{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T15:38:59Z","timestamp":1781797139981,"version":"3.54.5"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2008,2,27]],"date-time":"2008-02-27T00:00:00Z","timestamp":1204070400000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2008,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Multiple treatments of resistant tattoos often result in fibrosis and visible textural changes that lessen response to subsequent treatments. The aim of this study is to evaluate the influence of beam profile and spot size on clearance rates and side effects in the setting of resistant tattoos.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design\/Material and Methods<\/jats:title><jats:p>Thirty\u2010six professional, black tattoos (32 patients) were treated unsuccessfully with a Q\u2010switched Nd:YAG laser (MedLite\u2122 C3, HoyaConBio Inc., Fremont, CA). Because of therapy resistance all tattoos were re\u2010treated using a new generation Nd:YAG laser (MedLite\u2122 C6, HoyaConBio Inc.). Maximum energy fluence (<jats:italic>E<\/jats:italic>\n<jats:sub>max<\/jats:sub>), mean energy fluence, mean spot size, level of clearance, side effects and beam profile (irradiance distribution) of both laser systems were assessed and evaluated in a retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All tattoos were previously treated with the C3 laser at 1,064 nm using a mean <jats:italic>E<\/jats:italic><jats:sub>max<\/jats:sub> of 5.8\u00b10.8 J\/cm<jats:sup>2<\/jats:sup> (range 3.8\u20137.5 J\/cm<jats:sup>2<\/jats:sup>) as compared with a mean <jats:italic>E<\/jats:italic><jats:sub>max<\/jats:sub> of 6.4\u00b11.6 J\/cm<jats:sup>2<\/jats:sup> (range 3.2\u20139.0 J\/cm<jats:sup>2<\/jats:sup>) during the C6 treatment course. Corresponding spot sizes were larger during C6 treatments as compared with C3 (5.0\u00b10.9 and 3.6\u00b10.2 mm, respectively). The C6 laser had a \u201cflat top\u201d and homogenous profile regardless of the spot size. For the C3 laser the beam shape was \u201cGaussian,\u201d and the homogeneity was reduced by numerous micro\u2010spikes and micro\u2010nadirs.<\/jats:p><jats:p>After the C6 treatment course 33.3% of the tattoos showed clearance of grade 1 (0\u201325%), 16.7% of grade 2 (26\u201350%), 16.7% of grade 3 (51\u201375%), 30.5% of grade 4 (76\u201395%), 2.8% of grade 5 (96\u2013100%). The total rate of side effects due to C6 treatment was 8.3% in all tattoos (hyperpigmentation 5.6%, hypopigmentation 2.7%, textural changes\/scars 0%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This clinical study documents for the first time the impact of a 1,064\u2010nm Nd:YAG laser with a more homogenous beam profile and a larger spot size on the management of resistant tattoos. Only a few treatment sessions were necessary to achieve an additional clearance with a low rate of side effects. Lesers Surg. Med. 40:139\u2013145, 2008. \u00a9 2008 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.20605","type":"journal-article","created":{"date-parts":[[2008,2,27]],"date-time":"2008-02-27T16:16:49Z","timestamp":1204129009000},"page":"139-145","source":"Crossref","is-referenced-by-count":25,"title":["Treatment of resistant tattoos using a new generation Q\u2010switched Nd:YAG laser: Influence of beam profile and spot size on clearance success"],"prefix":"10.1002","volume":"40","author":[{"given":"Syrus","family":"Karsai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gudrun","family":"Pfirrmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Hammes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Raulin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,2,27]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.6836297"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12462144"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.20159"},{"key":"e_1_2_1_5_2","first-page":"53","article-title":"Effects of laser beam shapes on depths of penetration in dermatology","volume":"6191","author":"Saghafi S","year":"2006","journal-title":"Biophotonics New Ther Front"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001050050885"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2004.07.028"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1993.01680290043007"},{"key":"e_1_2_1_9_2","first-page":"291","article-title":"Tattoo removal with the Q\u2010switched ruby laser and the Q\u2010switched Nd:YAG laser: A comparative study","volume":"55","author":"Levine VJ","year":"1995","journal-title":"Cutis"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2006.32192.x"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1117\/12.469493"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.134.2.167"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(99)70444-5"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.10065"}],"container-title":["Lasers in Surgery and Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flsm.20605","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flsm.20605","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lsm.20605","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T04:14:59Z","timestamp":1700021699000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lsm.20605"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,2]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2008,2]]}},"alternative-id":["10.1002\/lsm.20605"],"URL":"https:\/\/doi.org\/10.1002\/lsm.20605","archive":["Portico"],"relation":{},"ISSN":["0196-8092","1096-9101"],"issn-type":[{"value":"0196-8092","type":"print"},{"value":"1096-9101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,2]]}}}