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Lasers for the treatment of eyebrow microblading and cosmetic tattoo pigment: a review of the literature

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Abstract

We aim to discuss the use of laser for the treatment of eyebrow microblading and cosmetic tattoo complications through a review of the literature. Our research question is whether quality-switched or picosecond laser is superior for the removal of eyebrow tattoos. This structured review was conducted using a PubMed search using the search terms “laser tattoo removal” AND “cosmetic tattoo” AND “eyebrow” with the article type filtered to “case reports,” “clinical trial,” and “randomized controlled trial” ranging from dates 1994–2023. All case reports or series evaluating the effect of laser on eyebrow cosmetic tattooing pigment were included. We summarize the results of 11 studies evaluating the use of laser for cosmetic tattoo removal, with 129 patients treated specifically for eyebrow pigment. Most studies (8/11) report Fitzpatrick skin type or race. Seven studies utilize quality-switched (QS) neodymium-doped yttrium aluminum garnet (Nd:YAG), alexandrite or ruby, three used picosecond (PS) Nd:YAG or alexandrite, and three used carbon dioxide (CO2) laser. We report laser energy, spot size, and pulse duration, as well as treatment outcomes and adverse events. Historically, methods of pigment removal included dermabrasion, cryosurgery, electrosurgery, radiofrequency, infrared light, intense pulsed light, and surgical excision; however, these methods often led to poor cosmetic outcomes including scarring and further dyspigmentation. QS laser treatments provided superior cosmetic outcomes and thus were considered the gold standard treatment option for pigment removal. However, the advent of PS lasers has challenged this given their increased selectivity, lower fluence requirements, and reduction in surrounding thermal damage. Our review demonstrates that PS Nd:YAG is quicker and more effective that QS Nd:YAG in the treatment of eyebrow tattoos. Additionally, the paradoxical darkening seen with QS lasers is less common with PS lasers. We also demonstrate that CO2 laser may be a helpful adjunct to QS or PS laser. This review focuses on Fitzpatrick skin type and race, providing a unique perspective on the use of laser treatment in skin of color, which often poses an additional treatment challenge.

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References

  1. Marwah MK, Kerure AS, Marwah GS (2021) Microblading and the science behind it. Indian Dermatol Online J 12(1):6–11. https://doi.org/10.4103/idoj.IDOJ_230_20

    Article  PubMed  PubMed Central  Google Scholar 

  2. Spurr A, Hanna N, Colantonio S (2022) Cutaneous sarcoidosis in eyebrows cosmetically pigmented with microblading method: a case report and review of the literature. SAGE Open Med Case Rep 10:2050313x221117720

  3. Sano E, Truong J, Chenevert L (2021) Bilateral periorbital cellulitis after eyebrow microblading. Visual J Emerg Med 25:101172. https://doi.org/10.1016/j.visj.2021.101172

    Article  Google Scholar 

  4. Haney B (2020) Permanent and semi-permanent micro-pigment treatments. In: Aesthetic Procedures: Nurse Practitioner's Guide to Cosmetic Dermatology. Springer, Cham, p 59–66. https://doi.org/10.1007/978-3-030-19948-7_7

  5. Ortiz AE, Alster TS (2012) Rising concern over cosmetic tattoos. Dermatol Surg 38(3):424–429. https://doi.org/10.1111/j.1524-4725.2011.02202.x

    Article  CAS  PubMed  Google Scholar 

  6. Garg G, Thami GP (2005) Micropigmentation: tattooing for medical purposes. Dermatol Surg 31(8 Pt 1):928–31; discussion 931

  7. Rassman WR, Pak JP, Kim J (2013) Scalp micropigmentation: a useful treatment for hair loss. Facial Plast Surg Clin North Am 21(3):497–503. https://doi.org/10.1016/j.fsc.2013.05.010

    Article  PubMed  Google Scholar 

  8. Rassman WR, Pak JP, Kim J, Estrin NF (2015) Scalp micropigmentation: a concealer for hair and scalp deformities. J Clin Aesthet Dermatol 8(3):35–42

    PubMed  PubMed Central  Google Scholar 

  9. Seyhan T, Kapi E (2021) Scalp micropigmentation procedure: a useful procedure for hair restoration. J Craniofac Surg 32(3):1049–1053. https://doi.org/10.1097/scs.0000000000007208

    Article  PubMed  Google Scholar 

  10. Park JH, Moh JS, Lee SY, You SH (2014) Micropigmentation: camouflaging scalp alopecia and scars in Korean patients. Aesthetic Plast Surg 38(1):199–204. https://doi.org/10.1007/s00266-013-0259-1

    Article  PubMed  Google Scholar 

  11. Francis A, Criton S, Shojan A, Philip R (2013) Micropigmentation in vitiligo of lateral lower lip. J Cutan Aesthet Surg 6(4):236–237. https://doi.org/10.4103/0974-2077.123416

    Article  PubMed  PubMed Central  Google Scholar 

  12. Singh AK, Karki D (2010) Micropigmentation: tattooing for the treatment of lip vitiligo. J Plast Reconstr Aesthet Surg 63(6):988–991. https://doi.org/10.1016/j.bjps.2009.03.013

    Article  PubMed  Google Scholar 

  13. Sharma A, Agrawal S, Dhurat R, Mhatre M, Surve R, Kerure A (2020) Micropigmentation-a revived therapeutic tool for recalcitrant, difficult-to-treat periungual vitiligo. Dermatol Ther 33(4):e13568. https://doi.org/10.1111/dth.13568

    Article  PubMed  Google Scholar 

  14. Starnoni M, Pinelli M, Franceschini G, De Santis G (2019) A rare case of nipple-areolar complex partial necrosis following micropigmentation: what to learn? Plast Reconstr Surg Glob Open 7(11):e2494. https://doi.org/10.1097/gox.0000000000002494

  15. Brown M, Turgeon L, Bojovic B (2020) 853 microblading in patients with facial burn injuries. J Burn Care Res 41(Supplement_1):S264–S265. https://doi.org/10.1093/jbcr/iraa024.421

  16. Brown M, Turgeon L, Bojovic B (2022) 787 two year follow up of microblading in patients with a facial burn injury. J Burn Care Res 43(Supplement_1):S200–S200. https://doi.org/10.1093/jbcr/irac012.338

  17. Leight-Dunn H, Lemly V, Chapas A (2022) Delayed granulomatous reaction after eyebrow microblading. Dermatol Surg 48(1):142–143. https://doi.org/10.1097/dss.0000000000003236

    Article  CAS  PubMed  Google Scholar 

  18. Tierney E, Kavanagh GM (2021) Koebnerization secondary to microblading. J Cosmet Dermatol 20(4):1040–1041. https://doi.org/10.1111/jocd.13695

    Article  PubMed  Google Scholar 

  19. Wetzel CL (2012) Permanent cosmetics. Plast Surg Nurs Jul-Aug 32(3):117–119. https://doi.org/10.1097/PSN.0b013e31826929c6

    Article  Google Scholar 

  20. Carney MJ, Weissler JM, Sauler M, Serletti JM (2017) Looking beyond the knife: establishing a framework for micropigmentation following breast reconstruction. Plast Reconstr Surg 140(1):243e–244e. https://doi.org/10.1097/prs.0000000000003466

    Article  CAS  PubMed  Google Scholar 

  21. Motoki THC, Isoldi FC, Ferreira LM (2020) Pathologic scarring after eyebrow micropigmentation: a case report and systematic review. Adv Skin Wound Care 33(10):1–4. https://doi.org/10.1097/01.Asw.0000672496.83825.75

    Article  PubMed  Google Scholar 

  22. Hartman N, Loyal J, Borsack S, Goldman MP, Boen M (2023) Retrospective review of the laser removal of facial cosmetic tattoos. Dermatol Surg 49(6):559–565. https://doi.org/10.1097/DSS.0000000000003766

    Article  CAS  PubMed  Google Scholar 

  23. Lahouel I, Salah NB, Machghoul S, Belhadjali H, Youssef M, Zili J (2022) Allergic contact dermatitis post-microblading eyebrow tattooing: a manifestation of pre-existing nickel sensitization. J Cosmet Dermatol 21(10):5270–5271. https://doi.org/10.1111/jocd.14920

    Article  PubMed  Google Scholar 

  24. Jimenez G, Weiss E, Spencer JM (2002) Multiple color changes following laser therapy of cosmetic tattoos. Dermatol Surg 28(2):177–179. https://doi.org/10.1046/j.1524-4725.2002.00161.x

    Article  PubMed  Google Scholar 

  25. Lee CN, Bae EY, Park JG, Lim SH (2009) Permanent makeup removal using Q-switched Nd:YAG laser. Clin Exp Dermatol 34(8):e594–e596. https://doi.org/10.1111/j.1365-2230.2009.03268.x

    Article  CAS  PubMed  Google Scholar 

  26. Fitzpatrick RE, Goldman MP, Dierickx C (1994) Laser ablation of facial cosmetic tattoos. Aesthetic Plast Surg Winter 18(1):91–98. https://doi.org/10.1007/bf00444255

    Article  CAS  Google Scholar 

  27. Moreno-Arias GA, Camps-Fresneda A (1999) Use of the Q-switched alexandrite laser (755 nm, 100 nsec) for eyebrow tattoo removal. Lasers Surg Med 25(2):123–125. https://doi.org/10.1002/(sici)1096-9101(1999)25:2%3c123::aid-lsm4%3e3.0.co;2-9

    Article  CAS  PubMed  Google Scholar 

  28. Moustafa F, Suggs A, Hamill SS, Friedman PM (2020) Successful treatment of cosmetic eyebrow tattoos in Fitzpatrick III-IV with picosecond (1,064, 532-nm) neodymium-doped yttrium aluminum garnet laser with a perfluorodecalin-infused patch: a pilot study. Lasers Surg Med 52(7):586–589. https://doi.org/10.1002/lsm.23189

    Article  PubMed  Google Scholar 

  29. Radmanesh M, Rafiei Z (2015) Combination of CO2 and Q-switched Nd:YAG lasers is more effective than Q-switched Nd:YAG laser alone for eyebrow tattoo removal. J Cosmet Laser Ther 17(2):65–68. https://doi.org/10.3109/14764172.2014.988724

    Article  PubMed  Google Scholar 

  30. Goldman A, Wollina U (2014) Severe unexpected adverse effects after permanent eye makeup and their management by Q-switched Nd:YAG laser. Clin Interv Aging 9:1305–1309. https://doi.org/10.2147/cia.S67167

    Article  PubMed  PubMed Central  Google Scholar 

  31. McIlwee BE, Alster TS (2018) Treatment of cosmetic tattoos: a review and case analysis. Dermatol Surg 44(12):1565–1570. https://doi.org/10.1097/dss.0000000000001572

    Article  CAS  PubMed  Google Scholar 

  32. Menozzi-Smarrito C, Smarrito S (2023) Laser removal of cosmetic eyebrow tattoos with a picosecond laser. Dermato 3(3):182–192

    Article  Google Scholar 

  33. Cannarozzo G, Negosanti F, Sannino M et al (2019) Q-switched Nd:YAG laser for cosmetic tattoo removal. Dermatol Ther 32(5):e13042. https://doi.org/10.1111/dth.13042

    Article  PubMed  Google Scholar 

  34. Feng H, Christman MP, Muzumdar S, Geronemus RG (2020) Successful treatment of cosmetic oral mucosal tattoos using QS 694-nm ruby laser and 755-nm alexandrite picosecond laser. Lasers Surg Med 52(8):705–707. https://doi.org/10.1002/lsm.23207

    Article  PubMed  Google Scholar 

  35. Dash G, Patil A, Kassir M et al (2022) Non-laser treatment for tattoo removal. J Cosmet Dermatol. https://doi.org/10.1111/jocd.14819

  36. Fitzpatrick RE, Lupton JR (2000) Successful treatment of treatment-resistant laser-induced pigment darkening of a cosmetic tattoo. Lasers Surg Med 27(4):358–361. https://doi.org/10.1002/1096-9101(2000)27:4%3c358::aid-lsm9%3e3.0.co;2-0

    Article  CAS  PubMed  Google Scholar 

  37. Han Y, Kim S, Woo YR, Cho SH, Lee JD, Kim HS (2022) Permanent leukotrichia after picosecond laser treatment for tattoo removal. J Cosmet Dermatol. https://doi.org/10.1111/jocd.15372

  38. Wu DC (2020) Successful treatment of scalp micropigmentation with 1064 nm picosecond Nd:YAG laser. Lasers Surg Med. https://doi.org/10.1002/lsm.23364

  39. Seitz AT, Grunewald S, Wagner JA, Simon JC, Paasch U (2014) Fractional CO2 laser is as effective as Q-switched ruby laser for the initial treatment of a traumatic tattoo. J Cosmet Laser Ther 16(6):303–305. https://doi.org/10.3109/14764172.2014.956669

    Article  PubMed  Google Scholar 

  40. Vanarase M, Gautam RK, Arora P, Bajaj S, Meena N, Khurana A (2017) Comparison of Q-switched Nd:YAG laser alone versus its combination with ultrapulse CO(2) laser for the treatment of black tattoo. J Cosmet Laser Ther 19(5):259–265. https://doi.org/10.1080/14764172.2017.1314506

    Article  PubMed  Google Scholar 

  41. Leu FJ, Huang CL, Sue YM, Lee SC, Wang CC (2015) Effects of tattoo ink’s absorption spectra and particle size on cosmetic tattoo treatment efficacy using Q-switched Nd:YAG laser. Lasers Med Sci 30(1):303–309. https://doi.org/10.1007/s10103-014-1657-6

    Article  PubMed  Google Scholar 

  42. Suchin KR, Greenbaum SS (2004) Successful treatment of a cosmetic tattoo using a combination of lasers. Dermatol Surg 30(1):105–107. https://doi.org/10.1111/j.1524-4725.2004.30024.x

    Article  PubMed  Google Scholar 

  43. Chang SE, Kim KJ, Choi JH, Sung KJ, Moon KC, Koh JK (2002) Areolar cosmetic tattoo ink darkening: a complication of Q-switched alexandrite laser treatment. Dermatol Surg 28(1):95–96. https://doi.org/10.1046/j.1524-4725.2002.01118.x

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Dermatology, Emory University, 1525 Clifton Road NE, 3rd Floor, Atlanta, GA, 30322, USA

    Amaris N. Geisler

  2. Skin Care Physicians, Boston, MA, USA

    Ariel Eber, Karen Kim & Kenneth A. Arndt

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  1. Amaris N. Geisler
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  2. Ariel Eber
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AG, AE, KK, and KA contributed to the design and implementation of the research. AG was responsible for data collection and writing the manuscript. AE, KK, and KA were responsible for the revisions of and supervision of the manuscript.

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Correspondence to Amaris N. Geisler.

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Geisler, A.N., Eber, A., Kim, K. et al. Lasers for the treatment of eyebrow microblading and cosmetic tattoo pigment: a review of the literature. Lasers Med Sci 38, 256 (2023). https://doi.org/10.1007/s10103-023-03921-z

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