Copper vapor laser treatment of granuloma of the vermilion border of the lips arising as a complication after permanent make-up

Background. Granulomas of the vermilion border of the lips (GVBL); as a complication of lip tattooing; inevitably poses cosmetic problems. Surgical excision and cryodestruction are associated with an increased risk of scarring and recurrence of GVBL. Laser therapy can selectively destroy a pigment and achieve the desired cosmetic result with minimal risk of side effects. So laser treatment was reported to be a more relevant method of treatment of GVBL.

Aim. To evaluate the effectiveness of treatment of GVBL with copper vapor laser (CVL) radiation.

Case report. 39-year-old female patient; without manifestations of systemic sarcoidosis; reported a 2-year history of granulomas of the lips’ vermilion border. She had a permanent makeup cosmetic tattoo before the onset of granulomas after lip tattooing. Histopathological examination revealed the presence of pigment in the upper and middle layers of the dermis. GVBL treatment was performed using a CVL during a single procedure; with an average CVL power of 0.6–0.8 W; with a ratio of 3:2 at wavelengths of 511 nm and 578 nm; exposure time — 0.3 s. Light spot diameter — 1 mm. CVL treatment led to a pronounced elimination of all GVBL without side effects within five years.

Discussion. CVL allows a combined mode of exposure; consisting of grinding large granules of pigment to sizes that can be absorbed by the lymphatic system and suppressing VEGF expression using radiation with a wavelength of 578 nm.

Conclusions. The CVL treatment provided an excellent cosmetic result due to selective photodestruction of the pigment and complete remodeling of the vascular bed associated with GVBL. The high clinical efficiency of eliminating post-tattooing foci of GVBL using CVL without side effects allows us to suggest this method for dermatologists and cosmetologists as a highly effective and inexpensive way to eliminate complications of permanent makeup.