Other Associated Terms: Laser Tattoo Removal, Intense Pulsed Light Therapy, ILP Tattoo Removal, Excision Tattoo Removal, Dermabrasion Tattoo Removal.
Overview
Tattoos have been around since ancient times. Mummies from ancient Egypt have been discovered with evidence of tattooing. The tattoo process involves the injection of various colored pigments into holes that are made in the skin. This means that the process is more or less permanent. A tattoo can fade, over time, but the pigmentation will still be evident over the years. For this reason, there can be occasions when someone might wish to have a tattoo removed.
Tattoos can be successfully removed through several methods. However, there will be some coloration or scarring left behind in most of these procedures. The visibility of these blemishes will depend on different factors such as location, the method in which the tattoo was done, the individual’s physiology, its size and the age of the tattoo.
One example would be a more easily removed tattoo from a skilled tattoo artist. This would be due to an evenly injected pigment placed in a consistent depth of the skin. You can compare this with the difficult removal of an inconsistent amateur tattoo. Older tattoos can also be more difficult than newer tattoos to remove.
Benefits
Getting a tattoo is a personal decision that can be sometimes be based on emotions that will change over time. Whether the tattoo was an expression of a current ideology, artistic concept or a statement involving a current relationship, these things can alter with time. Realizing that you have a “permanent” sign on your body that you may no longer agree with, can be traumatic.
Being able to remove the tattoo can give one a fresh new outlook and a feeling of “starting over again”. Having control over one’s body is a powerful psychological motivation.
Patient Characteristics
The ideal candidates for tattoo removal are those in good health, both physically and psychologically, and wish to change their appearance. They should be non-smokers or at least be able to refrain from smoking during the time frame of the treatment sessions. They should have realistic expectations of the outcome and be willing to invest the time that is needed to complete the treatment.
They should also not be prone to scarring or have scars in the tattoo area. There also should be no fluorescent pigments in the tattoo to be removed. Connective tissue diseases (ex. - lupus) will disqualify a patient for this procedure and Accutane should not have been taken for a least 18 months prior to treatment.
Procedures
There are several procedures available for tattoo removal. These are:
Laser tattoo removal
This is the most common form of tattoo removal. It involves utilizing the high intensity light of lasers to remove the tattoo by breaking up pigment coloration. As more treatments are performed, more laser light will penetrate the skin to eliminate the ink. There is a limit, however, to the number of treatments that can safely be performed since too many treatments can damage the skin and scarring can occur.
There are several factors that can ultimately affect the outcome of laser treatments. These will include, among other things, the type of laser used, the number of procedures and the patient’s physical reactions to the treatment. Anywhere from 1-10 sessions may be needed to complete a treatment.
Intense Pulsed Light Therapy (IPL)
Intense Pulsed Light Therapy (IPL) is a technique that uses intense light, which targets upper skin layers in order to burn off the tattoo. This procedure will also stimulate the growth of new skin which makes the tattoo much less visible, as the skin heals. It’s reported that this treatment is less painful than laser therapy, requires fewer treatments and can be more effective. Due to the time needed for the skin to heal, it will usually take up to 12 months for the final results to be evident.
Creams that fade tattoos
Topical creams are a non-invasive approach to tattoo removal. Used over a period of time, they can eventually cause a tattoo to fade. Results, however, cannot be guaranteed and some creams can cause scarring by burning the skin. Positive aspects of this method are lower costs compared to laser removal, IPL treatments, etc. This is the least reliable method of tattoo removal and is usually resorted to when other methods are cost prohibitive.
Excision
This method involves the actual removal of the tattooed skin area and then suturing (stitching) the area closed. This procedure is usually used to target smaller tattoos – but larger tattoos can be addressed in this manner, as well. With larger tattoos, a skin graft from another location on the body will be required.
Dermabrasion
This is a surgical procedure in which the doctor uses a medical sanding tool to “sand off” the upper layers of the skin. This reveals the fresh layers of skin underneath – thus removing the tattoo. Local anesthesia will be required and there will be a recovery time involved that may extend over a few weeks. This procedure may not be advised for those prone to scarring, hypo-pigmentation (skin lightening) or hyper-pigmentation (skin darkening).
Salibrasion
This is a much older technique that involves injecting the tattoo area with epinephrine and lidocaine (for numbing and to control bleeding/bruising). The area is then vigorously rubbed with a sanding block made of salt or plain salt, itself. This method can be quite painful and is usually only used when other methods are either not medically viable or they are cost prohibitive.
Saline Injections
This method involves injecting the tattoo area with lidocaine and salt water (saline) which will assist in breaking up the pigments in the tattoo. This will not actually remove the tattoo, but it can blur the image significantly.
Recovery
Recovery details will depend on the type of treatment the patient receives. You should discuss all recovery specifics with your doctor.
In general, redness will be apparent for several weeks. Some bruising may have developed, as well. Bleeding can occur with the removal of deeper tattoos. Your doctor may treat the area with antibiotic ointments and apply a bandage
The total recovery time depends on the physiology of the patient and the extent of that particular treatment. The treatment area may retain some discoloration or exhibit different skin texture. This may gradually improve. Avoid exposing the treated area to direct sunlight (or use a good sun block when going outside. But most importantly – alert your physician immediately if you suspect that you are developing an infection. This can lead to severe, permanent scarring.
Some other general recovery instructions may include: using a gentle cleanser to clean your face and your doctor may also recommend special moisturizing lotion or cream. Make sure to avoid any exfoliation products and acid-based products as these will act as irritants and slow the healing process.
Most patients are happy with the results achieved through qualified, professional removal treatments. You should keep in mind, though, that the appearance of the skin in the treatment area will never be quite the same as it was before you had the tattoo applied.
Dermabrasion Recovery
With dermabrasion, you need to discuss the various complications and risks with your doctor. You medical history should also be discussed, at length. Those who are susceptible to scarring, have certain medical conditions or have skin infections may wish to reconsider dermabrasion.
Darker skin tones may react badly to dermabrasion, as well. Laser resurfacing, chemical peels and dermabrasion all can damage certain ethnic skins. You can have your doctor performs a small area “spot test”, if there is any uncertainty.
Blister (bullae), whiteheads (milia), hyper-pigmentation, hypo-pigmentation or scar tissue formation can also occur. If you’ve taken Accutane within the past 18 months, you need to be aware that Accutane causes thickening of the skin which can lead to a scarring risk.
Risks Associated with Tattoo Removal
Infection is always a concern with any surgical procedure. So, care should be taken when touching the treatment area. Make sure your hands are clean any only allow sterile bandages and other sterile fabrics to touch treatment areas. Also, make sure you check the credentials of the facility you are having the procedure in. Defective machinery can cause scarring or burns.
The same can be said of unskilled technicians. Hyper-pigmentation (skin darkening) or hypo-pigmentation (skin lightening) can also occur. Small cysts can develop superficially with laser treatments. These, however, can easily be removed with surgery.
Procedure Costs
Average costs for laser tattoo removal can range from $200 - $500 per session. The price depends on several things which can include the size and type of tattoo and the experience of the surgeon performing the procedure. In 2007, the average cost for laser removal, nationwide, was $2,484 as reported by the American society of Plastic Surgeons.
Since multiple treatments will, most likely, be needed to complete the process, the total expenses for removal could possibly range from $1000 up to $10,000 or more.
Other removal cost averages
The cost of IPL is priced “per pulse” and the cost will depend on the number of pulses required to remove the tattoo. The price range is $10-$15 for each pulse.
You may wish to inquire about financing options from your cosmetic surgeon in order to cover the costs of tattoo removal.
Things to Discuss with Your Doctor During Your Consultation
During your initial consultation with the doctor, you have the opportunity to discuss several topics which can include; are the results that you expect realistic? How tattoo removal procedure is right for you and why? Where will the procedure be performed and is the facility accredited? What are your anesthesia options?
You will also need to determine the surgeon’s experience level with regards to the proposed procedure. How many treatments have he or she performed in the last year? You will also want t know what is involved in the recovery and what are the risks that possibly be encountered. What percentage of that doctor’s patients has experienced complications in the past year? What is the policy for correcting or treating procedures that don’t meet agreed upon results? How much does the entire procedure cost and what financing options are available (if needed).