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Archive for the ‘tattoo removal’ Category

Tatt2Away vs Laser Removal of Tattoos

Sunday, December 12th, 2010

The impregnation of various types of pigment into the skin has been around for thousands of years. Any health risks associated with them appear to be negligible to non-existant other than local discoloration of the skin and finding pigment particles in regional lymph nodes and even more distant organs. Until recently, however, their removal has not been able to done on an effective basis until the introduction of the laser. Laser tattoo removal has been popular over the past decade and the technology and effectiveness for doing it continues to improve.

While the mechanism for how laser energy breaks down tattoo pigments is well known, what happens to the pigment in the absorption process is not well studied. As the laser breaks apart the pigment, is there any negative side effects to doing so from the composition of the tattoo pigment? Some opinions have been made that there are health risks associated with the laser treatment of some types of tattoo pigments. This has led to the analysis of the ingredients in tattoo pigment by many regulatory agencies including the FDA.

When laser pulses are applied to a tattoo, the focused light energy penetrates through the skin and is absorbed by the tattoo pigment particles.  Within thousands of a second, high temperatures are reached in the pigment moleculesThis causes them to expand due to the heat absorption and explode apart into many smaller particles. This is similar to hitting a boulder and breaking it into many smaller rocks. Once reduced in size, these pigment ‘rocks’ can then be picked up and removed by macrophages and transported to the liver for either excretion or retention

Most commercially available tattoo pigments are known to be inorganic azo-pigments or polycylic compounds. Analysis of lasered red tattoo pigments, such as Cardinal Red 22 and 18, showed toxic and carcinogenic decomposition products such as dichcloroaniline, dichclorobenzene, methyl – 5- nitroaniline and nitrotoluene.Sixteen of the 28 organic colorants used in tattooing are of the azo type and may possibly split metabolically into aromatic amines. Four of the 16 azo colorants “contain” amines that are classified carcinogens.  Solvent Red 1 “contains” o-anisidine, Pigment Red 7 “contains” 4-chloro-o-toluidine and Pigment Yellow 87 and Pigment Orange 16 contain 3,3′-dichlorobenzidine. The amines and the other metabolites of the colorant molecules may possess other inherent toxic properties.Out of 40 organic colorants identified, 24 (60%) are azo compounds -of which, 9 “contain” an amine that has been classified carcinogenic within the framework of the chemical regulations. In reality, the pigments used for many tattoos are mostly unknown and there is no disclosure of admixtures and no clinical approval cycle for tattoo pigment. Of most concern is the fact there is nothing known about the systemic health effects of tattoos, in particular about long-term effects which may contribute to specific types of cancer.

While it is likely that the laser breakdown of tattoo pigments does not pose a significant health threat, alternative approaches to laser tattoo removal should be considered. One such treatment approach is that of Tatt2Away. This is a transdermal approach to leeching the tattoo pigments out of the skin through the same process that was used to put them in….micropigmentation. By implanting a proprietary chemical using tattoo needles, the pigments are released back through the skin without heat or chemical breakdown of their structure. This would seem to lessen the potential risk of the release of any toxic compounds from the tattoo pigments.

Dr. Barry Eppley

Indianapolis Indiana

Non-Laser Tattoo Removal – The Tatt2Away Concept

Wednesday, September 22nd, 2010

Tattoos have become as commonplace today as having coffee at Starbucks. While one perceived as a social stigma, tattoos have become an accepted, and often desired, part of contemporary society. It is estimated that about 10% of Americans have at least one tattoo and some of these tattoos are even for aesthetic hair enhancement of the eyelashes and eyebrows. (also known as micropigmentation or permanent makeup) Despite the popularity of having a tattoo, their removal for some is equally desired.Whether it is a poor design, rash decision, change of partners, workplace requirement or stigmata or just boredom with the design, tattoo removal may be needed.

Laser treatments are the accepted method of tattoo removal currently. While better than any other treatment method in the past, laser tattoo removal has an interesting paradox. While it may cost just a few hundred dollars to have the tattoo applied, it will costs thousands to turn it into a faint smudge for many. When exposed to high-intensity laser light, the tattoo pigments are essentially hit with a hammer and broken into smaller pieces. These small pieces may then be cleared by the body. But this laser light creates tremendous heat which makes the treatment not only painful but may create skin damaging/scarring results. This is particularly relevant in patients with darker skin pigments. And laser light is expensive. Machine costs alone are often into six figures for the treating physician. In addition, laser light can only treat a limited range of colors and works best on black, blue and red pigments. Many other tertiary colors and pigment blends respond very poorly.

A new non-laser tattoo removal method has now become available. Using the reverse concept of tattooing, known as micropigentation, a proprietary fluid is ‘tattooed’ into the tattoo. This fluid releases the pigments from the deeper tissues and brings it to the surface. This creates a temporary scab, which when healed, leaves the underlying skin more clear. In essence, this is a forced leaching method.Many have tried a similar approach using glycolic acids and other solutions but without the success of what is known as the Tatt2Away method.

Tatt2Away offers numerous advantages and some similarities to that of laser tattoo removal. One of its biggest advantages is cost. Without using a laser, the cost of tattoo removal treatments drops by about 50% or even more. While more affordable treatments are appealing in and of itself, that would be meaningless if it was not at least as effective. Current clinical experience indicates that it may be just as effective, if not more, because Tatt2Away can treat all colors including the most exotic hues and pigment blends. It is truly a color blind treatment method because its effectiveness is not based on color absorption unlike laser light.

Like laser treatments, Tatt2Away, requires a series of treatments spaced out over time. They are usually about six weeks apart and, just like the laser, an average number of treatments is four to six for maximal clearing. The results after each one will determine if more or less treatments are needed. During each treatment, the tattooed skin is lightly abraded with a special handpiece similar to the one used in your original tatto session. Unlike the laser, the procedure has minimal discomfort as heat is not being generated in the tissues. Each treatment session takes about 30 minutes in which small circle are created over the surface of your tattoo. The spaces between the circles are not filled in and are treated during the next session. This unique spacing strategy keeps the trauma to the skin minimized and lessens the chance for scarring. A scab will form after each treatment and will come off in about a week.

Despite the magic of laser light, it is interesting that a far simpler and less expensive strategy for tattoo removal can work just as well if not better. Essentially using a reverse approach to how the pigments got there in the first place, Tatt2Away helps rid tattoos with a biologically sound exit strategy that is more affordable for many patients.

Dr. Barry Eppley

Indianapolis, Indiana

Excisions of Residual Tattoo Pigments after Laser Treatments

Monday, October 12th, 2009

The treatment of undesired tattoos is best done with multi-wavelength laser technology. By using different laser wavelengths for the colors of tattoo pigments, many tattoos can be successfully reduced and some even completely cleared. While the process is not quick nor inexpensive, it is the most successful method we have to date to treat tattoos without causing a lot of scarring an ‘ghost imaging’.

Despite how far laser technologies have come, tattoo removal through heat particulation of the pigment particles is still an imperfect science. The different types of pigments used and the variable depths into the skin in which they may be placed, by both professionals and amateurs alike, make for different results for each patient. Many patients do not end up with the near perfect pigment clearance that one may find in promotional ads or on the internet.

As a result, there remains a subset of patients who will have residual pigments which still may make the outline of the tattoo discernible, even after numerous laser treatments. If a successful outcome is complete clearance, then ongoing laser treatments should be pursued. This may require going to another treatment site as the types of lasers used and experience in using them does vary.

But for some patients with post-laser residual tattoos, they may not require complete clearance for satisfaction. Many patients want its recognition to be gone but can live with scattered pigment. As long as one can’t see what the original tattoo was, this may be enough of a result. Particularly if they have tired of the laser treatment process.

 In select cases, tattoo ‘derecognition’ may be able to be achieved through spot or minute removals of residual pigments that lie along its outline. While one is trading off some small scars for the pigment removal, this may be the only way to get rid of them. There is usually a reason such areas have been refractory to the laser and it is likely due to the depth of the pigment location. Simple surgical excision under local anesthesia can provide an immediate solution that is quick and easy to do.

Surgical removal rarely has a role in tattoo removals, unless they are very small, However, in spot areas that are resistant to laser treatments, minute excisions can be useful for further obscuring of tattoo outlines. In my Indianapolis plastic surgery practice, I find this approach to be occasionally useful for certain tattoo patients that is more cost-effective than ongoing laser treatments. 

Dr. Barry Eppley

Indianapolis, Indiana 


Guidelines for Laser Tattoo Reduction Treatments

Sunday, January 20th, 2008

The popularity of tattoos in the past two decades has spurned an alternative industry….tattoo removal. According to some studies, approximately 20% to 30% of tattooed individuals will eventually desire their removal. The use of the laser offers a more cosmetically acceptable method than surgery or dermabrasion. When I see patients that are considering laser tattoo removal, laser tattoo treatment would be a more accurate term, I like to emphasize the following principles.

Tattoos are a form of exogenous pigments, historically composed of heavy metal salts and oxides of various colors and dyes. Tattoo pigments, unlike drugs and most cosmetics, are unregulated. The exact composition of tattoo pigments is unknown to either the tattoo artist or the patient. As a result, it is impossible to predict whether any tattoo will respond effectively to laser treatments.

There are two fundamental types of artistic tattoos, professional and amateur. Highly decorative professional tattoos have a variety of pigments and are very difficult to remove, requiring a lot of treatments and complete clearance is rarely achieved. Many times they use colors that are particularly resistant to laser removal including colors such as pink, orange, yellow and lighter greens. Amateur tattoos often use carbon ink as the pigment, are usually one color, and respond fairly well to laser treatments. Some amateur tattoos, however, are placed very deep into the skin, often portions of the tattoo being below the skin surface, and these are impossible to completely clear.

For a patient to consider laser tattoo treatment, they must accept the following:

1) Multiple treatment sessions are always required, anywhere from 4 to 10 treatments per tattoo. It is impossible to predict how many laser sessions may be needed before the first treatment.
2) Complete clearance of most tattoos is not achieved. Lightening, partial clearance, and a residual ‘ghost’ is often the best result for many patients.
3) Patients with darker skin pigmentation are poor candidates for laser tattoo treatments and are at high risk for scarring and hypopigmentation of treated areas.

Lastly, it is important to know that cosmetic tattoos, i.e., permanent makeup such as eyeliners and lip liners, usually contain iron oxide and titanium dioxide compounds These types of tattoos will darken, rather than lighten, with laser treatments.

Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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