Q-switched Nd-Yag lasers have proven useful for treating deep-pigmented lesions, such as nevi of Ota and tattoos in dark skinned persons, with a reduction in the risk of epidermal injury (57). Freckles and lentigines in Fitzpatrick prototypes IV or prototypes IV-IV can also be successfully treated with the Q-Switched Nd-Yag laser. Minimum adverse reactions and good cosmetic results can be expected (58).
Tattoos also can be effectively treated and removed with several Q-switched lasers, resulting in minimal scarring (59).
In our clinical practice, a thorough and detailed medical history is performed on each patient seeking treatment for a pigmentary disorder before using any kind of laser. This is done to identify high-risk patients, such as dark skinned patients with Fitzpatrick IV-VI, since post-laser repigmentation and PIH are common occurrences (Table 6).