Table 4.

Summary of advanced treatments for tattoos in SoC based on recent studies.

Author	Study Type	Year	Laser	Therapy Parameters	Fitzpatrick Scale	No. of Cases	Clinical Outcome	Adverse Events
Sirithanabadeekul et al. [47]	RCT	2022	Fractionated 1064-nm picosecond lasers and unfractional 1064-nm ps-laser	1064-nm ps-laser: fluence 1.5–7.24 J/cm2; 3–4.5 mm spot, 2–5 Hz; fractionated 1064-nm ps-lasers: fluence 0.8 J/cm2; 8 mm spot, 2–5 Hz	III–V	11	The combination side showed greater clearance scores and fewer adverse events than the side of unfractional 1064-nm picosecond laser alone.	Temporary crusting, purpura, edema, erythema, burning sensation, and petechiae
Kasai et al. [45]	Retrospective case series	2017	Multi-colored tattoos with a ps 755 nm Alexandrite laser and a ps Nd:YAG laser	/	/	4	Ps-lasers require fewer sessions than ns-QS lasers for treating black-colored tattoos and are more efficient than ns-QS lasers for multi-colored tattoos.	Transient PIH in 1 patient
Kauvar et al. [49]	Prospective clinical study	2017	Dual-wavelength, 1064/532-nm, ps-laser	Both wavelengths are used on the same tattoo. Spot sizes 2 to 6 mm, maximum fluence 1.9 J/cm2 for 532-nm and 8.5 J/cm2 for 1064-nm handpieces	Only 26% of subjects were non-Caucasian	34 (34 subjects with 39 tattoos)	86% (31 of 36 tattoos) showed at least a 50% clearance after three treatments. Patient satisfaction and treatment tolerability were high.	Adverse events were few and transient in nature.
Sirithanabadeekul et al. [47]	RCT	2022	Fractionated 1064-nm picosecond lasers and unfractional 1064-nm ps-laser	1064-nm ps-laser: fluence 1.5–7.24 J/cm2; 3–4.5 mm spot, 2–5 Hz; fractionated 1064-nm ps-lasers: fluence 0.8 J/cm2; 8 mm spot, 2–5 Hz	III–V	11	The combination side showed greater clearance scores and fewer adverse events than the side of unfractional 1064-nm picosecond laser alone.	Temporary crusting, purpura, edema, erythema, burning sensation, and petechiae

/ Refers to details not mentioned in study.