[R0 Tattoo Removal] 1 Visit, 3x Effect

R0 Method Tattoo Removal

Immediate Repetitive Laser Tattoo Removal Technique Using PFD

Laser tattoo removal has become a 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 a total of more than 10 sessions on average, which demands a considerable amount of time.

One new approach to address these issues is the R0 method.

What is the R0 Method?

R0 is a tattoo removal technique that allows for up to 4 repetitive laser passes on the same area during a single visit.

The key to this method is the use of a special liquid medication called 'PFD (Perfluorodecalin)'.

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

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

Previously, we had to wait for tens of minutes for these bubbles to naturally disappear, but even then, they wouldn't vanish completely. Or, it was common to postpone until the next session.

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

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

Actual Research Findings

• Biesman et al., 2013
• In patients treated with the R0 method, the number of treatment sessions could be reduced by approximately 30-50% compared to traditional methods, and
• It was demonstrated that immediate repetition after laser application is possible.
• Kauvar et al., 2020
• In patients who underwent the R0 method approximately 3 times, based on the total number of laser passes, approximately 10 sessions (around 3 sessions with the R0 method),
• Resulted in over 70-90% pigment removal, and
• The incidence of side effects such as PIH (post-inflammatory hyperpigmentation) was also reported to be low.

Nevertheless, why do we only perform '3' repetitive passes instead of '4'?

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

In actual clinical practice, it is common to stop at 2-3 repetitive passes.

The reasons are as follows:

1. Characteristics of Asian Skin

Asian skin has high responsiveness of melanin-producing cells and a higher incidence of post-inflammatory hyperpigmentation (PIH).

Especially for Fitzpatrick Skin Types III~IV,

If repetitive passes are excessive, beyond just 'breaking down' the pigment, there is a risk of irritating the skin itself, which can worsen hyperpigmentation.

2. Balance between Number of Passes and Safety

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

If exceeding 4 passes, the risk of damage to normal tissue, pain, erythema, and minor burn reactions rapidly increases.

3. Limitations of Pass Efficiency

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

After performing approximately 3 repetitive passes within one treatment session, the efficiency of passes decreases beyond that point, and

Even if the laser intensity is increased, the additional treatment effect is not significant, and instead, the risk of side effects often increases.

In other words, the 'technical possibility of up to 4 passes' and the 'optimal number of passes that can be safely applied to actual patients' are different, and

At Kkeut Clinic, we prioritize patient skin safety and effectiveness, thus adhering to the principle of 3 repetitive passes.

So why don't all clinics use R0?

This method doesn't only have advantages from the clinic's perspective.

• PFD drugs are expensive and difficult to obtain.
• Accurate application timing and repeated irradiation design require the judgment of experienced medical professionals.
• The procedure time itself takes 2 to 3 times longer than general tattoo removal.

Therefore, it is a method avoided by hospitals that prioritize 'patient turnover'.

However, we prioritize 'completion' and 'reducing patient burden',

we cannot ignore the efficiency of this method.

At Kkeut Korean Medicine Clinic, we perform repeated irradiation only as much as needed, without excessive treatment,

and always strive to achieve the maximum tattoo removal effect while ensuring the safety of the patient's skin.

Faster, with fewer sessions, safer, and more perfectly