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5 Things You Should Know About Tattoo Removal

Not as in love with your tattoo as you were once, and thinking about removing it? Then this article is just for you! Dr. Holly Singletary, a certified dermatologist, talks a bit about how tattoo ink has been removed historically and focuses on the specifics of how laser tattoo removal works today.

Interview has been edited for clarity.

1. How does tattoo removal work?

There are several techniques that have been used throughout history to remove tattoo ink from the skin.

Dr. Singletary tells us that historically, mechanical removal — dermabrasion, chemical destruction, trichloroacetic acid, or cryosurgery — was used to remove tattoos. Some people had their tattoos burned off or had surgical removal of their entire tattoo. All of these are considered destructive processes.

“As you can imagine, these methods create a wound and therefore a higher risk for scar formation or incomplete removal of the tattoo and are associated with more downtime. There have been significant advances in tattoo removal over the years, offering new and improved methods using different lasers and light devices,” says Dr. Singletary.

Tattoo removal quote

She also says that the majority of tattoo removal is now performed using lasers, particularly quality-switched — also known as Q-switched — ruby, Alexandrite, and Nd:YAG lasers. “The laser treatment protocols are also becoming more advanced, combining different lasers and doing multiple passes during the same treatment session. The most recent advancement is the ability to deliver the energy in very rapid pulses, for example, in the nanosecond or picosecond range.”  

2. Laser tattoo removal

Laser tattoo removal works by using a process called selective photothermolysis. This is a process that uses laser light to create heat to break apart a specific target. The target in tattoo removal is the ink placed in the skin. Which lasers to use are chosen based on their specific wavelength and the color of the ink in the tattoo. 

“The ink is very small and sitting in the dermis of the skin, so if heated rapidly using a laser with a very small pulse duration, the ink is then broken up,” explains Dr. Singletary. 

“The body will initiate a response that brings cells to the area to remove the [ink] particles. These are taken to the lymphatic system to be excreted from the body. It's a very effective way to selectively target a specific ink pigment and protect the surrounding tissue.”

3. Can a tattoo only be removed by professionals?

There are many people who offer tattoo removal. However, Dr. Singletary highly recommends seeing a physician or licensed professional under the direct supervision of a physician who specializes in tattoo removal. This will provide you with the most efficacious and safe treatment plan.

“It is possible that if you seek care from someone who does not have the experience and knowledge of the advancing technology, you could end up with an undesirable outcome.” 

4. Creams or gels for tattoo removal

There are topical creams and gels on the market that claim they can remove tattoos. But Dr. Singletary says that currently, there aren’t any topical agents that have the ability to remove a tattoo.

5. Possible side effects of tattoo removal

According to Dr. Singletary, immediate side effects of laser tattoo removal include redness and swelling in the area, and occasionally this is followed by slight crusting. Strict post-procedure care is recommended to minimize scar formation. 

“It is important for patients to understand that multiple treatment sessions are often needed, and depending on the nature of the tattoo, there could potentially be an incomplete removal of the tattoo pigment.”