# Picosecond Q-Switched 1064/532 nm Laser in Tattoo Removal: Our Single Center Experience
## 3 Results  
In this retrospective study, 34 patients were included and analyzed: 17 females (50%) and 17 males (50%). The mean age was 43.6 \(\pm\) 11 years. Participants' skin ranged from Fitzpatrick type II to IV; in detail, 10 individuals (29.4%) were type II, 13 (38.2%) were type III, and 11 (32.4%) were type IV. Most tattoos were professionally tattoos (_n_ = 15, 44.1%) and intensely colored in dark, red, or mixed tonalities; amateur tattoos (_n_ = 9, 26.5%) formed another relevant subgroup, followed by cosmetic (_n_ = 4, 11.8%), traumatic (_n_ = 4, 11.8%), and medical tattoos (2, 5.9%). The location of the tattoos spread from the head to the extremities, with a slight prevalence in upper trunk/shoulder (_n_ = 9, 26.5%) and a homogeneous rate among the lower trunk/upper leg, lower arm/leg, and face/head sites (_n_= 8, 23.5% in each subgroup. Patients' characteristics are reported in Table 2.  
Performed sessions ranged from 1 to 7, with a mean of 3.3 \(\pm\) 2.0 required sessions (Table 3). No differences in the number of sessions were noted after considering Fitzpatrick phototypes, while some differences could be observed based on tattoo location or subgroup classes (Table 4): professional andmixed colors tattoos required an higher number of sessions, as lesions interesting the extremities, while cosmetic, medical and, in general, face tattoos could be removed in fewer sessions. All included patients had a dermatologist-evaluated tattoo removal rate of 60% or higher, i.e., a score of \(>\)3 (Table 3), while 4 out of 10 participants (41.2%) scored a complete (80-100%) removal rate. Figure 4: (**A**) Picture before starting tattoo removal treatment, and (**B**) the same region at the 6-month follow-up, after all tattoo removal sessions had been completed. Figure 5: (**A**) Picture before starting tattoo removal treatment, and (**B**) the same region at the 6-month follow-up, after all tattoo removal sessions had been completed. The best outcomes were observed among phototype III patients (score = 4 in 61.5%), while for patients in phototypes II and IV, only about one-third of cases (30% for phototype II and 27.3% for phototype IV) reached 80-100% tatto removal. Though there were limited cases, and a non-homogenous number of cases in different subgroups, the collected data allowed for some qualitative observations. Considering medical, traumatic, and cosmetic \begin{table}
\begin{tabular}{c c c c c} \hline \hline  & **Mean No. Sessions \(\pm\) SD** & **No. Sessions Range** & \
\begin{tabular}{c} **Tatto Removal Score 3** \\ **(60–80\%) [n \%]** \\ \end{tabular} &
\begin{tabular}{c} **Tatto Removal Score 4** \\ **(80–100\%) [n \%]** \\ \end{tabular} \\ \hline _Fitzpatrick phototype:_ & \(3.6\pm 2.0\) & 1–6 & 7 (70\%) & 3 (30\%) \\ III & \(3.0\pm 2.1\) & 1–7 & 5 (38.5\%) & 8 (61.5\%) \\ IV & \(3.4\pm 2.2\) & 1–7 & 8 (72.7\%) & 3 (27.3\%) \\ _Tatto Type:_ & & & & \\ Professional: & & & & \\ Dark tattoos & \(5.0\pm 0.8\) & 4–6 & 5 (71.4\%) & 2 (28.6\%) \\ Red tattoos & \(5.3\pm 0.8\) & 4-6 & 4 (66.7\%) & 2 (33.3\%) \\ Mixed-color tattoos & \(7.0\pm 0.0\) & 7 & 0 (0\%) & 2 (100\%) \\ Amateur & \(1.7\pm 0.5\) & 1–2 & 6 (66.7\%) & 3 (33.3\%) \\ Medical & \(1.5\pm 0.7\) & 1–2 & 1 (50\%) & 1 (50\%) \\ Traumatic & \(1.8\pm 0.5\) & 1–2 & 2 (50\%) & 2 (50\%) \\ Cosmetic & \(1.5\pm 0.6\) & 1–2 & 2 (50\%) & 2 (50\%) \\ _Tatto Location:_ & & & & \\ Face/head & \(1.6\pm 0.5\) & 1–2 & 4 (50\%) & 4 (50\%) \\ Upper trunk/shoulder & \(3.3\pm 1.7\) & 1–6 & 6 (66.7\%) & 3 (33.3\%) \\ Lower trunk/upper leg & \(4.9\pm 1.9\) & 2–7 & 5 (25.2\%) & 3 (37.5\%) \\ Lower arm/leg & \(3.5\pm 2.5\) & 1–7 & 4 (50\%) & 4 (50\%) \\ Wrist/hand/ankle/foot & \(2\) (\(n=1\)) & \(2\) (\(n=1\)) & 1 (100\%) & 0 (0\%) \\ \hline \hline \end{tabular}
\end{table} 
Table 4: Tattoo removal scores and clinical characteristics among different subgroups.