Tattoo removal is a common aesthetic dermatology request. Dense, long-standing pigment may require prolonged treatment with nanosecond lasers and carries a risk of post-inflammatory pigmentation. Picosecond lasers use selective photoacoustic effects for more efficient pigment fragmentation. This case demonstrates Foremed Legend AstraPico, with a 290 ps pulse width and 1.4 GW peak power, for a decade-old black tattoo.

Patient Profile

Patient: 38-year-old woman with an exogenous tattoo on the left lower leg for more than ten years.

Examination: Fitzpatrick type III skin with an unevenly pigmented black letter tattoo. There was no scar, inflammation, ulceration, or texture abnormality.

Treatment Rationale

Black tattoo pigment is largely deposited in the dermis. The 290 ps pulse is shorter than the pigment's stress-relaxation time, creating a stress-confinement effect that fragments pigment into smaller particles for macrophage clearance. The 1064 nm wavelength reaches the dermis and has less competitive absorption by epidermal melanin in Asian type III skin, reducing PIH risk.

Protocol

Device: Foremed Legend AstraPico.

Wavelength: 1064 nm.

Spot: 3 mm.

Fluence: 2.8 J/cm².

Frequency: 4 Hz.

Endpoint: Mild overlapping coverage until slight frosting appeared, with mild surrounding erythema and no bleeding or blistering.

Results

Before (July 21, 2025): A sharply defined black letter tattoo with dense, uneven pigment.

Approximately five months after one session (December 9, 2025): Pigment had markedly faded, letter borders softened, and dense areas showed clear clearance. Skin remained flat without hypertrophic scarring or obvious PIH.

Practical Points

1. Assess color, depth, age, and skin type before treatment. Explain that dense, old tattoos usually require multiple sessions.

2. Use the clinical endpoint to guide parameters. Begin conservatively even on the more tolerant lower leg to avoid blisters and crusting.

3. Keep the handpiece perpendicular for even energy delivery and reduce fluence at tattoo edges.

4. Cool immediately after treatment, keep the area dry for three days, use topical antibiotic ointment if needed, and maintain strict sun protection.

5. Space black tattoo sessions 6–8 weeks apart and adjust parameters according to pigment clearance.

Clinical Summary

AstraPico's ultrashort pulse width provides strong photomechanical action with a favorable safety profile for long-standing black tattoos in Asian skin. The parameters and endpoint are clear and reproducible for standardized clinical use.

Treating Physician

Physician: Dr. Liao Xiaoxia.

Background: Dermatologist trained at West China School of Medicine, Sichuan University, and a member of professional committees in medical aesthetics and comprehensive skin anti-aging.

The core founding team of Suzhou Foremed Legend Medical Technology Co., Ltd. comes from well-known domestic and foreign universities such Peking University. Foremed Legend is based on compliance and takes product power as the core, focusing on the design, research and development, and application of high-end medical and photoelectric equipment, committed to becoming the leading enterprise in the global high-end medical beauty and photoelectric equipment field, the provider of integrated intelligent solutions for diagnosis and treatment, the pioneer of medical beauty data integration platform.
By tackling a series of key underlying technologies, Foremed Legend has now independently developed a number of high-end medical devices, as picosecond laser treatment equipment, long-pulse laser treatment equipment, intense pulsed light treatment equipment, photoacoustic imaging skin detection equipment and cold air treatment equipment, and to focus on the research and development of core technologies of products, using better technical solutions to benefit the vast number of beauty seekers.

Adhering to the goodness of technology,umaili will work with industry and ecological partners to bring more safe and effective medical beauty and photoelectric equipment and integrated diagnosis and treatment solutions to the global medical beauty market