Pico laser tattoo removal vs Q-switched laser
| Pico laser | Q-switched laser |
|---|
| Pulse duration | Picoseconds | Nanoseconds |
| Black ink | Effective, with limited evidence of faster clearance1 | Effective, the established standard2 |
| Blue, green and yellow ink | Clears more effectively than Q-switched2 | Less effective2 |
| Multicolour tattoos in Asian skin | More effective, with the 532 nm wavelength clearing red and green ink best3 | Less effective3 |
| Post-inflammatory hyperpigmentation in Asian skin | 22 to 24% of tattoos3 | 27 to 35% of tattoos3 |
| Eyebrow (cosmetic) tattoos | Faster clearance, less paradoxical darkening5 | Slower clearance, more paradoxical darkening5 |
A systematic review of 36 studies, including seven randomised controlled trials, found Q-switched laser safe and effective for black tattoos and picosecond lasers superior for blue, green and yellow pigment2. The clinic’s devices are described on the pico laser in Singapore and Q-switch laser in Singapore pages, and the pico laser vs Q-switched vs yellow laser guide compares the three lasers across pigment conditions.
How many tattoo removal sessions are needed?
The number of sessions depends on six factors, which the Kirby-Desai scale scores before treatment to estimate the length of the course4.
| Factor | Fewer sessions | More sessions |
|---|
| Skin type | Lighter | Darker (higher pigment risk, gentler settings) |
| Location | Head and neck | Hands, feet, ankles (slower lymphatic clearance) |
| Ink colours | Black only | Multiple colours, especially green and sky blue |
| Amount of ink | Amateur, sparse | Professional, dense |
| Scarring | None | Scarred or raised tattoo |
| Layering | Single tattoo | Cover-up over an older tattoo |
In the original chart review of 100 patients, the total score correlated with the number of sessions needed for satisfactory removal (r = 0.757), and all 100 patients reached that end point4. Sessions are usually spaced six to eight weeks apart, which gives macrophages time to clear the fragmented ink before the next treatment.
Eyebrow and eyeliner tattoo removal
Cosmetic tattoos, which include eyebrow embroidery, microblading, eyeliner and lip blush, often contain iron oxide or titanium dioxide pigments. The laser can convert these pigments to a darker form, so a brown or pink cosmetic tattoo may turn grey or black after the first session (paradoxical darkening). A review of 11 studies covering 129 patients treated for eyebrow pigment found that picosecond laser cleared the pigment faster and more effectively than Q-switched laser, and that paradoxical darkening was less common5. At the clinic, a test spot is treated and reviewed before the full cosmetic tattoo is treated, and eyeliner work is performed with protective shields placed under the eyelids.
Is tattoo removal safe for Asian skin?
Tattoo removal can be performed safely in Asian skin when the laser settings are matched to skin type. Asian skin carries a higher risk of post-inflammatory hyperpigmentation, a temporary darkening, and of hypopigmentation, a lightening of the treated skin. A prospective comparison of picosecond and nanosecond lasers in Asian patients with multicolour tattoos reported the following outcomes.
- No tattoo scarred, and lightening of the skin occurred only with the 532 nm wavelength, in about a quarter of tattoos3.
- Paradoxical darkening occurred in 5.4% of tattoos with each laser type3.
A recent tan raises the risk because melanocytes that are already active respond to laser by producing more pigment, so treated areas are protected from the sun before and after each session. The clinic’s guide to post inflammatory hyperpigmentation explains why dark marks can persist after any skin injury.
What is a tattoo blowout, and can laser treat it?
A tattoo blowout occurs when ink is placed too deeply or at too steep an angle and spreads beyond the intended lines, leaving a blurred halo. The stray ink sits in the same dermis as the tattoo, so the same laser can lighten the blurred edge. Lightening the blowout before a cover-up or touch-up gives the tattoo artist a cleaner outline to work over.
What happens during a tattoo removal session
- Assessment is carried out by Dr Rachel Ho, who records the ink colours, the age and depth of the tattoo, skin type, location and any scarring, and photographs the tattoo to track fading between sessions.
- A test spot is treated first for cosmetic tattoos and multicolour work, so that paradoxical darkening or an unexpected skin reaction appears on a small area before the full tattoo is treated.
- Treatment begins with topical anaesthetic cream and eye protection, followed by laser passes at wavelengths chosen for each ink colour. The skin turns white for a few minutes (frosting) as gas bubbles form in its upper layers, and the whitening fades without treatment.
- Aftercare covers the days in which redness, swelling and pinpoint bleeding settle. Blisters and crusts may form and are left intact, because picking them raises the risk of scarring and pigment change. Gentle cleansing, an occlusive ointment and sun protection continue until the skin has healed. The day-by-day course after pico treatment is set out in the guide to pico laser downtime and recovery.
Tattoo removal cost in Singapore
The cost of tattoo removal in Singapore depends on tattoo size, the number of colours, ink density and the number of sessions, which the Kirby-Desai factors above help to predict. A small black amateur tattoo on the upper arm usually needs fewer sessions than a large multicolour professional tattoo on the ankle, so the total cost differs widely between patients. The Skin Longevity Clinic provides a quote after consultation, once the tattoo has been assessed.
Other tattoo removal options
Surgical excision suits very small tattoos, because the wound can be closed directly and the ink is replaced by a fine linear scar. Ablative fractional laser, which creates microscopic channels in the skin, is sometimes combined with a pigment laser to reduce blistering6. Dermabrasion and chemical removal more often leave scarring and uneven pigment, and are not used at the clinic5,6.
