[3 times the effect in just 1 session!] R0 Tattoo Removal

R0 Method Tattoo Removal

Immediate Repetitive Laser Tattoo Removal Technique Using PFD

Laser tattoo removal has become the standard method, using nanosecond lasers such as Q-switched Nd:YAG (1064nm) to break down pigments.

However, the traditional method requires a recovery period after each session, with the next session taking place 6-8 weeks later, and the total number of treatments averaging over 10 sessions, which takes a considerable amount of time.

One new approach to solve these problems is the R0 method.

What is the R0 Method?

R0 is a tattoo removal technique that involves repeatedly irradiating the same area with a laser up to 4 times during a single visit.

The key to this method is the use of a special liquid drug called ‘PFD (Perfluorodecalin)’.

When a laser is applied, white bubbles called 'frosting' form on the skin's surface.

These bubbles cause light scattering, which significantly reduces the effectiveness of subsequent laser passes. 

Previously, we had to wait tens of minutes for these bubbles to disappear naturally, but they never completely vanished. Alternatively, it was common to postpone until the next session.

However, applying PFD allows for the removal of frosting within seconds and reduces the laser irradiation interval to 1-2 minutes, enabling repetitive passes.

This means that significant pigment reduction can be achieved with a much shorter treatment period compared to traditional methods.

Actual Research Findings

• Biesman et al., 2013
• Patients treated with the R0 method were able to reduce the number of treatment sessions by approximately 30-50% compared to traditional methods,
• and it was proven that immediate repetition after laser irradiation is possible.
• Kauvar et al., 2020
• In patients who underwent the R0 method around 3 times, based on the total number of laser passes, approximately 10 sessions (around 3 sessions using R0 method),
• the results showed pigment removal of over 70-90%,
• and the incidence of side effects such as PIH (post-inflammatory hyperpigmentation) was reported to be low.

Nevertheless, why do we only repeat passes '3 times' instead of '4 times'?

Theoretically, the R0 method allows for up to 4 repetitive laser passes, but

in actual clinical practice, most procedures stop at 2-3 repetitive passes.

The reasons are as follows:

1. Characteristics of Asian Skin

Asian skin has highly reactive melanocytes and a higher incidence of post-inflammatory hyperpigmentation (PIH).

Especially for Fitzpatrick Skin Types III~IV,

excessive repetitive irradiation can do more than just ‘break up’ pigment; it can over-stimulate the skin itself, increasing the risk of worsening hyperpigmentation.

2. Balance between Number of Passes and Safety

Up to 3 passes, repetitive irradiation is possible while monitoring skin reaction, but

exceeding 4 passes rapidly increases the likelihood of associated risks such as damage to normal tissue, pain, erythema, and subtle burn reactions.

3. Limitations of Irradiation Efficiency

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

If approximately 3 repetitive passes are performed within one session, the irradiation efficiency decreases after that point, and

even if the irradiation intensity is increased, the additional therapeutic effect is often not significant, and instead, the risk of side effects frequently increases.

In other words, there is a difference between the technical possibility of ‘up to 4 passes’ and ‘the optimal number of passes that can be safely applied to actual patients’,

Therefore, at Ggeut Clinic, we prioritize patient skin safety and effectiveness, adhering to the principle of 3 repetitive passes.

So why don't all clinics use the R0 method?

From the clinic's perspective, this method doesn't only have advantages.

• PFD drugs are expensive and not easy to procure.
• Precise application timing and repetitive irradiation design require the judgment of experienced medical professionals.
• The procedure time itself takes 2-3 times longer than general tattoo removal.

Therefore, it is a method disliked by clinics that prioritize 'turnover'.

However, we prioritize 'perfection' and 'reducing the patient's burden',

we cannot ignore the efficiency of this method.

Kkeut Korean Medicine Clinic performs repetitive irradiation only as much as needed, without excessive irradiation,

we always strive to achieve the maximum tattoo removal effect within the safe limits of the patient's skin.

Faster, with fewer sessions, safer, more perfectly