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