Laser Tattoo-Removal

If you're considering laser tattoo-removal; this comprehensive guide will help inform you on the process involved and set your expectations.

Laser tattoo-removal is a medical procedure, and as such research should play a critical role in your decision.

Recognising how time-consuming such research can be, we've made it easier by answering the most important questions about tattoo-removal so that you can make an informed decision.

HOW DOES LASER TATTOO REMOVAL WORK ?

First, you should be aware that Laser tattoo-removal does not provide instantaneous results; removal of the ink pigments is achieved through multiple treatments that take place over an extended period of time.

During each session, a trained Laser Specialist utilises a multi-wavelength laser that fires pulses of high intensity light beams at the area where the tattoo is located.

It is vital that the laser light energy is delivered in a high-intensity, very, very rapid, burst (known as Q-Switched) as only the very first energy has an effect on the tattoo. All subsequent energy is simply absorbed by the body, increasing the temperature and the risk of side effects.

One of the immediate effects of laser tattoo-removal treatment is the liberation of gas with in the deeper layers of the skin, which collects above the tattoo pigment and is visible as whitening of the treated area. This does not last for long, but does prevent the same area being treated twice in rapid succession.

The laser light energy hits the top most layer of ink and breaks up the tattoo pigment in to smaller particles – it quite literally shatters the pigment globules which have until that moment been retained in the dermis of the skin as the tattoo. The resultant much smaller pockets of pigment are then recognised as foreign matter by the body's immune system, which attacks and removes them over time. Treatments are spaced 4 to 6 weeks (or more) apart, to give the body ample time to heal and process the ink.

During subsequent treatments, remaining particles, which are still too large for the body to identify, are fragmented into even smaller components, which the body continuously processes. These follow up treatments also deal sequentially deal with deeper layers of ink. With each treatment and the time that passes in between, the tattoo becomes lighter, and eventually disappears.

Pigments of different colours absorb light energy of different wavelengths, and therefore in order to remove pigments of multiple colours a variety of different laser wavelengths are required.

Quality tattoo-removal treatment centres will utilise equipment with at least 2 different wavelengths, in order that as many pigment colours as possible can be tackled. Remember 80% of tattoo’s are black and red so there is limited benefit for a clinic to invest in more than 2 wavelengths, which will bring in very little additional business?

HOW EFFECTIVE IS TATTOO REMOVAL ?

Until recently, surgery was the only effective method for tattoo removal. However, it was painful and carried risks of infection and severe scarring. Fortunately, over the last decade, laser tattoo removal has supplanted surgical removal and is now considered the gold-standard of tattoo removal, because, in skilled hands, it is both safe and effective.

Most tattoos can be removed completely after a series of treatments. In most cases the Laser Specialist will be able to assess the tattoo and give a you a good idea of whether the tattoo will be completely removed, or whether there is likely to be residual ink visible.

Unfortunately, professional tattooists use a wide variety of ingredients in their pigments, and some include metal and non-metal particles along with organic and inorganic pigments. All these elements are affected to varying degrees by the laser, and since there is seldom any record of the pigment used, 100% accuracy in the number of treatments or the degree of removal can never be guaranteed.

HOW LONG WILL IT TAKE TO REMOVE MY TATTOO ?

While some patients are interested in the total removal of their tattoo, others are looking to lighten a tattoo so they can get another one in its place.

In any case, it will take multiple treatments to achieve your desired result. To some degree, the longer you wait between treatments the better your final results will be, since it gives the body’s defences the maximum time to remove the pigment debris.

The number of sessions it takes to remove a tattoo, however, depends on a multitude of factors that hinge on the individual undergoing treatment and the tattoo itself. The most influential factors include:

Constituents of the pigment, as discussed above.

  • Individual’s skin tone
  • Location of tattoo
  • Amount of ink in tattoo
  • Colours of ink in tattoo
  • Depth of tattoo ink

CAN ALL COLOURS BE REMOVED ?

Most tattoo ink colours can be removed, but certain colours may take more treatments.

Black and red tend to be the quickest colours to resolve. Blues and greens are more challenging and therefore take longer, but in most cases they can be completely removed or at least faded significantly. Yellows and purples tend to be the most resistant colours but on lighter skin types they can often be faded to the point where they are difficult to see at all. 

For this reason, if you have a tattoo with multiple colours, you may find that parts of the tattoo fade at varying degrees during the process.

The above description assumes that laser energy of the correct wavelength is being applied to achieve treatment. If the wrong laser wavelength is in use, the ink will not be removed regardless of the amount of energy applied or the number of repeat treatments made.

HOW LONG WILL EACH TREATMENT TAKE ?

The length of time each treatment takes is determined predominantly by the size of the tattoo being treated. Typically is will and can range from a minute or so seconds to 10 minutes or more. Small tattoos take less than a minute or two, while a sleeve tattoo might take considerably longer.

Very large tattoos may be treated in parts, with half or quart of the design treated on one visit and another portion treated on a separate occasion. This can be of value to the patient in restricting the area needing post treatment care at any one time, but obviously results in additional visits for complete removal.

DOES TATTOO REMOVAL HURT ?

Laser tattoo-removal can be uncomfortable but is generally tolerable. The extent to which it is painful depends on your nerve sensitivity, threshold for pain and the location of your tattoo.

As many clients describe it, treatments may feel like grease splatters from a frying-pan or the snapping of a rubber band against the skin at a rapid pace. Few would describe the pain of laser tattoo-removal as anything near as significant as the pain of having the tattoo in the first place! In addition, treatments are fast, and take far less time than it took to get your tattoo originally.

Topical anaesthesia cream can be used to alleviate pain, and during the procedure many centres will utilise a chiller to blow cold air (eg -30oC) on to the area being treated; which will make the procedure significantly more comfortable. Once your treatment is over, the majority of the pain will subside rapidly and the resulting feeling is similar to a sunburn and lasts only a few days.

WHAT ARE THE SIDE-EFFECTS OF TREATMENT ?

After each treatment, the skin around the tattoo will most likely be sensitive. Common side effects are redness and inflammation, and sometimes blistering and scabbing. There may be some pin-point bleeding.

Keeping the area clean, protected, and applying a topical treatment on a daily basis, such as Aloe Vera, will help with healing process. Within less than a week the area is usually back to normal.

Infection may occur if the area in not taken care of following treatment and this can lead to permanent scarring, so should be dealt with immediately if it occurs.

Half of the success of tattoo-removal is dependent on the actions of the treatment clinic, but the other half is down to how well you take care of the area after you leave the clinic.

You should be provided with simple to understand after-care instructions, so you'll know exactly what to do for best results, and what to look out for as a sign of things going wrong (so that early medical treatment can be obtained).

The most serious side effect is ‘hypo-pigmentation’, which is when the area treated becomes permanently lighter in colour than the surrounding skin, due to irreversible damage to the melanocytes. (Melanocytes are the specialised cells found in the skin which produce Melanin – the pigment which gives humans their varying skin colour. The more Melanin in the skin, the darker it is – so destruction of the Melanocytes results in an area of lighter skin colouring. This side-effect is most common among people with darker skin tones, since the absorption of the laser energy in to the skin is greater and the effect will be more noticeable than on skin that is already lighter; but can usually be avoided by selecting a treatment clinic that has extensive experience and therefore has a full understanding of how and when to treat (and how and when not to!).

HOW MUCH DOES TREATMENT COST ?

Many people are surprised to find that tattoo removal is more affordable than they initially thought. 

Charging is normally calculated by the size of tattoo, the number of colours involved and the degree of fading or removal that you require. Many clinics will negotiate on price, so don’t be afraid to haggle.

To get an accurate price estimate you will need to book a consultation with your chosen Laser Specialist. Initial consultations are normally free of charge. During the assessment, the tattoo will be measured and an estimate of the number of treatments it will take to remove will be calculated, and you should receive a detailed proposed treatment plan.

DOES TECHNOLOGY MATTER ?

Technology is important, but it is not as simple as selecting a clinic that has the newest laser on the market. There are always new technologies emerging and some are not proven yet. Because it takes multiple treatments over time to remove a tattoo, it typically takes years to accumulate enough case studies to prove that a new technology is dramatically better than an existing one.

There's always a company claiming that their laser is the newest and most revolutionary, but it has been years since there has been any advancement that has significantly alter the length of time a tattoo takes to remove.

It doesn't mean that we will not eventually experience advances in that area, it simply means that there are a lot of companies making unsubstantiated and misleading claims.

Your best bet is to choose a clinic that is dedicated to tattoo removal, or at least to laser treatment, that uses proven, state-of-the-art, technology with multiple wavelengths of laser light energy, and that has performed hundreds of treatments. They will probably show you before and after photo’s of successful treatments – be sure to see if they have evidence of treating tattoos of similar colours and complexity as your own.

If you are unsure of the clinics ability to provide the required service, take independent advice – Your GP may be of help, or you can always ask us at The Laser Market.

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