Tattoo Removal

Tattoos are created by injecting colored pigment into the skin. Regardless of who or how the pigment is injected, the marks or designs are relatively permanent. People turn to physicians to have tattoos removed.

Fortunately, there are several methods for tattoo removal, which have proven successful. In most cases, however, some scarring or color variations remain. The conspicuousness of these blemishes depends upon several factors including size, location, the individual's healing process, how the tattoo was applied, and length of time it has been on the skin. A tattoo performed by a more experienced tattoo artist, for example, may be easier to remove since the pigment is evenly injected at the same level of the skin. A tattoo that has been on the skin for a considerable length of time may be more difficult to remove than a new one. Multicoloured tattoos are more difficult to remove than single coloured ones.

Methods of Tattoo Removal

Laser

In recent times, many physicians consider laser surgery one of the best methods of tattoo removal. Today, the Q-switched Nd:Yag, Q-switched Alexandrite and the Q-switched Ruby are among the most frequently used lasers for the removal of unwanted tattoos. They are all employed in a similar manner. A local anesthetic cream to numb the skin can be applied prior to the treatment. Pulses of light from the laser are directed onto the tattoo breaking up the tattoo pigment. Over the next several weeks the body's scavenger cells remove the treated pigmented areas. More then one treatment is usually necessary to remove the entire tattoo at intervals of eight weeks.

Several colors of laser light (measured as wavelengths of laser energy) are used for tattoo removal, from visible light to near-infrared radiation. Different lasers work better for different tattoo colors. Consequently, multi-color tattoo removal almost always requires the use of two or more laser wavelengths. Tattoo removal lasers are usually identified by the lasing medium used to create the wavelength (measured in nanometers (nm)):

Q-switched Nd:YAG 1064 nm.

This laser is most suitable for darker skin. This laser wavelength is best absorbed by tattoo pigments such as blue and black. Hence, it is very effective in blue and black coloured tattoos. It will have to be used in combination with other lasers for tattoos with red, green, yellow pigment. Q-switched Frequency-doubled Nd:Yag 532 nm, Q-switched Ruby 694 nm, Q-switched Alexandrite 755 nm are the other Q Switched systems but are less used due to side effects such as pigmentary changes in darker skin types.

Resurfacing

Resurfacing of tattoos removes only the top layers of the skin bearing the pigment of the tattoos. This technique may not always remove the pigment present in the deeper layers of the skin.

Resurfacing can be done through

  • Dermabrasion
  • Ablative lasers like CO2 laser and Erbium Yag Laser

Both these techniques may require local anesthesia. Because some bleeding is likely to occur a dressing is applied immediately to the area.


Frequently Asked Questions

What Results Can Be Expected?

Regardless of which method of tattoo removal is used, some colour variations are possible to remain. Healing time varies depending upon the size and depth of the tattoo, the procedure used and the patient's healing process.

How many sessions are required for tattoo removal?

Complete laser tattoo removal requires as many as 8 to 12 treatments, typically spaced at least 8 weeks apart. At each session, some but not all of the tattoo pigment particles are effectively fragmented, and the body removes the smallest fragments over the course of several weeks. The result is that the tattoo is lightened. Remaining large particles of tattoo pigment are then targeted at subsequent treatment sessions, causing further lightening. The number of sessions and spacing between treatments depends on various parameters, including the area of the body treated and skin color. Forearm and ankle tattoos generally take longest.

What are the possible side effects and complications of tattoo removal?
  • Hyper pigmentation (dark spots) or hypo pigmentation (white spots) may sometimes occur; however these are more common in darker skin.
  • ‘Paradoxal darkening’ of a tattoo may occur when a treated tattoo becomes darker instead of lighter. This occurs more often with flesh tones and lighter colored tattoos and maybe avoided by doing a ‘patch test’ ;where the laser is applied to one or two test sites prior to a decision to treat a full tattoo.
  • Scarring may occur when inappropriate laser energy is used.
  • Transient textural changes are occasionally noted but often resolve within a few months
  • Local allergic responses to many tattoo pigments have been reported, and allergic reactions to tattoo pigment after Q-switched laser treatment are also possible
Contraindications
  • Patients with hypertrophic or keloidal tendencies or hypertrophic scarring tendencies
  • Active inflammation at the tattoo site.
  • History of Vitiligo, Psoriasis.
Aesthetics