MAY-JUN 2014

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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ERASING THE PAST "Tattoos are not only permanent, they can't be edited or changed," says Jeffrey Dover, MD, a dermatologist at Skincare Physicians in Chestnut Hills, Massachusetts. "Some people have day-after-tattoo regret, meaning that maybe they drank too much at a bachelor party and woke up with a serpent on their ankle, but in truth, those 'mistakes' are few and far between." Most common are people, who are now in their late 20s, 30s and 40s, eager to get rid of any signs of past indiscretions as they embark on their future careers. Mitchell Chasin, MD, medical director of Refl ec- tions Center for Skin & Body, Livingston, New Jersey, has also noticed that tattoo removal clients are getting younger and younger. "Apparently people aren't wait- ing until they settle down to do something about that tattoo they regret," he says. "We're also seeing more tattoos that can't be concealed with clothing. We used to see them mostly on the shoulders and ankles and the lower back, places where the person could choose who saw their tattoos. But now we see art creeping down the sleeves and up the neck, displayed in places where it can't be hidden. Unfortunately, tattoos are a lot like fashion in that certain looks come into and go out of vogue. But, unlike trendy clothes, tattoos can't be hidden away in the closet when they're no longer in style." Another group of patients come from the armed forces and law enforcement. Dr. Chasin has seen a growing demand for tattoo removal among people who are trying to get their ink into compliance with military regulation. "We also see young men and women who have decided to pursue a career in law enforcement, but have tattoos that might keep them from making the grade," he says. TATTOO REMOVAL 101 In the past, tattoo removal procedures were painful and yielded mixed results. Options included salabra- sion (where salt is rubbed on the tattoo until it bleeds), dermabrasion using a diamond burr, serial excision to remove the tattoo with surgery, and use of an ablative CO 2 laser. Today, tattoo removal has improved to meet rising patient demand. "Laser tattoo removal has experienced unparalleled growth, following the explosion among those acquiring tattoos," says Philadelphia-based derma- tologist Eric Bernstein, MD. To treat the widest range of ink colors and skin types, laser surgeons are employing a variety of devices with multiple wavelengths. Dr. Bernstein explains that there are three main types of lasers used for removing tat- toos: alexandrite, Ruby and Nd:YAG lasers, and all are Q-switched or very short pulse-duration lasers. "The pulse duration of a laser is matched to the size of the particle being treated, and tattoo particles are micro- scopic—but aggregated in cutaneous macrophages into somewhat larger particles—and thus require very short pulses—nanosecond pulses—for removal without scar- ring," he explains. Although each physician will have his or her own preferences, there are some devices that are mainstays in practices that offer laser tattoo removal. The benefi t of these devices is that they offer versatility to treat many different dermatologic concerns. "The AlexTrivan- tage (Syneron/Candela, consists of a Q-switched alexandrite laser for treating pigmented lesions and tattoos, with a novel laser-pumped-laser 42 MAY/JUNE 2014 | Med Esthetics Laser tattoo removal requires the use of mutiple wavelengths to clear different ink colors. BSIP / PHOTO RESEARCHERS, INC. E r a s i n g t h e P a s t M E D 5 - 6 1 4 . i n d d 4 2 Erasing the Past MED5-614.indd 42 4 / 1 6 / 1 4 4 : 4 4 P M 4/16/14 4:44 PM

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