R0 Tattoo Removal Procedure - 3 sessions' effect in 1!

Tattoo Removal Using the R0 Technique

Repeated Laser Irradiation Method Using PFD Medication

Laser treatments for tattoo removal have traditionally involved using nanosecond lasers, such as Q-switched Nd:YAG (1064nm), to finely break down the pigment.

However, traditional tattoo removal treatments typically required a recovery period of about 6-8 weeks after each laser session before the next treatment could be performed. The total number of sessions also averaged over 10, which could be very time-consuming.

To address the limitations of these traditional treatments, the R0 method can be suggested as an alternative.

Definition of the R0 Technique

R0 refers to a tattoo removal method where laser is continuously applied to the same area up to 4 times in a single visit.

A key feature of this treatment is the use of a special liquid medication called ‘PFD (Perfluorodecalin)’.

When the laser touches the skin, a white foam known as ‘frosting’ appears on the skin's surface.

This foam can scatter the laser light, significantly reducing the effectiveness of subsequent laser applications. 

In the past, we had to wait tens of minutes for this foam to disappear on its own. However, even after waiting, the foam didn't fully clear, and subsequent treatments were often postponed to an entirely different day.

However, by applying PFD medication, the frosting phenomenon can be eliminated in just a few seconds. This allows for continuous treatment by reducing the time between laser applications to within 1-2 minutes.

As a result, this means that tattoo pigment can be significantly reduced with a much shorter overall treatment period compared to traditional methods.

Related Research Findings

• Biesman et al., 2013
• When using the R0 technique, it was observed that the total number of treatment sessions could be reduced by approximately 30-50% compared to traditional treatment methods.
• Furthermore, it was confirmed that it is possible to re-treat immediately after a laser session.
• Kauvar et al., 2020
• When the R0 technique was applied approximately 3 times, the total number of laser applications was around 10 sessions (about 3 sessions using the R0 method).
• At this point, results showed a reduction of 70-90% or more in tattoo pigment.
• Additionally, the incidence of side effects like post-inflammatory hyperpigmentation (PIH) was reported to be relatively low.

If theoretically, repeated irradiation up to 4 times is possible, why is it often limited to 3 times in practice?

The R0 technique was theoretically designed to allow continuous irradiation up to 4 times.

However, in actual treatment settings, there is a tendency to conclude the treatment after usually 2-3 repeated applications.

There are several reasons for this:

1. Characteristics of Asian Skin

Asian skin's melanin cells are sensitive to laser stimulation, making them relatively more prone to developing post-inflammatory hyperpigmentation (PIH).

Especially in cases corresponding to Fitzpatrick skin types III-IV,

Excessive repeated irradiation can go beyond pigment breakdown, causing unnecessary irritation to the skin and increasing the risk of more severe hyperpigmentation.

2. Considering the Balance Between Treatment Sessions and Safety

Generally, up to 3 repeated laser applications can be performed while closely observing the skin's reaction.

However, if treatments exceed 4 applications, the risk of damage to normal skin tissue, along with pain, redness, and minor burn reactions, can significantly increase.

3. Limitations of Laser Irradiation Efficiency

Even with PFD, there is a certain limit to the amount of tattoo pigment particles that the laser can react with.

After about 3 repeated applications in a single session, the efficiency of laser irradiation gradually decreases thereafter.

Therefore, even if the irradiation intensity is increased, the additional treatment effect may be negligible, and instead, the risk of side effects could increase.

In other words, while it may be ‘technically possible to perform ‘up to 4 times’, there can be a difference from ‘the actual optimal number of irradiations considering patient safety.’

Our medical team prioritizes your skin's safety and treatment effectiveness, generally adhering to a basic principle of 3 repeated irradiations.

So, why don't all medical institutions adopt the R0 technique?

This treatment method doesn't always offer only advantages from the medical institution's perspective.

• PFD drugs can be costly and their supply may be difficult.
• The medical staff's extensive experience and professional judgment are crucial in determining the timing of drug application and the number of laser irradiations.
• This procedure may take 2 to 3 times longer than typical tattoo removal methods.

an approach that may be somewhat less preferred in places prioritizing time efficiency. This is also the case.

However, we value both patient satisfaction with the procedure and alleviating any discomfort they may experience.

Therefore, we cannot overlook the potential benefits of this treatment method.

We repeatedly apply the laser only within the necessary areas, without causing undue stress to the skin.

Prioritizing the safety of the patient's skin and aiming for positive tattoo removal results within the possible scope, our medical team consistently researches to provide them.

We help to ensure a more efficient process, reduce skin burden, and allow for stable results.