Tattoo Removal
Lasers have been used for tattoo removal for more than 20 years. Leading plastic surgeons and dermatologists regard laser as the superior method for the safe removal of amateur and professional tattoos. For the last 15 years, the Q-switched ruby laser has been the acknowledged laser of choice for all tattoos. Expert consultants have been successfully removing tattoos at The Cottage Surgery since 1992.
The following information is designed to cover the most commonly asked questions about laser tattoo removal.Why is a tattoo so difficult to remove?
A tattoo results when the skin is punctured and pigment is inserted into the lower layer of skin. The body’s own defence mechanism reacts to this ‘injury’ but is unable to cast out the pigment particles since they are larger than white blood cells. The alternatives to laser treatment are, either to physically remove the pigment and the surrounding skin by surgical excision and skin grafting, or chemically destroy the pigment using salts or acid. In either case the skin is damaged and will require considerable aftercare. Significant scarring would be an expected outcome of non-laser removal methods.
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How does the Q-switched Ruby Laser work?
By firing a beam of light through the skin in extremely short pulses. The light is absorbed by the tattoo ink creating a reaction which breaks it down into very tiny particles. This allows the immune system to take over and gradually remove the pigment over a period of time.
Because each pulse is so short (typically 25 billionths of a second!) and is targeted directly onto the pigment, there is normally no lasting damage to the skin or surrounding tissue. The whole procedure is repeated several times, usually at about six weekly intervals, so allowing time for the body to remove as much pigment as possible.
How many treatments are required to remove the average tattoo?
Due to the very many variations in size, colour and type, there is no such thing as an average tattoo. The number of treatments required will also depend on the body’s own defence mechanism and how effective it is. As a guide, most indian ink amateur tattoos should respond with between one and five treatments. Coloured professional tattoos can take rather longer - usually between eight and fifteen treatments.
What are the costs likely to be?
The actual cost of a single treatment will depend on several factors such as the size of the tattoo and the number of pulses required to treat it. Without first examining the tattoo it is impossible to give an accurate guide to cost. The total cost will depend on the number of treatments required. This is determined by the physical make-up of the tattoo which not only varies enormously from patient to patient, but can also vary as the course of treatment progresses. It is not possible to predict the number of treatments required and it would be misleading to quote examples of total cost which are based merely on assumptions.
Is the treatment cost fixed throughout?
The number of pulses required for each treatment can vary up or down according to how the tattoo is reacting. No additional charge is made for an increase in the number of pulses used. However if, in the later stages of treatment, there is a significant reduction in the area requiring treatment, the cost will be reduced accordingly.
Do all tattoos respond to treatment?
Yes in the majority of cases, although it is impossible to give an absolute guarantee as some pigments can resist treatment. Dark blues and blacks are generally the first to respond and usually all the pigment will be removed. Bright colours, especially greens, are less predictable, they may take longer to fade, and in some cases may not go entirely.
Some red, white and flesh coloured inks have been known to turn black in the early stages but this is rare. People who have experienced any allergic reaction to their tattoo(s) in the past should inform the consultant as this may be relevant to their laser treatment.
How long does it take?
Typical treatment sessions last between 5 and 40 minutes depending on the size of the tattoo.
Does it hurt?
The laser does cause discomfort during treatment, similar to being "snapped" with a rubber band. Most patients equate the pain of tattoo removal with the pain of getting the tattoo. Some areas are more sensitive than others, such as ankles and the shoulder blade. The pain tends to decrease as treatment progresses and the tattoo ink fades. Most patients tolerate the discomfort of treatment very well, but a local anaesthetic cream is available if required.
Are there any after-effects following treatment?
Some patients may blister. This is quite normal and does not indicate potential scarring. Rarely is any specific treatment required and it will usually clear within a few days. A dry dressing may be applied to avoid contact with clothes, etc.
When bathing or showering, the area should be patted dry and not rubbed. If blistering occurs, prolonged immersion in water, e.g. swimming, should be avoided. Patients will be provided with a detailed after-care advice sheet.
During the period over which the tattoo is being removed, the treated area must be protected from strong sunlight or sunbeds by means of a reputable sun-blocking cream (available from The Cottage Surgery) or by covering the tattoo. This is very important and will help to avoid any pigment changes in the treated area. Any sun tanned skin will not be treated.
Does laser treatment scar?
The Q-switched ruby laser neither burns nor cuts the skin’s surface and has been used extensively in medical practice for more than 30 years.
Some people are very sensitive to the inks used in their tattoo which can lead to a severe inflammatory response during treatment - this may on rare occasions result in a scar. Since the first centre opened in 1991, Laserase has treated very many thousands of tattoos with the vast majority of people being delighted with the results. Although scarring is a possibility, we have found the chances of this occurring to be very low.
Will the skin be normal when treatment is finished?
During treatment with the 0-Switched Ruby Laser, it is quite normal for the tattoo area to become paler and any freckles may disappear. This is because the laser is also effective at removing natural skin pigment. Once all the treatments have been completed, the pigment should slowly return, usually within six to twelve months. However sometimes there may be some permanent loss of natural pigment and the area may remain pale. This risk is minimised by avoiding strong sunlight and sunbeds whilst undergoing treatment. A tattooed area which is particularly hairy must be shaved prior to treatment. The hair should grow back normally but in some cases may be slower than expected.
Is ‘Laserase’ treatment safe?
Yes. There is no evidence whatsoever to suggest that the treatment can lead to skin disorders or an increased risk of cancer. Furthermore, every precaution has been taken to ensure the safety of the patient. Having met all the necessary conditions, each ‘Laserase’ Centre is registered with the Healthcare Commission and is regularly inspected. The lasers are also subject to periodic checks by the Regional Radiation Physics Protection Service.
The ‘Laserase’ treatment is carried out only by qualified and fully trained practitioners. Patients are required to wear approved protective goggles at all times. Children are not allowed into the treatment room.
Updated Monday 17th 2010f May 2010
