BACKGROUND AND OBJECTIVE: Pigment fanning or spread is one complication of decorative tattooing, but is also seen after traumatic tattoos. The reason for this spreading remains unclear. While excision of the diffused pigment was previously considered the treatment of choice, today destruction of the pigment with Q-switched laser systems is the therapy with the highest efficiency and lowest rate of side effects. Therefore areas of pigment spread should be excised only in rare exceptional cases. PATIENTS/ METHODS: 4 patients with pigment fanning after permanent make up and traumatic tattooing of the periorbital region were treated with the Q-switched ruby (694 nm) and Q-switched Nd:YAG (1064 nm) lasers. RESULTS: All patients showed a significant (70-80%) clearance of the spread pigment; two had complete clearing. Side effects such as hyper- or hypopigmentation, scarring or ink darkening were not seen. CONCLUSIONS: The Q-switched ruby- and Q-switched Nd:YAG-lasers are a therapeutic modality for pigment fanning with high efficiency and low rate of side effects. Attempts of explanation for pigment spread after tattoos are given, but further histological and electron microscopical investigations are needed to find the pathogenetic mechanism.
BACKGROUND AND OBJECTIVE: Pigment fanning or spread is one complication of decorative tattooing, but is also seen after traumatic tattoos. The reason for this spreading remains unclear. While excision of the diffused pigment was previously considered the treatment of choice, today destruction of the pigment with Q-switched laser systems is the therapy with the highest efficiency and lowest rate of side effects. Therefore areas of pigment spread should be excised only in rare exceptional cases. PATIENTS/ METHODS: 4 patients with pigment fanning after permanent make up and traumatic tattooing of the periorbital region were treated with the Q-switched ruby (694 nm) and Q-switched Nd:YAG (1064 nm) lasers. RESULTS: All patients showed a significant (70-80%) clearance of the spread pigment; two had complete clearing. Side effects such as hyper- or hypopigmentation, scarring or ink darkening were not seen. CONCLUSIONS: The Q-switched ruby- and Q-switched Nd:YAG-lasers are a therapeutic modality for pigment fanning with high efficiency and low rate of side effects. Attempts of explanation for pigment spread after tattoos are given, but further histological and electron microscopical investigations are needed to find the pathogenetic mechanism.