Laser Tattoo Removal

Laser tattoo removal is a cosmetic procedure that uses pulses of intense light to break up and remove a tattoo. The laser targets pigment colors in the dermis of the skin and the light from the laser targets the ink and is absorbed by the pigment of the tattoo. This causes the ink to fragment and become absorbed/removed by the patient’s own cells. While tattoos were once considered a permanent addition to the body, they can now be taken away with laser tattoo removal.

Am I a Good Candidate for Laser Tattoo Removal?

A GOOD CANDIDATE for laser tattoo removal is any patient who desires to remove or lighten an existing tattoo. It is important to understand that certain ink colors respond better to the laser light than others:

• Patients with black, brown and red ink will respond well since these pigments can be removed completely
• Patients who have tattoos with blue and green ink will not see their tattoos completely removed but they can be lightened
• The easiest tattoos to remove are those with black ink since the ink isn’t very dense and the laser can target it in a more precise manner
• The older the tattoo, the easier it can be removed since the body has removed some of the tattoo pigment over the years
• Fair skinned patients are ideal since there is a greater difference between the ink pigment and the skin tone

Patients who are NOT GOOD CANDIDATES include:

• Darker skinned patients since the skin may potentially lighten, or darken, around the tattoo and cause pigmentation issues
• Patients without a healthy immune system since laser tattoo removal relies on the immune system to dispose of the ink particles once they are broken down
• Patients who smoke and don’t follow a healthy diet and exercise routine

How is Laser Tattoo Removal Performed?

The amount of treatment sessions depends on the size, color(s) and age of the tattoo. The technician may need to use different wavelengths to treat different colors so, if the tattoo is very colorful, a combination of lasers may be needed. The skin tone of the patient, and how deep the pigment is, will also determine the laser technique. In general, smaller tattoos require fewer light pulses while larger tattoos will need more. Furthermore, the amount of sessions needed to remove a tattoo may depend on the skill of the tattoo artist. A professionally done tattoo is harder to remove since the ink tends to be inserted deeper. Patients with dark skin need more sessions at a lower laser setting to avoid bleaching the skin. Each treatment should be about four to six weeks apart to allow for proper healing.

Laser tattoo removal can cause discomfort. A topical anesthesia cream, that has lidocaine, can be applied to the treatment area prior to the procedure. An anesthetic can also be injected directly into the site but this generally extends the removal process and causes the need for additional treatments. This is because the anesthetic can cause swelling of the skin that affects the efficiency of the laser. Before the removal process begins, the patient will be given a pair of protective eye shields. The technician will test the skin’s reaction with a very low laser setting to help determine the most effective pulse energy for the treatment. The technician will pass the pulses of light through the top layers of the skin that will be absorbed by the tattoo pigment. Once the technician ascertains how the patient will respond, he or she can increase the intensity of the treatment. The length of the procedure depends on the individual patient and their tolerance to pain. Patients will be given an ice pack to soothe the area immediately after the treatment. The technician will apply an antibiotic cream and bandage to protect the area during the healing process.

Alternative Methods:

Alternative tattoo removal methods include dermabrasion, salabrasion and excision. Laser treatments selectively treat the pigment in the tattoo while other procedures are more abrasive to the treated area as well as the surrounding areas.

• Dermabrasion involves abrading and removing the top layers of skin with a diamond tipped device.
• Salabrasion is when the technician removes the tattoo using water and granular salt that is scrubbed down into the tattoo ink.
• Excision surgically cuts away the tattoo before the skin is sewed back together. Excision may also include a skin graft to cover the damaged skin.

What is the Cost of Laser Tattoo Removal?

The cost of laser tattoo removal depends on the technician, the area of the country where it is performed and the extent of the tattoo. Typically, laser removal costs around $200 to $1500 to remove the entire tattoo.

Recovery and Downtime

The first few days of RECOVERY are similar to the first few days after getting a new tattoo. The patient can expect some redness, tenderness and bleeding for three to seven days. Patients may take Tylenol for discomfort but should avoid the use of ibuprofen and aspirin since these can increase bruising and bleeding. A temporary darkening of the tattoo is also common but it will continue to fade with further treatments. Blistering, crustiness or scabs will usually form and they can last for 2 weeks or more. Once the scabs fall off, the area may appear pink or pale. With the first session, recovery can take one to two weeks for complete healing. The second treatment may only take five days to heal and the third may only take three days. It is important to wait four to six weeks between treatments to allow for proper healing and to avoid complications. 

Body Hair:

If laser tattoo removal is performed on an area with body hair, the patient should not shave until the area has completely healed. Shaving will scrape the region and can cause an infection and/or scarring. To help the body absorb the ink particles quicker, the patient can massage the treatment area for 5 to 10 minutes each day after the treatment area has healed.

Keeping the Treatment Area Clean:

During the recovery period, the patient will need to apply Neosporin on the treatment area and keep the skin protected with a bandage for the first 3 days. It is important to keep the area clean and dry to avoid the possibility of an infection. Physical activity, saunas and hot showers should be avoided for the first 24 hours. When showering, patients should not allow high-pressure water to hit the treatment area. Direct sun exposure, salt water, pool water and hot tubs should be avoided for the first 2 weeks.

Results

Laser tattoo removal is a permanent solution. Patients should be positive that removing the tattoo is what they want. It is important to remember that certain colors do not respond as well to the treatment and may not return the same results as other colors. Having realistic expectations prior to the procedure, and an understanding of how laser lights work, can help provide successful results.

Since the first session is performed on a lower setting, patients should not expect to see a major difference in appearance. However, after each visit, the tattoo should become progressively lighter. Fading is typically slower with tattoos that are located further away from the heart, such as down the arms or legs. Tattoos that are closer to the heart get better circulation and provide quicker results. Treatment areas are very vulnerable to sunlight and can burn easily after the treatment. Burning can cause scarring on the newly treated skin. Therefore, patients should ensure that the treated area is protected with sunblock whenever they go outside. To obtain the best results, patients should adhere to their after-care instructions.

Limitations and Risks of Laser Tattoo Removal

There are a few LIMITATIONS of laser tattoo removal:

• Newer tattoos may have a limitation in how easy they are to remove so they may need additional sessions for removal
• A tattoo which consists of a turquoise color is limited in how much can be removed since there isn’t a laser that effectively targets this color
• Some tattoos only partially fade after being treated

The RISKS of laser tattoo removal include:

• Leaving behind a ghost image of the tattoo
• Permanent raised scarring
• Skin irritation
• Poor wound healing
• Infections
• Darkening or lightening of the skin after the tattoo removal
• Burning

Choose a Skilled Doctor

The decision to get a tattoo may seem like a good idea at the time. However, when the tattoo becomes something a person later regrets, laser tattoo removal may be a good option. For the safest procedure and best results, patients should choose a board-certified plastic surgeon or dermatologist. The physician should be adequately skilled in performing laser tattoo removal and be able to show results using “before and after” photographs of his or her patients. Furthermore, the patient should ensure that the doctor is performing the procedure and not a nurse practitioner or physician assistant.

Written by Cosmetic Town Editorial Team - MA

Based on an exclusive interview with Ernesto Hayn, MD in Palm Beach, FL.