Removal of a tattoo by laser is accomplished by
matching the tattoo color with a precise beam of laser light tuned to
the tattoo pigment. The tattoo ink is superheated very quickly, causing
ink to break down into smaller pieces. Once the ink is in small enough
pieces, the person's immune system
gradually removes the ink. As a
result, most laser tattoo removal is a slow process needing multiple
sessions to fully remove the ink trapped in the skin. Of note, there is a
new ink on the market that is designed to be removable in 1–2 laser
sessions.
Removing a tattoo is similar in some aspects to trying to
remove a stain from clothing. A stain that takes a split second to
happen may take quite a bit of work to remove, and sometimes the stain
cannot be fully removed. Once removed, the results are permanent;
however, predicting how many sessions a patient will need is difficult.
Amateur tattoos are the easiest to fade, as they contain little ink.
Deeply colored professional tattoos can be difficult, often requiring a
double digit number of treatments. Some colors respond to only certain
types of laser energy, so for the best success, matching the right laser
to the type of ink is important.
Each color responds to one or
more unique wavelengths (in nanometers [nm]) of laser energy. Matching
the wavelength to the color may optimize the response:
- Black ink – nearly any wavelength but most commonly 1064 nm
- Green ink – 755 nm is best; 694 nm or 650 nm can be effective
- Blue ink – 585 nm
- Red ink – 532 nm
Preparation / Typical Procedure
Prior to a session, avoiding a tan in the area to be treated
is extremely important. A combination approach to keep the skin as
light as possible in the tattooed area is helpful:
- Use a high SPF sunblock daily, and re-apply periodically if in the sun.
- Avoid outdoor activity during peak sun hours (10 AM to 3 PM).
- Wear sun-protective clothing, such as long sleeves and a hat.
- Sit in shady areas when outdoors.
- Wearing a protective bandage over the tattoo will block sun exposure.
Most
patients prefer to use numbing cream for 45–90 minutes immediately
before treatment. Once the skin is cleaned, laser treatment is usually
fairly quick for a small- to medium-size tattoo. The laser handpiece is
placed over the skin and repeatedly pulsed with laser light until the
entire tattoo is treated. A major issue can be the pain of the laser
treatment, which is often more painful than getting the tattoo.
Some
compare the pain of laser tattoo removal to being snapped by a rubber
band.
Following the Procedure / Aftercare
After treatment, the skin is temporarily swollen and
sometimes temporarily white. Occasionally, blistering can occur. Gentle
skin care and sun protection is important to promote proper healing.
Risks or Side Effects
- Blistering
- Temporary darkening of the skin
- Temporary or permanent lightening of the skin
- Scaring
- Ineffectiveness
- Tattoo darkening (in red eyebrow or lip tattoos)
Alternatives
- Surgical removal
- Dermabrasion (sometimes with salt)
- Laser vaporization
- Topical products (heavily advertised but their effectiveness is questionable)
- A second tattoo to cover the area
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