CO2 Laser Treatment of Traumatic Tattoos

In a correspondence from 1989, two cases of successful CO₂ laser treatment for the removal of traumatic tattoos caused by firearms were reported. The first case involved a 32-year-old policeman with multiple black tattooed skin foci on his face and left arm, which were treated with the CO₂ laser at 25-W, 0.05-second pulses, requiring four passes for complete removal. The second case was a 17-year-old man with similar tattoos on his face, requiring three passes and subsequent sessions for over 100 focal areas, with some areas needing up to five passes. Both cases resulted in acceptable cosmetic outcomes with minimal scarring or other unwanted effects. The authors suggested that the CO₂ laser is a selective method that can remove traumatic debris effectively, even beyond what is safely removable by dermabrasion, and should be considered for treating a reasonable number of lesions or as an adjunct for deep tattoos. The correspondence also included a reply from another doctor, acknowledging the results but suggesting that dermabrasion might be more suitable for extensive superficial injuries, while CO₂ laser could be used for deeply embedded fragments or less extensive injuries.