How Laser Tattoo Removal Works:
Laser tattoo removal employs a special type of laser called a Q-switched laser, which uses a process called selective photothermolysis. This means that the lasers used to remove tattoos have the ability to selectively target only specific pigments and break the ink up into tiny particles.
Why is this process important? Because it means that the tissue surrounding the pigment is left intact. Also, since only light is entering the skin (and light is sterile), there is a very low risk of infection. This differs from older methods of tattoo removal that required the breaking, cutting, or abrasion of the skin.
Who Is a Good Candidate for Laser Tattoo Removal?:
The best candidates for laser tattoo removal are patients who are generally in good health and who have a positive outlook and realistic expectations about the procedure’s outcome. Although all skin types can be treated, patients with pale skin and dark tattoos usually enjoy the fastest and best results.
Who Is Not a Good Candidate?:
Laser tattoo removal should not be performed on those with compromised immune systems, including patients with diabetes, HIV or other immune disorders. If you tend to form keloids or hypertrophic scars, you are not a good candidate for laser tattoo removal. The same goes for people taking certain medications, especially those which make the body and skin more sensitive to light (i.e., accutane, some antibiotics, antidepressants, and others).Pre-Operative Considerations:
It is best to avoid smoking for a period of several weeks before and after your procedure, as smoking constricts the capillaries and taxes the immune system, thereby slowing healing and results. The procedure will sometimes be postponed if you have an active infection or other inflammatory skin condition present. As with all other cosmetic procedures, you should let your doctor know about any allergies and any medications or herbal supplements you may be taking.
Post-Operative Care:
Try to keep the treated area elevated above the level of the heart for the first 24 hours. Apply ice to control swelling and the feeling of excessive heat. Keep the area scrupulously clean to avoid infection, and do NOT apply tight bandages or apply thick layers of occlusive substances such as petroleum jelly and the like. (This only traps heat, which is the exact opposite of what you want to do.) Avoid environments like hot tubs or steam baths. Over-the-counter pain medicine can be used to ease any discomfort. In short, treat the area as you would a severe sunburn or a new tattoo.
Recovery & Downtime:
You should be able to return to work and most normal activities immediately following your procedure, although strenuous activity should be avoided for at least 24 hours. Ideally, treatment sessions should be spaced at least 6 weeks apart. This is mainly because the laser itself does not actually remove the ink. It simply breaks the ink down into smaller pieces, enabling your immune system to do the work of removing it from the body. This process takes time. Therefore, the full result from your previous session will not be seen until around the 6 week mark.
Risks & Complications:
Risks and possible complications include:
- pain during the procedure
- pigmentation and/or textural changes in treated area
- hypertrophic or keloid scars
- swelling
- blistering
- secondary infection
- allergic reactions to the topical anesthetic used
Costs:
The costs for laser tattoo removal are highly variable, depending on the experience and reputation of your doctor or technician, geographic area, skin type, and the size and color(s) of your tattoo. A big factor in the cost, too, is the fact that tattoo removal almost always requires multiples sessions. With 2 to 15 sessions needed, at an average cost of $30 to $60 per square inch, the range in expense is wide. So, if you have an average-sized tattoo (approximately 4 square inches), removing that unwanted ink could cost you anywhere from $250 to $2,200. Larger tattoos, of course, can cost considerably more.
Humanitarian Tattoo Removal:
If your tattoo is gang-related, there are doctors in many different areas who will remove it free of charge. There are also special gang outreach programs that host tattoo removal “clinic” days for which doctors and nurses volunteer their time, services, and equipment. Usually, there are requirements to receive free tattoo removal services, such as showing that you are no longer involved in any gang, volunteering in gang outreach programs, and/or commitment to some other sort of community service.How It's Done:
The first step is a thorough consultation with your doctor. He or she will complete a detailed history and physical examination to ensure there are no underlying medical conditions that would preclude your having the procedure. Your tattoo will also be physically assessed to determine whether you are a good candidate for the procedure.
On the day of the procedure, the area will be numbed. Although some patients may choose not to have any anesthetic, most do. Usually, this involves the application of a topical anesthetic approximately 30 minutes prior to the start of the procedure. Sometimes an injectable local anesthetic is used instead of or in addition to the numbing cream, although this is not preferred because it can cause or worsen swelling and/or bleeding. In rare instances, an oral sedative may be given.
Patients often say that the sensation of being treated is similar to being snapped with a rubber band.
Protective eyewear should be worn during the procedure. A test spot might be performed to determine the best laser settings based on skin type and the tattoo itself.
The actual procedure involves the targeted application of the laser to the treatment area. In some cases, the entire tattoo will be treated. In the case of a large or multi-colored tattoo, it is possible that only part of the tattoo will be treated in a session. Treatment with the laser generally lasts only 30 to 60 seconds.
After the area is treated with the laser, a loose dressing may be applied over a thin layer of aloe and hydrocortisone-based healing balm to facilitate healing and protect the area from bacteria and trauma. Your doctor will provide post-op instructions on how to care for the treated skin, which may involve more than what's listed above.
Sources:
Interview with Will Kirby, DO, FACOS, Los Angeles, CA; conducted on November 19, 2008
Laser Treatment of Tattoos, Eric F. Bernstein, Clinics in Dermatology, Volume 24, Issue 1, January-February 2006, Pages 43-55
