PRIME Journal Vol. 11 Issue 4

58 September/October 2021 | T he CURAS ILOODA Q-Switched laser device is safe and effective for tattoo removal. The purpose of this study was to evaluate the new Q-Switched CuRAS ilooda laser in the treatment of tattoos. Wavelength was chosen according to the colour of the ink: 1064nm was chosen in case of dark ink, 532nm for red and yellow ink, and ‘dye’ handpieces for blue, green, purple and resistant colour ink. Parameters were adapted to the end point that consisted of bleaching the ink without ulceration in the first sessions, or erythema/oedema in later sessions. The healing protocol was made using Cicabio pomade (Bioderma, France) under dressing until total recovery. Minimal spot size (2 to 4mm) were chosen with 5 to 10Hz frequency for treatment. Sessions were spaced 2 months apart. All patients paid the standard price for their treatment. In some case, Fraxis Co 2 fractional laser (ilooda) was added in order to improve efficacy and limit side effects. Parameters were 500 to 1000ms, 30W, 0.6 to 0.7mm spacing. CuRAS Q-Switched laser efficacy and safety in tattoo removal is higher andmore superior than older generation Q-Switched lasers PROMOTION TATTOO REMOVAL WITH SHORT- NANOSECOND Q-SWITCHED CURAS ILOODA LASER IN ‘REAL LIFE’ CONDITIONS Figure 1 (A) Before and (B) after treatment with ilooda CuRAS Results 19 patients were included, 3 amateurs, 16 professionals. 3/19 were coloured tattoos. Fluence ranged from 3 to 8J/cm². Mean number of sessions to obtain more than 90% improvement was 6 (from 2 to 10 sessions). Satisfaction rate was very high 3.5/4. No resistance was reported from patients that remained until the end of treatment. No side effect was reported except one transient hypochromia on a phototype VI patient. Discussion Our study shows that more than 90% improvement of the tattoo could be obtained in 6 sessions on average without major side effect. On the contrary to other laser procedure that implicate endogenous target, tattoo removal implicate exogenous target. Q-Switched lasers target ink in the tissue in order to destroy pigment in a photoacoustic way. The number of sessions was variable from one patient to another depending on the quality, quantity, deepness, surface, and colour of the ink. Efficacy and safety of CuRAS laser in tattoo removal is higher in our study than in previous studies that implicates old generation’s Q-Switched lasers. This could be due to protocol, quality of laser, especially short nanosecond pulse duration, and adjunction of CO 2 fractional laser. Our protocol aims to treat the patients very safely, using the smallest spot size and lowest energy to have end point in order to avoid scars, especially in the first sessions. Indeed, high parameters are useless and could cause side-effect in early sessions because of hard explosion of high-density ink that may cause scar. Spacing sessions at least 2 months is important to respect healing process and ink elimination. ilooda CuRAS use short- nanosecond pulse duration that allows better efficacy on small ink particles and less thermal effect on surrounding tissues. The spectrum of pulse duration in Q-Switched laser is very large, from 70ns to 350ps, depending of the device technology. Shorter pulse duration targets smallest ink particles in order to have better efficacy. So called ‘picosecond’ lasers, that have shortest pulse duration, studies failed to prove better efficacy than ‘nanosecond’ laser probably because of a lack of energy in spot emission. Short nanosecond Q-Switched laser like CuRAS ilooda is the best compromise because it allows high energy spot emission, higher than most ‘picosecond’ laser and short pulse duration, shorter than old generation Q-Switched devices. Our criteria of success was higher than in other studies with 90% success rate instead of 70% usually adopted.  Findoutmore at: MICHAEL NAOURI, MD , Centre Laser du Grand Paris (Nogent sur Marne), Hôpital Universitaire St Louis (Paris)