And Now … Disappearing Tattoo Ink

According to the American Academy of Dermatology, 24% of Americans have at least one tattoo, and as many as 17% of them would like to have them removed. Until now, removing tattoos made from traditional ink was a painful and incomplete process. However, a new ink technology allows tattoos to be removed with a single, standard laser treatment and helps ease the pain of individuals who have had a change of heart about their dermal artwork.

“The removable tattoo ink is a combination of dyes and an FDA-approved polymer,” says Tina S. Alster, MD, of the Washington (DC) Institute of Dermatologic Laser Surgery. “The polymer is a plastic that can’t be absorbed by the body, but the biodegradable dyes can. As long as the dyes are bound to the polymer, the ink is permanent—like regular tattoo ink. But with a single laser treatment, the bond to the polymer is destroyed. The tattoo disappears as the dyes break down and are absorbed by the body.”

The Freedom 2 (F2) ink, developed by Freedom-2 Inc in New York City, is a patented ink designed for safe and easy removal. The technology is the result of combined discoveries by R. Rox Anderson, MD, at Massachusetts General Hospital in Boston; and Craig A. Drill, Susanna Mlynarczyk-Evans, PhD, Bruce Klizman, PhD, and Kim Edward Koger, MD, FACS, of Duke University in Durham, NC.

The ink technology uses biodegradable and bioabsorbable dyes, such as cosmetic-grade iron oxide, encapsulated in a biocompatible polymer bead made of poly(methyl methacrylate) (PMMA). The microscopic PMMA beads compose the F2 ink. Tattoo artists use traditional methods to create an F2 tattoo.

Most conventional tattoos can be removed, but the process is often expensive, painful, and time-consuming. Multiple treatments are needed to avoid skin damage from the laser. During tattoo removal, brief pulses of energy are aimed at the tattoo, heating skin cells and breaking up the ink particles. The body’s natural ability to remove foreign particles clears the ink fragments. The top layer of the skin may bleed and form scabs. Because of the inflammation produced by the laser, only a small area of the skin can be treated at one time.

Conventional tattoo removal has additional complications. Physicians often do not know which type of ink was used and at what depth the ink was applied. It is important for physicians to warn their patients that scarring can occur if multiple treatments are needed, and that some tattoos cannot be completely removed.

An F2 tattoo is easily removed by a single, standard laser treatment that ruptures the PMMA beads, allowing the body to naturally expel the dye trapped inside. Because of the way the beads are constructed, they fall apart when laser energy is applied. Unpublished tests on humans and animals show that only one laser treatment is typically needed to fully remove an F2 tattoo, and that most Q-switched lasers that physicians use for tattoo removal can be used for the procedure.

According to the company, F2 ink is slightly more expensive than conventional ink. The company will sell only black ink initially, but will eventually add other colors. The ink will be available for retail sale by midyear.

This Laser Restores Hair

Lexington International LLC, Boca Raton, Fla, has received clearance from the FDA for its handheld laser device, called the Hairmax Lasercomb, that promotes hair growth. A 26-week clinical trial conducted by the company has found that the device increases the number of thick hairs on the scalp.

“I think that a fair comparison would be the effectiveness of the Lasercomb versus other forms of medical therapy such as minoxidil and finasteride,” says Bernard P. Nusbaum, MD, of Coral Gables, Fla. “Studies with a greater number of subjects and for a longer duration of treatment will have to be performed to effectively make this determination. Hair-restoration surgery remains the only modality that can restore hair to individuals with advanced baldness stages.”

According to the company, the Lasercomb, meant for home use, combines a low-level laser with a comb—as its name implies. When drawn through the hair, the laser strikes the scalp to promote hair growth. The comb works by placing it on a specific spot on the head and gently gliding it back 0.5 inch each time the audible four-second beep occurs. The user moves the device from the front of the hairline to the back of the head, then repeats the process, this time in the opposite direction. The company recommends that the comb be used three times per week, 10 to 15 minutes per treatment, for optimal results.

Nusbaum says that it is difficult to determine, in the long run, what effect any nonsurgical modality will have on the business of surgical hair restoration.

“At present, hair-restoration surgeons welcome any modality that may be effective in slowing down or stabilizing ongoing baldness, because maintaining the hairs which already exist around transplanted areas enhances the overall appearance of the transplants,” he says. “This makes our surgical patients look better and reflects positively on the field of hair-restoration surgery.”

Jeffrey S. Epstein, MD, FACS, of Miami and New York City, agrees that the Lasercomb may be a useful adjuvant therapy to hair restoration, and adds that it must be “promoted responsibly and accurately—otherwise, patients will develop unrealistic expectations, and thus mistrust any other treatments, including hair transplants.”