Unusual Color Changes of Eyebrow Tattoo after Laser: A Retrospective Case Series

<b><i>Background:</i></b> Paradoxical darkening is a well-known complication with laser therapy for tattoos. However, there are limited reports of other color shifts after treating tattoos with laser. The aim of this study is to characterize cases of unusual eyebrow tattoo color change after laser. <b><i>Methods:</i></b> All cases of eyebrow tattoo color change after laser therapy from two dermatology clinics were reviewed. <b><i>Results:</i></b> A total of 10 females with unusual lighter color change after laser were identified. This was noticed by all patients within a few days after the first laser session. The color shift occurred after picosecond (PS) 755 nm (<i>n</i> = 5), PS 1064 nm (<i>n</i> = 4), and Q-switched 1064 nm (<i>n</i> = 1) laser therapy. The initial color shift was red or orange-red in eight patients and yellow in two patients. Treatment of color change was performed in six patients, with significant improvement. Two were treated with PS 755 nm laser and four were treated with PS 532 nm laser. After the first PS 532 nm laser session, the tattoo turned yellow in three patients. None of the patients developed paradoxical darkening of the light-colored tattoo after additional laser treatment. <b><i>Conclusions:</i></b> Some eyebrow tattoos might turn red, orange, or yellow after laser therapy. This color shift usually responds to subsequent therapy with PS 532 nm laser.