INTRODUCTION
Tattoos have been used throughout history as an expression of cultural identification and aesthetic adornment and as a mechanism of social bonding among various groups. Recent studies estimate a tattoo prevalence of up to 25% in the United States1 and higher among certain ethnic groups in South America, Africa, and Polynesia. Tattoos are created by the deposition of nanoparticles of pigment in the dermis. Professional tattoos are generally applied with a tattoo needling machine which deposits pigment in layers of the dermis. Amateur tattoos are less precise; they can be shallow and light, or very deep (beyond the dermis and into the fat layer).5 Tattoos can also be acquired through traumatic deposition of pigment from an abrasion, laceration, or explosive injury.
Tattoo removal is often a time-consuming and costly process. Prior to the advancement of various tattoo removal lasers, commonly utilized methods were excision, dermabrasion, salabrasion, ablative laser, and electrodesiccation. Many of these treatment modalities were frequently associated with incomplete tattoo removal and scarring, making them less desirable. Common day tattoo removal lasers include Q-switched lasers (Ruby, Nd:YAG, and Alexandrite) with nanosecond pulse durations and even faster picosecond lasers.7 Absorbed laser energy explodes pigment particles in the extracellular matrix and within membrane-bound organelles in macrophages, fibroblasts, and mast cells.6 This results in the breakup and release of tattoo pigment into the extracellular space where it is conveyed deeper into the body via lymphatic drainage.
In recent years, various components of tattoo inks, which are also found in other cosmetics, have come under scrutiny for their potential carcinogenic effects. In early 2022, the European Chemical Agency (ECHA) prohibited the use of over 4000 compounds found in tattoo inks due to insufficient safety data and ongoing questions about their carcinogenicity and impact on human health. Laser tattoo removal does not completely vaporize tattoo pigment, but rather destroys the compartments where it resides allowing the body to clear it through the lymphatic system and other immune mediators. Considering the unclear safety data of tattoo ink components, a tattoo removal method that disperses the pigment from the skin to the lymph nodes may not be ideal and underscores the need for alternative methods. In this manuscript, we aim to discuss we aim to discuss the Trans-Epidermal Pigment Release (TEPR) method (Tatt2Away by Rejuvatek Medical Inc., Salt Lake City, Utah), which utilizes superficial dermabrasion and dermal disruption to transepidermally eliminate tattoo pigment.
While tattoos can be regarded as a form of artistic and cultural expression, they have also been linked with substance use and impulsive behavioral tendencies.2 As the prevalence of tattoos continues to increase, so does the demand for tattoo removal. Recent survey studies in the United States have shown that nearly 1 in 4 individuals regret getting their tattoos.3 Other reasons for this increased demand for tattoo removal include new employment, changes in social circles, or changing attitudes regarding old tattoos.4
Tattoo removal is often a time-consuming and costly process. Prior to the advancement of various tattoo removal lasers, commonly utilized methods were excision, dermabrasion, salabrasion, ablative laser, and electrodesiccation. Many of these treatment modalities were frequently associated with incomplete tattoo removal and scarring, making them less desirable. Common day tattoo removal lasers include Q-switched lasers (Ruby, Nd:YAG, and Alexandrite) with nanosecond pulse durations and even faster picosecond lasers.7 Absorbed laser energy explodes pigment particles in the extracellular matrix and within membrane-bound organelles in macrophages, fibroblasts, and mast cells.6 This results in the breakup and release of tattoo pigment into the extracellular space where it is conveyed deeper into the body via lymphatic drainage.
In recent years, various components of tattoo inks, which are also found in other cosmetics, have come under scrutiny for their potential carcinogenic effects. In early 2022, the European Chemical Agency (ECHA) prohibited the use of over 4000 compounds found in tattoo inks due to insufficient safety data and ongoing questions about their carcinogenicity and impact on human health. Laser tattoo removal does not completely vaporize tattoo pigment, but rather destroys the compartments where it resides allowing the body to clear it through the lymphatic system and other immune mediators. Considering the unclear safety data of tattoo ink components, a tattoo removal method that disperses the pigment from the skin to the lymph nodes may not be ideal and underscores the need for alternative methods. In this manuscript, we aim to discuss we aim to discuss the Trans-Epidermal Pigment Release (TEPR) method (Tatt2Away by Rejuvatek Medical Inc., Salt Lake City, Utah), which utilizes superficial dermabrasion and dermal disruption to transepidermally eliminate tattoo pigment.
