Title : Ozone and ultrasound in tattoo removal: Preliminary in vivo study
Abstract:
Tattoo removal is a widely performed procedure, but it is still considered painful and subject to adverse effects. The most widely used method in human aesthetic health for tattoo removal is laser therapy, applied by means of the Nd-YAG laser, which can leave scars and is carried out in several sessions. As an alternative, this study investigated the use of ozone and therapeutic ultrasound in tattoo removal, exploring their effects on the pigment and the biological response of the skin. Three piglets (Sus scrofa domesticus) were tattooed on the side of the thigh with blue ink and, after 30 days, the sites were divided into four groups: Control (no intervention), Ozone (application of ozone gas to the tattooed area), Ultrasound (use of ultrasound on the tattooed area) and Hybrid (combination of the two techniques). The protocol consisted of 10 treatment sessions at weekly intervals, totaling 70 days. Analyses were carried out using macroscopic and microscopic evaluations, including skin biopsies for histological analysis. The macroscopic results indicated that both ozone and ultrasound promoted a reduction in tattoo pigmentation over the course of the sessions. The hybrid technique, however, did not show superior efficacy compared to the isolated approaches. Image analysis showed progressive lightening of the tattoos in the treated groups, with greater efficiency in the ozone and ultrasound groups alone. Histological analysis revealed important differences between the groups. In the control and hybrid groups, the blue pigment in the dermis was of moderate intensity, while in the ozone and ultrasound groups the pigment was discreet. Ozone's mechanism of action seems to be related to its ability to induce a level of oxidative stress, promoting pigment manipulation. Ultrasound, in turn, may have facilitated pigment dispersion by increasing apparent permeability and the cavitational effect generated by ultrasonic waves. However, in the hybrid group, the interaction between the heat generated by ultrasound and the oxidative action of ozone presented limitations in terms of the effectiveness of the treatment. The study concludes that both ozone and ultrasound have the potential to be explored as alternatives for tattoo removal, especially with regard to reducing pain and side effects. However, more studies are needed to refine the protocols and evaluate the effectiveness on older tattoos and tattoos of different colors, as well as to better understand the biological mechanisms involved.
Audience Takeaway:
- Professionals working in dermatology and aesthetic health can use ozone and/or ultrasound to depigment obsolete tattoos. As there is a need for more in-depth studies with dosage and protocol adjustments, the technique can be used as an adjunct to treatments already established in clinical practice, such as laser. The techniques discussed in this study could contribute through the mechanisms of action of each technology, due to the oxidative action of ozone and the modulation of the inflammatory process caused by the ablative action through the application and use of laser.
- The results of the study show the benefits of ozone and ultrasound in removing exogenous pigments from the skin. The techniques are promising and are already used in the clinical routine of professionals in the field of tissue rehabilitation and dermatology, as well as being accessible and practical in the application of both techniques and safe for the patient. It is therefore important to disseminate this information and enable further study and development of future protocols.
- I am interested in extending this study, leading to multicenter research, and this research can be used by other professors to expand their own research or for teaching. The preliminary study on the use of ozone and ultrasound in tattoo removal presents an innovative approach that can be explored in various academic and professional areas. The study can be used as a reference in health and engineering courses, such as physiotherapy, aesthetics, biomedicine and biomedical engineering, using new approaches to removing pigments from the skin, making it possible to use the technique in a way that is adapted to the individual needs of each patient.
- This research could offer a practical solution that could specifically impact the work of designers, especially those involved with tattooing and removing pigment from the skin. Here are a few points on how it could simplify or make work more efficient: A less aggressive alternative to tattoo removal. Many tattoo designers also deal with clients who want to remove or modify old tattoos. The traditional laser method can be painful, expensive and cause scarring. The use of ozone and ultrasound can represent a less invasive and more affordable alternative.
- Easy correction and modification of tattoos. If partial pigment removal can be done more efficiently, tattoo designers will have more freedom to make corrections without the need for long laser sessions. Possible reduction in healing time. Conventional tattoo removal techniques that require months for removal and healing between sessions.
- Expansion of the techniques used in the market for health professionals working in dermatology and aesthetic health. Aesthetic professionals can incorporate this technology into their services, which opens up a new market niche related to tattoo removal and modification. Exploring new applications in leather design.
- The research could lead to the development of new lightening techniques for pigments, which could contribute not only to the depigmentation of tattoos, but also to other areas of skin design, such as semi-permanent make-up.
List all the other benefits.
As well as simplifying or making more efficient the treatment of skin pigment removal, the research has several other potential benefits:
- Less risk of scarring: compared to laser, which can cause hypopigmentation, burns or keloids, the ozone and ultrasound method can be less aggressive.
- Less pain during the process: Ultrasound can be a less painful option than laser removal, which usually requires topical anesthesia.
- Less risk of allergies: Some pigments may contain allergenic substances; ozone removal can prevent adverse reactions in sensitive people.
- Reducing inflammation: Ozone has anti-inflammatory properties and can reduce edema and symptoms after tattoo removal.
- Shorter recovery time: Gentler techniques can reduce recovery time, enabling efficient removal and providing emotional well-being for these patients. Contributions to Public Health, offering fewer dermatological complications, as poorly made tattoos or contaminated pigments can lead to infections and allergic reactions.
- Removal with ozone, which has antimicrobial properties, can reduce infections and improve the safety of the procedure.
- Some patients resort to unsafe methods of tattoo removal (acids, homemade abrasives), which can lead to scarring and serious infections.
- Accessible and professional treatment, avoiding dangerous and inappropriate practices.
