Laser therapy is the gold standard method to remove unwanted tattoos. It is available and widely accessible. This study was done to assess the efficacy of the R20 method (multi-time separated passes in one session for 20 min) using Q-switched ND: YAG laser for the removal of tattoos and was compared with the traditional method. Forty patients with 40 Tattoos were included. These tattoos were separated into two halves left and right. One half was treated with a single pass and the other half with R20. Both halves were treated using Q-switched ND-YAG laser with 10 J/cm2, 1.064 µm, 8 ns pulse width, and 3 mm spot size. The treatment regimen included three sessions at three-week intervals. Tattoo bleaching was evaluated in each session by means of using the imaging process by two dermatologists. It could be concluded that the treatment with traditional single-pass is less effective than the R20 method in the three-month period. Epidermal healing period needs more than three weeks with the R20 method. The amateur tattoos have a significantly better response than professional tattoos. The R20 method is better than the traditional method to remove a tattoo, where most tattoos can be removed in one session. Amateur tattoo is removed faster compared to professional tattoo using R20 method because amateur tattoo affects the skin surface.
Keywords: SPSS, multi passes, tattoo removal, Q-switched ND-YAG laser..