title: The Incidence of Hypertrophic Scarring and Keloid Formation Following Laser Tattoo Removal with a Quality-switched Nd:YAG Laser.
abstract: BACKGROUND
  Laser tattoo removal using quality switched technology is widely accepted as the standard of care. Determining the risk of hypertrophic scarring and keloid formation more precisely delineates the safety of this procedure and improves patient education regarding the risk of scarring.
  
  
  OBJECTIVE
  To investigate the incidence of hypertrophic scarring and keloids in a large patient population following treatment with a Q-switched neodymium-doped:yttrium-aluminum-garnet laser.
  
  
  METHODS
  In November 2012, after a single Institutional Review Board approved retrospective chart review, 1,041 charts demonstrating greater than five treatment sessions were analyzed. All patients in the current retrospective study were treated under one study protocol.
  
  
  RESULTS
  An overall incidence of 0.28 percent (3/1,041) of patients receiving a minimum of five laser tattoo treatments with a Q-switched neodymium-doped:yttrium-aluminum-garnet laser developed clinical evidence of hypertrophic scarring. None of the 1,041 patients in this study developed keloid scars.
  
  
  CONCLUSIONS
  With the Q-switched neodymium-doped:yttrium-aluminum-garnet laser utilizing accurate, protocol-based settings, the incidence of hypertrophic scarring following laser tattoo removal treatments was 0.28 percent (3/1,041) and the incidence of keloid scarring was 0.00 percent (0/1,041).
authors.affiliation: LaserAway and Kirby Dermatology, Hermosa Beach, California;
authors.forename: William
authors.initials: W
authors.lastname: Kirby
authors.affiliation: University of North Texas, Heights Dermatology and Aesthetic Center, Houston, Texas;
authors.forename: Dylan B
authors.initials: DB
authors.lastname: Alston
authors.affiliation: Midwestern University, Department of Plastic and Reconstructive Surgery, Downers Grove, Illinois.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Chen