The best way to think about tattoo removal is to consider why a tattoo does not go away on its own. A tattoo may appear to be on the surface of the skin, but in reality it is a complex ink deposit deep in the dermis of the skin. The ink particles are too big for the body to break down and cart away. So it stays. And stays.
Some tattoos are placed for meaningful cultural reasons while others in hindsight may seem frivolous—a mistake of youth. Time has passed. You've changed. Now so can your skin. A tattoo is no longer forever. More people than ever are saying goodbye to their tattoos for personal, professional and social reasons.
Until recently methods of tattoo removal carried a high risk of scarring and treatment failure. The introduction of Q-switched laser technology revolutionized tattoo removal, allowing many tattoos to be successfully removed with a low risk of adverse effects. Q-switched lasers deliver a specific wavelength of light that interacts with the tattoo pigment, breaking it up into smaller particles that the body's immune cells can then cart off and eliminate.
Treating a tattoo takes multiple sessions, with the number required depending on many factors such as skin type, colors in the tattoo, complexity of the tattoo, density of ink, type of ink, location on the body, and presence or absence of scarring, among other variables. Typically, professional tattoos require from 6 to 15 treatments, while amateur tattoos may need only four or five. Treatments are spaced four to eight weeks apart. Although all tattoos may not be completely eliminated, most will fade substantially.
Laser treatment of colored tattoos requires multiple wavelengths that interact with different pigments. Typically four wavelengths are required, covering dark colors (black), red, orange, green, light blue and yellow. Dark inks (black and dark blue) and red are the easiest to treat. Oranges and purple also respond well. Green, sky blue and yellow are more difficult, requiring additional treatments. The most popular lasers for tattoo removal are the RevLite from Cynosure and the TriVantage from Candela.
Laser tattoo removal is well-tolerated by most patients, with the pulses of laser energy feeling like a sharp rubber band snapping on the skin. Usually topical or injected anesthetic is used along with ice or chilled air. After treatment an antibiotic ointment is placed on the tattoo with a dressing. Your physician will provide further instructions on caring for your tattoo while it heals.