Tattoo Removal Guide

Tattoo removal is the practice of removing unwanted tattoos. It is increasing in popularity. According to a 2008 poll by Harris Interactive, 14% of the United States population has a tattoo. 17% of people in the United States have some form of regret involving their tattoos. The American Society of Dermatology says that half of people with tattoos want to remove them. Hiding the marks with clothing, makeup, or covering up with a new one to hide their discomfort with the artwork create their own problems. Laser tattoo removal can rid you of the embarrassment.

Tattoos are made up of thousands of pigment particles inside your skin. Every-day life of physical growth and healing disposes of foreign elements, but tattoo pigments stay because of their size. While early forms of the procedure involved dermabrasion, cryosurgery, excision and salabrasion, today’s methods use non-invasive lasers to eliminate the marks. Laser tattoo removal is effective and safe, and the method is fast. Recovery time is minimal. There are several techniques to remove tattoos. Q-switched lasers are the most effective to eliminate different color spectrum scales, using multiple wavelengths and wider ranges of pigments. They also rarely scar via application of a topical anesthetic.

Laser tattoo removal uses selective photothermolysis to break down tattoo pigments. This depends on the laser light’s color being able to breach the skin to target the tattoo’s pigment; the laser color being absorbed at a higher rate by the pigment than adjacent skin; the pulse (time) period of the laser to fragment the tattoo pigment without the heat affects neighboring skin; and ample energy in each laser pulse to heat the pigment particles. The lasers in tattoo removal break down the ink by heating up the particles, breaking them into smaller bits. Because tattoo pigments have unique light absorption range, the laser needs to emit enough energy within that field to be effective. This ink is absorbed into the body-similar to natural exposure to the sun and resulting fading-and discharged through human waste products.

Side effects for laser tattoo removal are mild and include temporary bruising, swelling, numbness and tingling. There will be some discomfort or pain, and you may be restricted from certain activities after the treatment. The post-procedure recovery is worth the regained confidence in your appearance.

The best thing to do to prepare for tattoo removal is to do research. Consult our guide for medical specialists in your area via our search function as well as the accredited facilities that they practice in to set up a consultation. The initial session can help you learn if you are a good candidate; if the procedure is right for you; how much the treatment costs; how the treatment is administered; the recovery time; side effects; and what the outcome of the removal will look like. Keep in mind that you will probably need to undergo several sessions to eradicate the tattoo. Costs will depend upon the type of treatment and the specialist. A good candidate for the procedure is one that is in good health and is emotionally stable to handle the recovery.

Tattoo Removal Info

How can tattoos be removed?

Tattoos are made up of thousands of pigment particles inside your skin. Laser tattoo removal uses selective photothermolysis to break down tattoo pigments. This depends on the laser light’s color being able to breach the skin to target the tattoo’s pigment; the laser color being absorbed at a higher rate by the pigment than adjacent skin; the pulse (time) period of the laser to fragment the tattoo pigment without the heat affects neighboring skin; and ample energy in each laser pulse to heat the pigment particles. The lasers in tattoo removal break down the ink by heating up the particles, breaking them into smaller bits. Because tattoo pigments have unique light absorption range, the laser needs to emit enough energy within that field to be effective. This ink is absorbed into the body-similar to natural exposure to the sun and resulting fading-and discharged through human waste products.The tattoo should appear to fade over the course of eight weeks, and additional treatments can be altered based on your visible results.

Tattoo removal in stages

Who is a good candidate?

A good candidate for laser tattoo removal is one that is in good overall health. A patient has a fine immune system for recovery, sufficient hydration, maintains a good diet and exercise, does not smoke, gets adequate amount of sleep, and preserves a healthy weight may have better recovery results. Those with immune system problems are advised not to go through with the procedure.

What techniques are used to remove tattoos?

There are many ways to remove tattoos. Modern laser removal methods originated in the early 1990s and involve Q-switched lasers, creating light pulses with high peak output, lower pulse duplication, higher pulse power, and longer pulse intervals. Another form laser tattoo removal includes continuous-wave lasers, which uses electromagnetic waves of constant volume and abundance for infinite periods. (Both methods can be used at the same time.) Yet another form of laser tattoo removal is intense pulsed light therapy (IPL).

Early forms of tattoo removal involved chemical peels, salabrasion (exfoliating the skin with salt), cryosurgery, excision, and dermabrasion. Other methods included lime, garlic, pigeon excrement, and wine application or injection.

Is it Safe?

Laser tattoo removal is safe, more so than older methods, and chances of scarring are lower. Certain colors are more effective to treatment than others. Patients often describe a feeling of hot oil being applied on the skin or a rubber band slap during the procedure. Some patients may need local anesthesia to deal with the pain.

Post-treatment changes may include a white discoloring of the skin (heat-formed gas or steam exposure) and possible pinpoint bleeding-vascular trauma brought on by the laser’s exposure to the tattoo pigment. Possible edema or erythema of nearby skin goes away after a day, and a crust on the tattoo subsides after about two weeks. Recovery also includes taking care of the wound and applying a dressing to block it from air exposure. Do not use topical antibiotics, as they may bring on allergic reactions.

Is the tattoo removed in one or several session?

Laser tattoo removal usually requires several treatment procedures, often administered every eight weeks. The number of removal sessions and time between treatments depend on several factors including skin color; the amount of ink, its resolution and color; reducing side effects; scarring; layering; and the area and size of the tattoo treatment section. (Tattoos on extremities take longer.) The Kirby-Desai Scale uses six parameters-color, location, scarring, layering, location, and skin type-and assigns statistical values to determine the number of laser removal procedures and odds for success.

Some of the tattoo pigment elements are broken apart, and the patient’s body discharges the particles over many weeks. This leads to a lighter tattoo, which is the subject of additional treatments. Sessions handled less than seven weeks do not speed up tattoo breakdown and traditionally lead to more adverse effects of scarring and a condition called dyschromia-a change in the color of the skin.

Tattoo Removal Techniques

Excision

Excision is one of the older forms of tattoo removal that involves cutting the artwork from the skin. The invasive method is fast and works best for small tattoos. It can be removed in one outpatient session if small enough, but more excision appointments are necessary for larger tattoos. It is inexpensive (around $150 for a small tattoo) and is about 95% successful. Those with uneven diabetes or auto-immune diseases are not good candidates for the procedure.

The procedure starts with local anesthesia injected to numb the area. The section of skin with the tattoo-including the exposed (epidermis) and lower (dermis) skin-is removed with heated needles via electrocautery that closes off blood vessels near the tattoo removal area. Sutures are used to stitch up the gap edges from the tattoo removal.

For large tattoos, the specialist starts by injecting local anesthesia. They initiate the procedure by removing skin from the tattoo’s middle, moving outward in bits in secondary sessions as the wound heals. A skin graft may be needed at the end, taken from elsewhere on the body to place over the exposed wound.

Excision provides immediate effects for those wanting their tattoos removed. It results in minimal blood loss due to the use of heated needles. The affected area will be tender and needs to be covered to avoid infection, as excision brings the most risks of germs. Patients can go back to normal activities soon after the procedure. Direct sunlight must be avoided before and after the procedure on the vulnerable area to prevent pigmentation. Scars fade over time. Ensure that the excision is done by a qualified specialist. Take prescribed antibiotics before and after the excision.

Laser Removal

There are several types of laser tattoo removal to break down tattoo pigments. Modern methods involve Q-switched lasers, creating light pulses with high peak output, lower pulse duplication, higher pulse power, and longer pulse intervals. Another form of laser tattoo removal includes continuous-wave lasers, which uses electromagnetic waves of constant volume and abundance for infinite periods. (Both methods can be used at the same time.) One of the first uses of lasers in tattoo removal involved an argon laser in 1979 with inadequate results.

Laser Tattoo Removal

Laser tattoo removal uses selective photothermolysis. This depends on the laser light’s color being able to breach the skin to target the tattoo’s pigment; the laser color being absorbed in a higher rate by the pigment than adjacent skin; the pulse (time) period of the laser to fragment the tattoo pigment without the heat affects neighboring skin; and ample energy in each laser pulse to heat the pigment particles. The lasers in tattoo removal break down the ink by passing through the skin and heating up the colored particles, breaking them into smaller bits. Because tattoo pigments have unique light absorption range, the laser needs to emit enough energy within that field to be effective. This ink is absorbed into the body-similar to natural exposure to the sun and resulting fading-and discharged through the lymphatic system.

Q-switched laser treatments average eight sessions. Post-treatment changes may include a white discoloring of the skin (heat-formed gas or steam exposure) and possible pinpoint bleeding-vascular trauma brought on by the laser’s exposure to the tattoo pigment. Possible edema or erythema of nearby skin goes away after a day, and a crust on the tattoo subsides after about two weeks. Recovery also includes taking care of the wound and applying a dressing to block it from air exposure. Do not use topical antibiotics, as they may bring on allergic reactions.

Side effects from Q-switched laser treatment includes changes in skin pigmentation (likely to return to normal within 12 months), hyperpigmentation (skin darkening due to increased melanin), textural changes (resolved within several months), allergic reactions, ruptured blood vessels (rare), erythema (inflammation), pruritus (itching), and even inflamed nodules, verrucous papules, enlarged bulla (vesicle), or granulomas (unique inflammation of bacteria, fungi, suture or keratin fragments) may present and aerosolized tissue. Do not expose the tattoo site to sunlight.

Salabrasion

This older form of tattoo removal is simple in nature. The person administering the treatment shaves the area that contains the tattoo. Local anesthesia is sometimes used before the treatment for pain. The ingredients (tap water, table salt, an object covered by an abrasive material) are then applied. The salt and water are mixed together and placed on the tattooed skin. The abrasive material is rubbed on the area until it turns deep red. The treatment should take about 30-40 minutes.

Antibiotics and a gauze covering are applied for about three days, followed by salt for a few hours. The wound is given ointment and covered for three days to heal.

Dermabrasion

Dermabrasion is the removal of dead skin by abrasive means to remove tattoos via surgery. This leaves the skin red and raw. Rudimentary ways (also called microdermabrasion) include sandpaper, rocks, shells, and aluminum oxide crystals. Dermabrasion includes Erbium: YAG lasers (which use infrared light), chemicals, scrubbing products, and CO2 treatments. It is non-invasive and can be done by a trained skincare expert or at home.

Before dermabrasion, the specialist will inform you of the potential complications and risks of the procedure. Photographs will be taken prior to and after treatment for comparison. Anesthesia is administered. At the procedure, anesthesia is given and the area of the tattoo is cleansed with an antiseptic. A skin-freezing spray is then used. A rotary tool attached to an abrasive instrument removes outer epidermis layers.

Side effects from dermabrasion include dryness, irregular skin color changes, skin pigment changes, momentary bruising, scars, infection, and sensitivity to sunlight. Do not expose the wound to sunlight for 3-6 months. Recovery time varies between weeks to months. The specialist can give you medication to lessen pain. The affected skin will regain color within eight weeks. Normal activity can resume within 1-2 weeks. Do not use aspirin or ibuprofen for up to a week after the procedure. Alcohol is prohibited for two days after surgery, and smoking should be avoided.

Intense Pulsed Light Therapy (IPL)

Intense pulsed light therapy (IPL) uses light at a broad spectrum that infiltrates the skin and filters unnecessary wavelengths to treat tattoos. Those with problems with scars, keloids, skin burns or diabetes should not get IPL because of the lack of wound-healing capabilities. Consult a specialist before IPL to inspect the skin and your scars, and you will be given a patch test to gauge your skin’s reaction; the test area should be watched for redness, blistering, pigment issues and rashes. You might be recommended to do certain things before your IPL treatment, including the sun and particular medication avoidance-such as ibuprofen and aspirin-to lessen bleeding risk.

For the procedure, the specialist will give you a topical anesthetic. A cold gel will then be placed on the area and a glass prism is applied to channel intense light. Several treatments will follow every 3-4 weeks, all more aggressive than the first.

The skin will be pink or red after your procedure. Side effects from IPL include blistering, small bleeding, scarring, swelling and changes in pigment. You should use a sunscreen with high SPF in the affected area.

Chemical Peels

There are several types of chemical peels for tattoo removal. Trichloroacetic acid (TCA) removes skin layers as deep as the tattoo pigments, applied on the skin and left for approximately five minutes. The resulting inflammation causes it to peel, lifting the tattoo ink closer to the epidermis surface. TCA should be done in seven-week shifts, and completion is based on your skin type-with the disappearance of the tattoo marking the end of treatment.

Phenol Chemical Peel is another form of tattoo removal treatment. It is more painful due to its use of phenol seeping deeply into the skin. The treatment time is short (about 10 minutes) but it requires several weeks for recovery and new skin growth. Side effects include pigment changes in darker skin, scarring, and need for pain medication.

A Jessner chemical peel goes deeper than normal peels. It contains several chemicals-including lactic acid, resorcinol, and salicylic acid. It is good for people that have skin irregularities and effective if done properly. It takes approximately 45 minutes to administer the treatment. A positive in favor of Jessner chemical peel is a lack of downtime or surgery. You should see results within a week. Side effects include swelling, itching, infection, hyper- or hypo-pigmentation, allergic reactions, redness, and pain.

Cryosurgery

Cryosurgery uses very cold temperatures to remove unwanted tissue. For tattoo removal, ice crystals form on skins with tattoo pigments, fragmenting them. It can be done with liquid nitrogen, carbon dioxide, argon or a combination of dimethyl ether and propane to freeze the skin. The epidermis peels and comes off; tattoo ink residing underneath the skin should come off as well. Several cryosurgery sessions will be necessary.

Patients may experience some pain and redness at the site, which can be dissipated by pain relief medication. Blisters go away after a few days. Small white spots may form around the area and are most likely permanent. This form of treatment is minimally invasive and comes with a lack of pain and scarring. Risks include nerve tissue damage.

Cost of a Tattoo Removal

The cost of tattoo removal varies by geographical area, specialist, tattoo size (per square inch), post-operational treatment, and facility fees. Certain areas of the body are more expensive than others due to the amount of space the tattoo can occupy, the type of ink used and the professionalism of the artwork. Tattoo removal is rarely covered by insurance companies.

Expertly done tattoos take longer to eradicate than novice ones, and colorful marks (green, yellow, pastels) are harder to remove than black- or blue-colored ones. Older tattoos are easier to remove and less costly than newer ones. Ink density also plays a role in cost and treatment sessions.

Excision Cost

The average cost of excision tattoo removal ranges from $800-10,000. The cost depends upon the specialist, facility fees, use of anesthesia (the procedure can be painful), post-operational treatment, and the size of the tattoo. Because the procedure is best for smaller artwork, excision removal is faster (about 2 hours) and requires less sessions-as low as one or two.

Laser Removal Cost

The cost for tattoo removal by Q-switched laser varies by geographical area, specialist, tattoo size (per square inch), post-operational care, and facility fees. The cost ranges from $39-75 per square inch per visit. The price per inch is on a sliding scale, with costs coming down when factoring in larger tattoos. Some specialists have a minimum amount you need to pay per visit-about $100 on the low end of the scale. You will have approximately 3-20 procedures to remove the artwork, with the average being 6-12 sessions. Certain areas of the body are more expensive than others due to the amount of space the tattoo can occupy, the type of ink used and the professionalism of the artwork.

Expertly done tattoos take longer to eradicate than novice ones, and colorful marks are harder to remove than black-colored ones. Part of or the entire tattoo can be removed. Financing is available at most facilities to appeal to those with financial need.

Salabrasion Cost

The cost for salabrasion tattoo removal depends on body area, the physician, tattoo size (in square inches), local anesthetic, post-operational treatment, and facility fees. The average treatment is between $200-600. The typical amount of treatments ranges from 2-5 and each session is about 30-40 minutes. If the tattoo cannot be fully removed, it can be lightened further by micro-pigmentation.

Dermabrasion Cost

The cost of dermabrasion tattoo removal depends on the region, physician, tattoo size (per square inch), post-operational treatment, and clinic fees. It can be done in a specialist’s office or at home. The cost ranges from $200-300 per visit and about $1,500-4,000 overall over the course of several sessions.

Intense Pulsed Light Therapy (IPL) Cost

The cost for IPL treatments varies based on body area, the physician, tattoo size (in square inches), post-operational treatment, and clinic fees. Intense Pulse Light therapy treatment is on a per-pulse basis, and sessions are dependent on the number of pulses to eliminate the tattoo. The average is $10-15 per pulse. While it has fewer appointments than laser removal, the average tattoo takes 10-12 months of sessions.

Chemical Peel Cost

The cost for chemical peel treatments varies based on body area, the specialist, tattoo size (in square inches), post-operational treatment, and facility fees. Chemical peel tattoo removal can be done at a doctor’s office or at home and it is significantly cheaper outside of the clinic. In a specialist’s office, ranges between $300-1,000 per session, might involve phenol for strong-strength peels and may involve several procedures. A Jessner peel ranges between $100-500 per session. Trichloroacetic acid (TCA) treatments cost between $30-50 for a 1-2 oz bottle and are recommended for medium-strength applications. Glycolic acid peels (or alpha hydroxy acid peels) react similarly to TCA treatments and are for lighter applications. TCA can be administered every 2-6 weeks to allow time for tattoo ink to fragment and migrate toward the skin’s surface.

Cryosurgery Cost

Cryosurgery costs are dependent upon the surgeon, the facility and its fees, the tattoo area, and post-operational expenses. The procedure runs between $200-600 on average and may require several visits. It is minimally invasive and more cost-effective than laser tattoo removal and other treatments.