Erasing Ink: A Guide to Laser Tattoo Removal

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Tattoos are a popular form of self-expression, but what we want to express can change as we age. Fortunately, laser tattoo removal is an effective solution for starting over with a clean slate. Here, top laser experts share how it works, the lasers that work best and the ins and outs of hitting the reset button on past, not so permanent, choices.

How does laser tattoo removal work?

Laser tattoo removal uses laser energy to break down the tattoo pigments embedded in the skin. The high-intensity laser emits pulses of light, which are absorbed by the tattoo ink, causing the pigment to fragment into smaller particles. “After shattering the ink into smaller particles, the immune system will help to carry the particles away,” explains Rochester, NY dermatologist Lesley Loss, MD. “Think of smashing boulders into rocks, and then rocks into pebbles, and then pebbles into sand.”

Generally, black and dark-colored inks are easier to remove and respond best to treatment. Light-colored inks, like pastel shades, may require more sessions, notes New York dermatologist Orit Markowitz, MD.

Dr. Longwill used the Q-Switch laser to treat this patient’s collarbone tattoo.

Which lasers work best for tattoo removal?

Different tattoo colors respond best to specific laser wavelengths. For instance, black and dark-colored inks can be effectively targeted by Q-switched Nd:YAG lasers. “We use a Q-switch 1064 laser that produces short, high intensity pulses of light that specifically targets the breakdown of tattoo ink,” says Miami dermatologist Dr. Deborah Longwill.

Red and orange inks are better treated with ruby or alexandrite lasers. Green and blue inks are most responsive to Nd:YAG lasers. “We recommend the PicoWay laser, which is a best-in-class picosecond laser designed for laser tattoo removal and used at all Removery locations,” adds Dr. Loss. 

Dr. Loss removed this patient’s script tattoo using the PicoWay laser over the course of 13 sessions.

What are the benefits and risks of laser tattoo removal?

Lasers that treat tattoos can selectively target tattoo pigments, minimizing scarring and damage to surrounding skin. They can treat tattoos of different sizes, colors, and ink depths. 

While the treatment is generally safe and well-tolerated, some individuals may experience temporary hyperpigmentation (darkening) or hypopigmentation (lightening) of the treated area. “These changes are usually temporary but can persist in rare cases,” says Dr. Markowitz.

“Redness, swelling, blistering and scabbing may occur. One might feel sensitivity and discomfort in the area,” says Dr. Longwill. “Over a couple weeks after the treatment the skin will begin to heal, and the tattoo ink will begin to break down. If multiple sessions are required there is a recovery period between each session.”

To erase this outdated butterfly tattoo, Dr. Loss targeted the ink with the PicoWay laser over the course of six treatments. Photo: Removery

How many sessions are needed?

The number of sessions required for complete tattoo removal depends on several factors, says Dr. Loss. “This is variable and depends on the age of the tattoo, professional versus amateur, the depth of the ink, color, location on the body and the goals of the individual,” she explains. “Lightening a tattoo for a cover up may only take four or five sessions. Removal until it cannot be seen easily may take 12 or more sessions.” 

Davie, FL dermatologist Lesley Clark-Loeser, MD used the PicoWay laser during four treatment sessions to erase this patient’s outdated tattoo.

Does it hurt?

Our experts say the level of discomfort can vary from person to person. While some may find the sensation tolerable, others may find it painful or uncomfortable. “The laser pulses can cause a snapping or stinging sensation, similar to a rubber band flick,” says Dr. Markowitz. However, a topical anesthetic and cooling techniques are used to numb the area beforehand. 

What does recovery entail?

During the recovery period, it is important to protect the treated area and keep it clean, says Dr. Longwill. “Immediately after the area is treated it is covered with an ointment to protect the skin.” After treatment, avoid sun exposure and leave any blisters undisturbed.

Prior to getting a tattoo, it is crucial to recognize that tattoos are intended to be permanent, and the process of removing them requires multiple sessions over an extended period. Nonetheless, our experts say there’s no better time than now to get a fresh start and a new canvas. 

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