Things You Should Know About Tattoo Removal
A complete guide on what to expect from the tattoo removal process.
The fact that you can now get a tattoo removed at all is another feather in the cap for medical science. However, this cosmetic process is no walk in the park. Tattoo Cares has put together this 5 step guide to help you understand exactly what to expect from tattoo removal.
Tattoo Removal Before And After Dermabrasion
Dermabrasion removes layers of skin with a sanding device to allow ink to leach out. Its effectiveness varies greatly between individuals, making it a less popular option.
You should avoid dermabrasion if you have extremely sensitive skin or a skin condition such as eczema. If you consume blood thinners, you may be more likely to experience bleeding, bruising, and changes in skin color after the procedure. Individuals with darker skin may be additional prone to skin pigment changes.
A clinician will administer a local anesthetic during a typical dermabrasion session to alleviate pain. Theyll use a high-speed rotating abrasive device to sand away the top layers of skin, allowing tattoo ink to escape.
This is usually done in a single procedure at a cosmetic surgeons office. The length of the procedure is determined by the size and color of your tattoo. Larger tattoos with multiple colors may take longer to treat.
The treated area will most likely feel painful and raw for several days after the procedure. It will be two weeks to fully recover. In most cases, the pinkness or discoloration of the treated area fades within 8 to 12 weeks.
As you heal, your doctor may advise you to:
- To avoid infection, apply an ointment.
- Avoid openness to direct sunlight for 3 to 6 months following the procedure.
- Every time you go outside, apply sunscreen to the affected area.
- Wear loose clothing on the affected area until it heals.
- As the wound heals, avoid soaking it in water.
The Tattoo Darkens Before It Starts To Fade
It may sound weird, but it is true. The tattoo gets darker before it starts to disappear, which is normal.
So, do not be judgmental or doubt the efficacy of the treatment. It is a part of the removal phase.
The tattoo will either remain the same or darkens after your first session of laser tattoo removal. It reflects the way lasers impact the layers and tissues of the skin.
As the lasers target the deepest layer of the pigment first, the layers present near the surface become darker.
Another reason for the darkening of the tattoo is the irritation and bruising that occurs after the treatment.
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How Tattoos Are Removed
Since ink-noshing macrophages are what make tattoos, scientists have proposed removing unwanted tattoos by activating some other immune cells to grab the ink and take it off to lymph nodes, to be carried off in lymph fluid. But this is just an idea for now.
Momentarily, the most widely used tattoo removal procedures involve firing ultra-short laser pulses onto ink particles to break them up. The lasers fire a pulse every trillionth of a second, delivering a lot of energy to the particles in a very short amount of time. This procedure is known as photothermolysis, and is exactly the same process used in laser hair removal.
Once the ink particles which may be made of titanium dioxide, lead, chromium, nickel, iron oxides, ash, carbon black, and other ingredients are broken apart by the laser, the remnants are transported by white blood cells to the liver. Even without the laser breaking apart the ink, armadas of white blood cells are always moving small quantities of ink particles away from the tattoo site. However, theyre much too small to gobble up ink particles whole, so their impact is minimal. They nevertheless cause the tattoo to fade over time and lose its luster.
Black-colored tattoos are the easiest to remove since the dark ink absorbs virtually all laser wavelengths. Color pigments need to be treated by lasers firing at certain frequencies, typically requiring more lengthy sessions to remove.
How Long Will It Take To Remove My Tattoo
The duration of the tattoo removal process is a concern for virtually all patients.
Some patients may wish to remove a visible tattoo before an event such as their wedding or enlisting in the military. It’s important to establish upfront that tattoo removal is a process that relies on the body’s ability to eliminate ink from the skin.
It’s not unusual for the body to take over a year to completely eliminate ink. Setting expectations clearly upfront allows patients to be satisfied throughout the experience rather than feeling as if they were misled.
To allow the skin enough time to heal between treatments and the body’s immune system to flush away ink, we recommend a minimum of six weeks between laser sessions and eight weeks for darker complexions. Stacking the treatments too close together can cause damage and permanent side effects to the skin and doesn’t allow the body enough time to remove the ink that was shattered at the most recent session. For ideal results, we recommend waiting three months between treatments.
Ultimately, as a tattoo removal practitioner, you cannot know precisely how many treatments a tattoo will need to be fully removed. However, you should assess the patient’s tattoo for how easily it should remove.
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Improper Aftercare Or Incorrect Protocols Pose A Risk
While it is uncommon to cause scarring from the laser tattoo removal sessions themselves, it is still possible. For example, if you use excessive fluence when treating a tattoo and cause unwanted side effects , scarring may occur.
Another risk for scarring, even if the treatment is performed properly, happens when patients fail to follow aftercare instructions. Blisters and scabs are common side effects that are important in the tattoo removal healing process. However, picking scabs or not caring properly for blisters can allow scarring to happen. When discussing aftercare with your patients, make sure to emphasize their role in the outcome of their tattoo removal.
There are also some patients that may have a history of keloids and may be predisposed to scarring, which is why it’s important to take a detailed medical history of each patient.
Introduce The Discussion Of This Topic Even If The Patient Doesn’t
Many patients have the misconception that the laser “burns” the tattoo ink out of the skin. By discussing how tattoo removal works, you can help patients appreciate the role that the laser has in eliminating their unwanted tattoo.
We suggest having a simplified answer such as this:
“Each pulse of the laser sends light energy into your skin. We use different wavelengths of laser light to treat different colors of ink in your tattoo. As the light energy is directed into your skin, it is selectively absorbed by the tattoo ink particles trapped in the dermis of your skin. When the ink particles absorb this energy, they instantly shatter into tiny fragments. Once the laser has broken the ink into smaller pieces, your body’s immune system works to remove the ink over the following weeks, flushing it away from the tattooed area. We see the result of this as the tattoo lightening in appearance. Each additional laser treatment breaks down more and more ink until the tattoo can no longer be seen.”
This description achieves a few things:
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Is Laser Tattoo Removal Painful
Laser removal involves applying extremely hot, concentrated light to your skin, so some discomfort is expected. However, everyones tolerance for pain is different, so some people express significant discomfort, while others say its no worse than getting the tattoo in the first place. There can also be some lingering soreness after each session, usually similar to what you feel with a small burn or blister.
It Will Take Monthsif Not A Year Or More
Tattoos don’t just disappear after a once-over with the laser. A complete tattoo removal takes a minimum of two and a half years on average, says Bethany Cirlin, tattoo removal specialist and owner of Clean Canvas More Art. Laser treatments should be scheduled three months apart from one another so you get the most out of each treatment. This allows your body to break down as much of the tattoo as it can while also giving your body the opportunity to heal completely before your next session.”
As of writing this, I’ve had six sessions, and I’d wager that I need about five more, despite the fact that my initial estimate was six to eight sessions. It takes a long time to complete because each time the tattoo is lasered, particles are broken down and digested by the body’s immune system. The regeneration period is up to eight weeks, and the next time you go, the laser breaks down new particles of pigment, and so on and so forth.
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Pain Management During Treatment
Laser tattoo removal is painful many patients say it is worse than getting the tattoo. The pain is often described to be similar to that of hot oil on the skin, or a “snap” from an elastic band. Depending on the patient’s pain threshold, and while some patients may forgo anesthesia altogether, most patients will require some form of local anesthesia. Pre-treatment might include the application of an anesthetic cream under occlusion for 45 to 90 minutes or cooling by ice or cold air prior to the laser treatment session. A better method is complete anesthesia which can be administered locally by injections of 1% to 2% lidocaine with epinephrine.
A technique which helps to reduce the pain sensation felt by patients has been described by MJ Murphy. He used a standard microscope glass slide pressed against the tattooed skin and fired the laser through the glass. This technique may represent a simplest and effective method to reduce the pain sensation when treating small tattoos.
For Some Tattoo Removal Hurts More Than Actually Getting A Tattoo
If you thought getting inked hurt, wait until you try to undo it.
Dr. Morgana Colombo, board-certified dermatologist, MD, FAAD, and co-founder of Skintap, explains, “Although the treatments are usually quick they can be quite uncomfortable and painful. Patients describe a deep burning prick-like sensation which is significantly worse than the little pricks they feel when getting tattooed.”
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What You Need To Know
Laser tattoo removal is often easier to commit to than actual tattoos, but there are still things you should know beforehand. Its important to note that a single laser treatment probably will not completely erase your tattoo. The only way to completely remove a tattoo in a single session is through surgical removal, but this method is painful and leaves a scar.
It will probably take a few sessions to remove your tattoo, but PicoSure comes with the added benefit of being more comfortable, non-invasive, and more effective than other laser treatments. Where older methods like the Q-switched laser require different settings for separate colors, PicoSure targets all ink at once. This means you require fewer treatments and difficult colors can be removed more effectively.
Older laser treatments can cause a phenomenon called ghosting in which the laser removes normal pigment from your skin as well as tattoo ink. This can leave a pale area surrounding the tattoo area where your own pigment has been bleached out. The PicoSure laser does not cause ghosting it targets the tattoo ink but leaves your own pigment intact.
At Skin Deep Laser MD, we schedule PicoSure treatments at least six weeks apart to ensure that your skin has time to heal and eliminate the pigments. Older tattoos and amateur tattoos are easier to erase than newer or professional pieces, so your results may vary.
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The Results Are Not Immediate And Take Months If Not Longer To Surface
If you expect to erase your tattoo after a session of two, be prepared for it to take longer. Tattoos dont lift quite that quickly, even with laser tattoo removal. Depending on the size, colors, and age of the tattoo, it can take up to 12 sessions and 12 months for the tattoo to fully fade from the skin.
Youll need to space out each session by a few months, which adds time to the overall removal process. Giving your body ample time between sessions allows it to break down the tattoo as much as possible. With each session, the laser reaches down into the dermis to break down the pigment in the tattoo into tiny particles, which the immune system flushes out of the body. The break in time also allows the body to heal before the next session. And it reduces the risk of scarring, too
However, laser tattoo removal can remove all types of tattoo ink, no matter the color. It was one thought that lighter pigments were harder to remove, but todays laser tattoo removal devices can remove all colors from all skin tones.
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How Long Does It Take To Remove A Tattoo
Getting new ink can take as little as an hour, depending on what you’re getting. Unfortunately, removal is a much longer process that can take anywhere from six months to a year.
You’ll have four to eight weeks to heal between sessions, and each session can take up to half an hour. If your tattoo has colored ink, you’ll need more sessions with laser treatment. Dr. Shirazi notes that this process will look different for someone who uses Tatt2Away.
“Tatt2Away does not depend on ink color, as it removes all ink colors in a given session by drawing it out of the skin as a scab form and dispels the ink from the body,” she explains. “It often requires 3-5 sessions regardless of ink color whereas laser tattoo removal often requires 5-15 sessions.”
What Should I Do If I Develop Blisters Due To My Laser Treatment
Following your laser therapy, you may encounter some blistering. This should not concern you. This is a normal part of the healing process and frequently occurs on large tattoos or in zones with poor circulation, such as the fingers and ankles. Blisters are easily treated and, with proper aftercare, will heal perfectly while leaving the skin intact.
If blisters form, do the following:
- Do not pierce them. Apply ice packs to them for up to 48 hours after treatment. This will reduce and help prevent any associated discomfort and, in some cases, allow it to completely subside .
- If the blisters pop , apply an antibacterial lotion several times a day and protect them with a dressing or bandage. Maintain this treatment for at least 48 hours after the blisters have burst.
If the blisters have crusting, scabbing, or oozing:
- Picking at them or allowing the skin to be scraped may result in infection and scarring. Shave the area until it has completely recovered.
- Apply an antibacterial ointment or liquid several times daily and cover with a bandage or dressing.
- Repeat every day until there is no crusting, scabbing, or oozing.
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Laser Tattoo Removal Comes With Risks And Side Effects
Laser tattoo removal can have side effects. These can include swelling, redness, blistering and infections at the removal site. Some patients may also experience hyperpigmentation, inflammation and scarring, Dr. Graf notes. As such, it’s mega-important to follow your doctor’s instructions about preparation before lasering as well as maintenance following treatments.
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Laser Tattoo Removal Isn’t A One
Depending on the size, color and age of your tattoo, you can expect several sessions to get rid of it completely.
“With a picosecond laser, it can take between four and six treatments depending on your tattoo,” Dr. Qazi says. “Many things can factor into how quickly your tattoo can be removed. Size is one factor, and the colors used are another.”
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Consider A Doctor Or A Tattoo Removal Specialist
I previously had one tattoo zapped at a spa , where an aesthetician used an outdated heat laser that ended up burning and scarring my skin. This time around, I got my treatments done by John F. Adams, MD, at the New York Dermatology Group, where everything is done under medical supervision. I suggest you find your own removal expert by asking friends or influencers, or even stopping people that you see with removal in processwhich, yes, I have done.
Know That The Location Of Tattoo Ink And Size Of Tattoo Matter
Location on the body will affect your tattoo primarily based on vascular supply and healing ability. Essentially, that means that tattoos further from your heart will be harder to remove.
Why?
Blood flow helps you heal. Because the procedure for laser tattoo removal involves treating your skin with the laser, there will be some discomfort and short-term injury that has to heal. When the tattoo is located further away from your heart, the vascular supply is diminished, and it will heal slower. That makes it harder for your bodys lymphatic system to carry away the broken-down ink.
Ankle tattoos, for instance, are pretty tough to remove. Theyre not always impossible so do ask but they are notoriously difficult.
The size of your tattoo will have an obvious effect, as well. Larger tattoos take longer to remove.
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