The “R” stands for Repeating or Rapid while the “20 “stands for 20 minutes. The R20 Method will do a single pass of the laser every 20 minutes. This is essentially 2 (or more) removal treatments during one visit. A 20 minute wait period is required because each pass of the laser produces very small nitrogen bubbles that look like frost on top of the tattoo. The laser cannot penetrate through this frost until it dissipates in approximately 20 minutes, then another session can then be conducted.
Although this technique has frequently been used there are several draw backs. The patient is tied up generally for several hours. The staff will generally start running late which delays your treatment. Additionally by not leaving significant time between sessions you are not sure of the effectiveness of the previous pass. Waiting 20 minutes between passes will allow the frosting to dissipate, but swelling will increase, possibly decreasing the effectiveness of the laser on following passes. The body will not have had time to eliminate the fragmented ink particles, meaning the light from the laser will still encounter those before the ink deeper in the skin, further reducing the effectiveness of the laser. Another down side is when the laser does encounter and react with the already fragmented ink; it may cause further damage to the surrounding tissue.
Recently a new FDA product has been released to allow multiple passes without waiting between passes and eliminating most of the downsides of the R20. Known as the DeScribe patch it is only available at medical offices. Read below.