When treating near tattoos, what precaution should be taken?

• A. Laser energy over tattoo pigment is safe
• B. Avoid laser energy over tattoo pigment; adjust positioning or energy, and inform the patient of potential pigment changes
• C. Increase laser energy near tattoos
• D. Ignore tattoo boundaries

Answer: (B)

The key idea is that tattoo pigment can absorb laser energy just like skin pigment, so you must protect the ink from exposure. Laser hair removal relies on targeting pigment, and if energy is delivered over tattoo ink, the ink can heat up, leading to pigment changes such as fading, darkening, or even burns in the tattooed area. Therefore the safest approach is to avoid laser energy over the tattoo pigment altogether. If the treatment area is near a tattoo, adjust by repositioning the handpiece or lowering the energy (fluence) to minimize exposure to the ink, and always inform the patient about the possibility of pigment changes. The other options either assume safety over the tattoo, increase risk, or ignore tattoo boundaries, which is not appropriate.