All about tattoo removal

Do you have a tattoo that you want to remove? Well, then you aren’t alone. The demand for tattoo removal is increasing as fast as getting them placed.

The technology for tattoo removal has in recent years developed with great success. Inefficient grinding techniques and surgical cuts have been replaced with modern laser treatments.

All techniques for laser removal are not as effective and all tattoos are not as easy to remove.

On this page, you will receive objective information about the various treatment possibilities and limitations.

How tattoo removal with laser is performed

When making a tattoo, different colour pigments are inserted into the skin’s middle layer, the dermis. The colour is visible through the very thin outer layer of the skin, which is called the epidermis.

It is much easier to get a tattoo rather than get rid of it

Removing a tattoo is to remove the coloured pigmentation that is located in the dermis. This is done by “pushing” them apart with laser and then let the body’s waste removal system to get rid of the remains in a natural way.

The results varies depending on the tattoo’s colour, depth, age and location

Most tattoos can be treated. Some more successfully treated than others. Each tattoo features determines the number of treatments that will be required and the outcomes. Here’s a brief description of the characteristics that affect the outcome of a tattoo removal.

1. Colour – Tattoo colours have different resistance to laser energy. Less colours that has been used are simpler to treat. Dark colours are easiest to treat, while light colours need more treatments. Metallic colour or neaon colour can however not be treated.
2. Depth – “home-made” tattoos are often superficial on the skin and are therefore easier to remove than professional tattoos.
3. Age – older faded tattoos are easier to remove than fresh made ones.
4. Location – The “closer” the tattoo is to the body, the easier it is to treat. Hands and feet = severe, arms and legs = challenging, body = easiest. Most do not recommend treatment of tattoos on the face due to the risk of scarring.

A tattoo removal with laser treatment bleaches rather than removes the tattoo completely.

However, the final outcome cannot be predicted. If being treated with good conditions, the tattoo becomes largely invisible.

But in worse condition, it will bleach down by 50-70 %.

The right equipment and knowledge is necessary for effective tattoo removal

There are many lasers and treatment techniques. Learn more about the basics on the page about laser treatments.

The challenge with a tattoo removal is to smash as much pigment as possible with the help of heat that the laser develops without burning the skin. This is best done with the so called Q-switched laser.

Unfortunately,“Q-Switched” laser does not guarantee good treatment results for tattoo removal because:

1. It is difficult to do good tattoo removal lasers
2. It is expensive to buy them
3. It is important to be able to use them properly

To destroy the tattoo colour, you must use several different wavelengths of laser light which are given in nanometers (nm). The laser pulses must also, in order to be effective, have a very high energy under tremendous short time.

The above requirements mean that you need several different high quality lasers and a high quality “multi-spectral machine” for effective tattoo removal.

The different wavelengths of the laser specified in nanometers and their respective “specialties”:

• 1064 nm (infrared/invisible laser) takes care of dark shades such as blue and black
• 532 nm (green laser) is used for red, brown, purple and orange tattoo ink
• 650 nm (red laser) is used for intractable green colour tones
• 585 nm (yellow laser) has best effect on light blue tones

Unfortunately, a Q-Switched laser is not a guarantee for good results. It is almost impossible for a patient to verify the quality of the laser and practitioner. Even for me as a dermatologist, it took a lot of time to find right in this jungle! The fact that there are so many with inadequate skills and poor machines that are getting the entire industry into disrepute. – Tore Nilsen, cosmedicguide.co.uk specialist in aesthetic skin care

Inform yourself well or you will be disappointed!

Unfortunately, a tattoo removal is a decision with many uncertainties. For such you must as a customer inform yourself thoroughly before proceeding. Or you will be disappointed. Consider the following:

• Learn enough to understand the difference between laser and laser. No matter what clinic you ask, expect that they will describe their own equipment as a very good option.
• Choose a clinic with resources to invest in expensive equipment. Good lasers cost.
• Do not let price be a weighty factor in the decision. Equipment and skills need to be expensive.
• Choose a clinic with laser equipment from a well known manufacturer such as Fotona, ConBio, Candela and Cynosure. This way you ensure certain standard equipment. Ask exactly what laser / lasers they use and why.

Read more on the pages about laser treatments and to choose a clinic to get much better information.

Removing a tattoo cannot be done with a single treatment

Removing a tattoo with laser is more a like a process that treatment. A “normal” tattoo removal includes a consultation visit and then 6-12 treatments, a’ 40 minutes performed with 6-8 weeks intervals.

In some cases, the faster so called R20 method is used. It means that you perform 2-4 treatment sessions with 20 minutes intervals during one day.

It has also been shown that by pre-treating tattoos with fractional Er:YAG laser prior to R20 can reduce the processing time and improve the results even further.

No matter what method you choose, you must be patient and allow the treatment 4-12 months or more before seeing the final result.

Tattooing can be painful – but tattoo removal more painful

When the laser light hits the tattoo pigment, it should be divided of heat. And it does. But meanwhile the skin heats up. Many compare the pain with getting a tattoo. Other think it is worse.

To limit the pain, they put normally anesthetic cream prior to the treatment. You can also put a local anesthetic on the treated area. Same one you get at the dentist.

Expect discomfort afterwards and some risks

After each laser session swelling and blistering may occur. Followed by healing scabs. Then you put a bandage around the treated area and you will change it yourself and keep it clean as usual. Normally, it will heal within two weeks.

Temporary pigment change can occur. Exceptionally, it can remain permanently.

If the skin is not irritated, the treated area is exposed to the sun as early as 1 week after treatment.

Prices for laser tattoo removal

There are many factors that affect the prices for a tattoo removal. The total cost depends on its size, severity, location and patient demands.
The price for one single laser treatment with high quality laser machines performed by a specialist is:

• £50-100 for small tattoos
• £70-150 for medium tattoos
• £150-250 for large tattoos

Based on on an average need of 8 treatment sessions, the total cost is estimated on £400-£800 for removal of a small tattoo while £800-£2000 for a large one.

Additional information and guidance to tattoo removal with laser

• Search for clinics that perform tattoo removal
• Find more information on cosmetic laser on the page about laser treatments
• Read questions and answers about tattoo removal in “Ask the Expert”
• Discuss tattoo removal with others in our forum

This information about tattoo removal with laser is examined by dermatologist Tore Nilsen at Vaxsjo Medical Center. It provides general guidance but should not been viewed as a medical consultation.