Tattoo removal by laser

Why would we want to remove tattoos ?
After all they are supposed to last forever... Many people had them done initially to express their individuality, to make a statement, to belong to a group, to show attachment to a significant other or simply on a whim without thinking about the consequences. What seemed like a good idea at the time may not be so good now for different reasons:

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It was a mistake in the first place, you don't like the drawing or the cosmetic result.

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The tattoo may be too embarrassing to wear a bathing suit at the beach.

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It may be interfering with a current relationship: friend or spouse may not appreciate seeing the name of an old flame on the body of the person they love.

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Young parents do not want to have to explain their tattoos to their children as they become older.

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Your life may have changed and tattoos may be associated with other memories you would rather forget.

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What was popular and fashionable at a younger age may prove an embarrassment as you become older.

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Source of conflict between teenagers and their parents.

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In the workplace, tattoos are often the source of discrimination and prejudice and may be an obstacle to employment or career advancement.

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Etc...

How does laser treatment work ?

The laser emits repeated pulses of highly concentrated invisible infrared light lasting fractions of seconds. This energy is absorbed by tattoo pigment causing its destruction. Destroyed pigment is then removed by the body's natural filtration mechanism (the lymphatic system). Because laser energy is totally absorbed by tattoo pigment, no heat is generated in the surrounding skin which considerably reduces the risk of burns or scars. Treated skin may show mild pinpoint bleeding and usually heals within ten days. In the two months following treatment, tattoo ink should fade gradually and progressively and so on with each session.

Is the treatment painful ?

Yes. Pain is similar to that experienced during the tattoo procedure, but treatments are much shorter than a tattoo session. Many patients require no local anesthesia or use “EMLA” cream (which can be bought without prescription at the drugstore) 2 or 3 hours before treatment to minimize pain. (Apply a thick layer over the tattoo and cover with “saran wrap”). If there is too much pain, local anesthesia is used.

How many treatments are required ?

Most cases need an average of six treatments but it is impossible to accurately predict this number because it depends on several factors such as the type of tattoo pigment, its amount, its color, its depth in the skin, and its capacity to absorb laser energy. Treatments are usually repeated every two months until clearing is satisfactory. Treatments can be given every two months. If tattoo ink fades significantly after one or two treatments, the prognosis for a cosmetically acceptable removal is very good. The average cost is $1000-$2000 for the series of treatments over a one or two year period, but may vary with tattoo size, treatment time, technical difficulty, and total number of sessions. The most complex cases should expect higher costs.

Can the tattoo disappear completely ?

Yes, in most cases , the success rate is approximately 90%. Some inks however are impossible to erase completely. Black and red inks are much easier to erase than green and yellow. It has been reported that some modern inks contain titanium pigment which is very laser-resistant. (Avoid this)

Large multicolored tattoos have a lower success rate and may require a very high number of treatment sessions.

Permanent makeup is a difficult problem because it often contains iron pigment which is oxidized by laser energy and turns coal black! In other words, you can look worse after laser and some iron pigments may be impossible to erase or require multiple treatments, which can be costly. Despite these risks, I have had patients with fast spectacular clearing.

In summary:

There is no perfect method for tattoo removal, but despite the technical limitations, the Q-Switched Nd:YAG laser can help most of our patients. Other alternatives exist to remove tattoos, but they carry significant risk of scarring. Those techniques will be discussed with patients who can benefit from them.