[R0 Tattoo Removal] 1 Visit, 3 Sessions

R0 Method for Tattoo Removal

Immediate Repetitive Treatment Technique Using PFD

Laser tattoo removal has widely utilized Q-switched Nd:YAG (1064nm) lasers operating in nanosecond pulses to break down pigments.

However, with conventional methods, after one session, patients must wait 6 to 8 weeks for skin recovery before the next treatment can be performed. The total number of treatments is typically 10 or more on average, meaning the treatment usually takes a considerable amount of time.

One method to improve the inconvenience of these traditional approaches is the R0 method.

What is the R0 Method?

R0 is a tattoo removal treatment technique where the same area is treated with a laser up to 4 times consecutively during a single visit.

The core of this treatment lies in the use of a special liquid agent called ‘PFD (Perfluorodecalin)’.

When a laser is applied to the skin, a white foam called ‘frosting’ appears on the surface.

This foam scatters the laser light, which can reduce the effectiveness of subsequent treatments. 

In the past, it was common to wait several tens of minutes for this foam to subside naturally, or to postpone the next treatment session until the next visit. However, even with waiting, it never completely disappeared.

However, using PFD allows the frosting to subside quickly within seconds. This enables the interval between laser treatments to be shortened to 1-2 minutes, allowing for repetitive treatments.

This means it can help reduce tattoo pigments in a much shorter period than conventional methods.

Related Research Cases

• Biesman et al., 2013 Study
• It was confirmed that the number of treatment sessions in the patient group that received the R0 method was reduced by about 30-50% compared to the conventional method, and
• It was revealed that re-treatment is possible immediately after laser irradiation.
• Kauvar et al., 2020 Study
• In patients who underwent the R0 method approximately 3 times, the total number of laser treatments corresponded to about 10 sessions (approximately 3 times with the R0 method), and
• As a result, over 70-90% pigment removal was observed, and
• The incidence of side effects such as PIH (Post-Inflammatory Hyperpigmentation) was also reported to be low.

If so, why are only '3' repetitive treatments performed, not the theoretically possible '4'?

Theoretically, the R0 method is known to allow up to 4 repetitive treatments, but

In actual clinical settings, most cases involve only 2 to 3 repetitive treatments.

The reasons are as follows:

1. Characteristics of Asian Skin

Asian skin tends to have high melanin cell reactivity and a higher likelihood of developing post-inflammatory hyperpigmentation (PIH).

Especially for skin types corresponding to Fitzpatrick Skin Type III~IV,

Excessive repetitive treatments can over-stimulate the skin beyond pigment removal, actually increasing the risk of more severe hyperpigmentation.

2. Consideration of Treatment Count and Safety

While repetitive treatments can be performed up to 3 times while observing the skin's reaction,

If treatments exceed 4 times, the possibility of side effects such as damage to normal skin tissue, pain, redness, and minor burn reactions may increase.

3. Limitations of Treatment Efficiency

Even with PFD, there is a physical limit to the amount of pigment particles that the laser can reach and destroy.

After about 3 repetitive treatments in a single session, the additional treatment efficiency decreases thereafter.

At this point, even if the treatment intensity is increased, the therapeutic effect obtained is minimal, while the risk of side effects may only increase.

In conclusion, the technical possibility of ‘up to 4 times’ and ‘the optimal number of treatments that are safe and effective for the patient’ can be applied differently.

We prioritize patient skin safety and treatment effectiveness, and therefore adhere to the principle of 3 repetitive treatments.

Why don't all clinics choose the R0 method?

This treatment method does not only have advantages from a clinic's perspective.

• PFD medications can be expensive, and it can sometimes be difficult to ensure a smooth supply of the necessary quantities.
• The precise timing of drug application and the plan for repeated laser irradiation require the careful judgment of experienced medical professionals.
• This procedure can sometimes take 2 to 3 times longer than a typical tattoo removal process.

Therefore, it can be a somewhat burdensome method for clinics that prioritize a fast patient turnover rate.

However, we place greater importance on enhancing the completeness of the procedure and reducing the burden on our patients.

Therefore, we believe that the unique efficiency and advantages of this method cannot be overlooked.

We avoid over-irradiation of the skin and perform repeated laser treatments only as much as necessary.

We constantly research and strive to ensure the safety of our patients' skin while achieving satisfactory results for tattoo removal.

We aim for faster, appropriate treatment frequencies, prioritizing safety, and achieving high-quality results.