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Treatment of Cosmetic Tattoos

A Review and Case Analysis

McIlwee, Bridget E. DO*; Alster, Tina S. MD

doi: 10.1097/DSS.0000000000001572
Original Article

BACKGROUND Cosmetic tattoos such as eyeliner, brow liner, and lip liner have become increasingly popular in the United States and throughout the world. For a variety of reasons, patients frequently regret their tattoos and request their removal; however, removal is often complicated by the aesthetically sensitive location of these specialized tattoos and the fact that they often contain white metallic compounds that darken on pigment-specific laser irradiation.

OBJECTIVE To review the clinical use, effectiveness, and safety of an ablative laser technique for cosmetic tattoos.

MATERIALS AND METHODS A thorough literature review pertaining to laser treatment of cosmetic tattoos and a discussion of illustrative patient cases showcasing the successful use of ablative carbon dioxide (CO2) laser to treat cosmetic tattoos is presented.

RESULTS Cosmetic eyeliner and lip liner tattoos were significantly improved after CO2 laser vaporization. Side effects were limited to erythema, edema, and serosanguinous drainage. No infection, scarring, nor tattoo ink darkening was observed.

CONCLUSION Because ablative lasers do not target specific tattoo inks, they do not pose a risk of paradoxical tattoo ink darkening and, thus, can be applied successfully in the treatment of iron oxide– or titanium dioxide–containing cosmetic tattoos.

*Department of Dermatology, University of North Texas Health Science Center, Fort Worth, Texas;

Washington Institute of Dermatologic Laser Surgery, Washington, District of Columbia

Address correspondence and reprint requests to: Tina S. Alster, MD, Washington Institute of Dermatologic Laser Surgery, 1430 K Street, NW Suite 200, Washington, DC 20005, or e-mail:

The authors have indicated no significant interest with commercial supporters.

© 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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