Using the Cold-Plasma Coagulator to remove tattoos.
Avramenko K. C.
The Cold-Plasma Coagulator (CPC) acts in this case as a complete analog of laser. That is why it is possible both to remove tattoos with the CPC and to polish keloid and wound cicatrices.
Tattoo is a drawing made with ink which is brought under skin at various depths. Therefore if one wants to remove a tattoo one has to take off a layer of skin above ink as well as a layer of skin with ink itself.
Usually removal of tattoos is made mechanically due to cutting off and polishing skin with special cutters or conchotomes. Sometimes a laser is used to cauterize the chosen layer of skin.
When tattoos are removed mechanically it is generally impossible to avoid multiple cicatrices remaining. They make appearance of the treated spot significantly worse.
Scars become much less visible when they are cauterized with lasers in comparison with mechanical treatment. Still even treated with laser the cicatrices remain bigger than in cases when tattoos are removed with CPC.
The reason is that skin gets much more energy from lasers than from CPCs. This is also the reason why thermal injury of skin and tissues underneath is much more serious, regeneration is longer, cicatrices of burns are more visible when tattoos are treated with lasers in contradistinction with the CPC treatment.
As it was mentioned in the previous article the CPC treatment of biological tissues helps 'take off' or cauterize layers of tissue 0.1 mm deep one by one. No injury of layers underneath takes place in this case.
The way to use the CPC for such a removal is very simple.
First novocaine (lidocaine) blockade of the removed part of tattoo is made with hypodermic and intradermic injections.
Then subject to the depth of location of the tattoo under skin the operator makes the CPC work in the mode '1' (green light) or in the mode '2' (red light). Layers of skin above the tattoo are cauterized first; the layer of skin with goes second.
The CPC treatment should be done with small 'strokes' not longer than 2-3 mm. The small plasma torch or 'small brush' generated at the very end of handpiece should be led from the beginning of the 'stroke' to its end and then backwards. It is necessary to spend not more than 2-3 seconds on average for every 'stroke'.
Observing edges of the 'stroke' contiguous to the tattoo's part which is not yet removed the operator can decide whether the depth of 'stroke' is sufficient or not, i.e. whether he reached the layer with ink or not. If this layer is not reached it is necessary to keep on removing skin layers.
Usually tattoos are located at the depth 0.2-0.7 mm. Tattoos of poor quality made in prisons are used to be the deepest. Tattoos made in beauty parlors usually are located at a small depth under skin and can be removed easier.
It is impossible to know in advance how deep the layer with ink is located under skin. Visually monitoring the border between cauterized 'stroke' and tattoo's part still to be removed the operator can always decide whether the layer with ink is already removed or not.
Tattoos can be also removed with periodical bringing the CPC handpiece nearer to the treated spot and moving it away 1-2 times per second on average. The discharge will appear and disappear with the same frequency.
The '1' mode (less powerful, green light is on) should be considered the best. It takes much more time to use this mode for removal of tattoos in comparison with the '2' mode (more powerful, red light is on) but there will be no scars at all. Mode '2' is also good but some insignificant scars might remain.
17 different tattoos or their parts (mostly deep) were removed with the help of CPC. Their square was between 2 mm2 and 2700 mm2.
The patients were observed during period which varied between 7 days and 1.5 years.
Slightly carbonized dry scabs very similar to burns of the 4th degree were observed on spots of CPC treatment during 3-6 days after operations.
It is expedient to prevent the scab from contact with moisture. Keeping the scab dry helps heal it sooner. It might seem strange but usage of regenerating ointments results in bigger and more visible scars in comparison with absence of any treatment at all.
The reason is that ions of metal getting to the wound from the needle of handpiece change electric potential in the wound for a long time and stimulate regeneration. Use of medicines makes this process less efficient.
It is forbidden to tear the scab off because it can result in worse appearance of the wound. The scab drops off 4-8 days after the treatment. This period depends on tattoo's depth as well as on regeneration ability of client's organism. If some people have poor immunity they should be recommended to take light antibiotics or sulphanilamides. Scars are visible during 1-1.5 months but they resolve almost completely within 4-5 months.
However scars might look lighter in comparison with skin around them during one year. So the patient is recommended to get tan on spots of skin with removed tattoo (if it is possible).
If the above-mentioned method is followed correctly it will be impossible to find scars one year after.
We hope that this method will be useful for your practice.