Tattoo Removal Basics from the Dermatologist

Tattoo-Removal-Options

(edited from the skininformation.com article: Tattoo Removal Q&A
and skintherapyletter.com article: The Use of Lasers for Decorative Tattoo Removal)

For some individuals, a tattoo can be a lifelong aesthetically pleasing and symbolic piece of body art. For others, a tattoo can be a quickly regrettable decision. Unfortunately, not all tattoos are keepers. That lower back tattoo you got in your early twenties may turn into a source of embarrassment later on in life.

In the United States, an estimated 7–20 million people carry at least one tattoo.1 Recently, Laumann and Farmer conducted a random survey of 500 men and women and found a prevalence of tattooing in 26% of males and 22% of females. Of those with tattoos, 17% considered tattoo removal.2 The top reasons for tattoo removal are to improve self-esteem, to remove a disliked design, and to increase credibility with friends.3

Currently, lasers are the gold-standard method for removing tattoos. Prior to laser technology, tattoos were removed via techniques with a high likelihood of scarring, such as surgical excision and cryosurgery. While no single laser system holds the answer for tattoo removal, Q-switched lasers can successfully fade most tattoos with minimal adverse effects.

Before considering treatment, here are the most commonly asked questions about tattoo removal:

Q: HOW DOES TATTOO REMOVAL WORK?
A: The principle at work is called thermolysis, which is chemical decomposition by means of heat. Lasers work by directing highly concentrated pulses of light into the skin, which break up the ink particles contained within the tattoo. Once the ink particles are fragmented, the body’s scavenger cells remove them from the skin.

Q: IS THE PROCEDURE PAINFUL?
A: Quite likely, although this will depend upon your pain threshold. In most cases, it’s more painful to have them removed than to have them applied. For more extensive and painful procedures, a local anesthesia will be applied to reduce discomfort.

Q: WHAT ARE POSSIBLE SIDE-EFFECTS FROM THE PROCEDURE?
A: Temporary or permanent change in skin color of the treated region can occur, especially following exposure to the sun. This is due to the melanin, which controls skin color, absorbing the lasers.

Q: WILL I REQUIRE MULTIPLE TREATMENTS?
A: Yes. Tattoo removal is performed over multiple sessions, performed in 4 to 8 week intervals. Lightening of tattoos will often take some time, and it isn’t uncommon for the tattoo to slowly lighten over months following the final treatment.

Q: ARE CERTAIN TATTOOS HARDER TO REMOVE THAN OTHERS?
A: Amateur tattoos generally require fewer treatment sessions than professional tattoos. People with fair skin and superficially placed tattoos (on arms, chest, buttocks, legs) tend to respond better to tattoo removal treatments. Tattoos on dark skinned individuals, or tattoos on the ankles or fingers, tend to be the most difficult to treat, and can have variable results. Lastly, bright-colored inks may necessitate more treatment sessions.

Q: WHAT CAN I EXPECT POST TREATMENT?
A: Immediate swelling and blistering is common following treatment, but will only last for a day or two. Crusts and scabs will often form afterwards, lasting up to 14 days. During this time, proper wound care will be required. Antibiotic treatment is common, and proper care should be taken to avoid exposure to the sun, and medication may be prescribed for pain and swelling. It can take 4 to 8 weeks for the treatment to take full effect, during which the tattoo will continue to become lighter.

Q: HOW MUCH DOES TATTOO REMOVAL COST?
A: The cost of laser tattoo removal varies, depending on the size, complexity of the tattoo, and number of inks used. Costs for laser removal can range from $200 to $500 per session, and typically 5 to 20 sessions are recommended. Consult with a tattoo removal specialist to get an estimate of the total cost and number of treatment sessions required.

If you are considering getting a tattoo, here is some additional information to consider:

  • First and foremost, only choose a professional artist who uses sterilized equipment and make certain that the work is performed in a hygienic environment.
  • Keep in mind that complications from tattoos can include infection, inflammation of connective skin tissues and scar formation. Sensitivities to components in the inks used for tattooing can also occur.

1. Anderson RR. Tattooing should be regulated. N Engl J Med 326(3):207 (1992 Jan).

2. Laumann AE, Farmer AJ. Tattoo and body piercings in the United States: a national data set. J Amer Acad Derm (in press).

3. Armstrong ML, Stuppy DJ, Gabriel DC et al. Motivation for tattoo removal. Arch Dermatol 132(4):412-6 (1996 Apr).