tattoo removal.