Management of Residual Red Pigment After Q-Switched Laser Treatment of Eyebrow

Patient description

35 years old F skin type III/IV

Case description

The patient underwent eyebrow tattooing performed by an amateur artist. We initiated tattoo removal using a Q-switched laser (Rohrer Spectrum).

First treatment session:

• Timing: ~6 weeks ago

• Laser: Q-switched (Rohrer Spectrum)

• Spot size: 4 mm

• Energy: 200 mJ

• Passes: 1 pass

Immediate frosting was observed with this setting, indicating a good acute tissue response.

Follow-up:
The second image was taken at 6 weeks post-treatment. At this visit, the remaining pigment appears lighter and has shifted toward a reddish hue.

Current plan:
I recommended waiting an additional 4 weeks before further treatment and reassessing at that time.

Questions for Discussion

1. What changes should be expected over the next 4 weeks in terms of pigment evolution or clearance?

2. Given the current red coloration of the residual ink, would you recommend switching to a 532 nm wavelength at the next session, or repeating treatment with the original Q-switched settings?

3. If treating again, would you adjust the fluence or spot size compared to the initial session, and if so, how?

4. Are there any additional precautions or timing considerations specific to eyebrow tattoos or amateur pigment formulations in this scenario?