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The Truth About Laser Tattoo Removal

If circumstances have you rethinking your ink, here’s what you need to know about the tattoo removal process from both an expert and patient perspective.

People get tattoos for any number of reasons — be it sentimentality, a special occasion, or just because — and, likewise, people choose to have their tattoos removed for a variety of reasons. Arriving at that decision can be difficult, especially if you don’t understand what the process entails.

The most common way to remove permanent tattoos is with laser treatments. While there are several types of lasers that can be used to remove tattoos, they all rely on the same principle. Lasers employ different wavelengths of light (each with the ability to treat specific pigment colors) that are absorbed by the ink particles in the dermis layer of the skin. The energy causes the pigment to shatter into fragments that can then be digested and excreted via the body’s immune system. Over time, this process lightens the appearance of the tattoo.

With the basics in mind, The AEDITION got the scoop on what to expect from laser tattoo removal from West Hollywood dermatologist Jason Emer, MD, and spoke to three patients about their personal experiences with the treatment.

THE LASER TATTOO REMOVAL PROCESS

Let’s get this out of the way: Tattoo removal requires patience — and, sometimes, lots of it.

For starters, Dr. Emer warns that “even the smallest black ink tattoos” can take “six to 10 sessions” to remove (though newer technologies, like the PicoLaser, may require fewer). While no two patients are the same, the time it takes for the fractionalized pigment to be excreted after a procedure can last several weeks, which is why patients are encouraged to space laser treatments anywhere from three to 12 weeks apart.

To maximize each session, Dr. Emer suggests patients request a perfluorodecalin (PFD) patch be used. The patch absorbs some of the energy produced by the laser, which, in turn, allows practitioners to pass over the affected area up to four times more than they would be able to without the patch in place. The result: fewer treatments and faster results.

And, while the process of removing an unwanted tattoo can be long and costly (the American Society for Aesthetic Plastic Surgery estimates one laser tattoo removal session costs, on average, $463), it doesn’t have to be painful. Dr. Emer says patients can ask for topical numbing creams, nerve blocks, or even sedation to ease any laser-related discomfort.

LASER TATTOO REMOVAL RECOVERY AND RESULTS

As with any laser treatment, the downtime after each session is relatively minimal. Patients are asked to protect the affected area from sun exposure and avoid submerging it in water for up to two weeks. They are also encouraged not to sweat or rub the site for 72 hours. Additionally, patients may notice scabbing, discoloration, swelling, and/or peeling as the area heals.

The number of sessions it will take to remove a tattoo depends on a variety of factors. The age of the ink and its location on the body, for instance, are key indicators. “The further away from the heart the tattoo is, the longer it will take to remove,” Dr. Emer explains. Whether or not it was done by a professional tattoo artist (amateur tats are typically easier to treat due to their superficial nature) and the colors that were used (green and light blue ink are the hardest to erase) also matters.

Another factor? Skin tone.

“The darker the skin tone, the harder it is to remove a tattoo,” he says. “The laser energy attracts the darker skin as opposed to the tattoo, so those with light skin and dark ink are likely to achieve the most effective results.”

Generally speaking, the tattoo should fade with time (and as additional treatments are performed), but the reality is that some tattoos will never be 100 percent erased. And while technological advances have significantly improved laser results, the potential for “ghosting” (no, not the dating kind) or lightened skin where the laser was applied is possible.

PATIENT PERSPECTIVE

So, what’s it like to go through the tattoo removal process? A few patients get candid about their experiences.

Sadie, Los Angeles Sadie is in the process of removing two tattoos — a small green, white, and yellow daisy on her lower back and a medium-sized butterfly on her hip bone. She commissioned the latter (a pink, yellow, and green design) to cover up an older tattoo but has since decided she wants to remove them all.

The AEDITION: Why did you decide to have your tattoos removed?

Sadie: I got the daisy when I was 18 simply because I thought tattoos were cool. I got the second one a year later and the cover up a couple of years after that. I didn’t put much thought into it at the time, and they have no meaning to me. I don’t like the way they look, and I also don’t like colored tattoos.

The AEDITION: How did you go about finding a doctor for your tattoo removal?

Sadie: I did a lot of research about the laser machine itself and some on doctors. My best friend’s husband, who is a dermatologist but doesn’t do tattoo removals, recommended a dermatologist to me who he said is great at tattoo removal and uses PicoSure.

The AEDITION: What has the removal process been like for you?

Sadie: I just did my fifth session last week. It’s a very long and slow process overall. I wait six weeks in between each session and do both tattoos at the same appointment. I always heard horror stories about the pain of laser tattoo removal — and that it was much worse than laser hair removal, which I have also done — but I have zero pain when the doctor is using the laser on me. If I didn’t hear the sound of the machine, I would almost think nothing is being done.

Before the laser itself, a nurse numbs both areas with injections. It’s a bunch of tiny needle injections, which can be a little painful and I do bleed a little. The nurse pokes the area to make sure I don’t feel anything before the doctor comes in to start the laser. After a session is done, they bandage the area up and I don’t workout for 48 hours. I can shower after 24 hours. I wash the area with unscented antibacterial soap, and, for the first five to seven days, I cover it with a large bandaid. I have been told to use Aquaphor on it and was also given a cortisone cream for the itch, but I rarely use them.

I have only had one large blister after my third session, which went away quickly, and then I have had some tiny ones, which, again, went away fast. I also don’t go in the pool for a couple of weeks since it’s technically an open wound. Anytime I am in the sun, I use sunscreen on the tattoos being removed.

The AEDITION: Are you pleased with the results so far?

Sadie: I am very content with the results so far, but I wish there was a way to do the sessions more often. I am very excited to see the final results.

The AEDITION: Do you have any advice for people considering having a tattoo removed?

Sadie: You need to be patient! It’s a long process and doesn’t look so great to have a faded tattoo on your body, which, after a few sessions, doesn’t even look like anything but some light ink. It’s not pretty, and you can’t speed up the sessions or see drastic results fast. But if you’re patient, you will reach your desired results. It’s also an expensive process, so make sure you’re ready for that. You don’t want a lack of patience or not being able to pay for it to be the reason you are left with a faded tattoo that no longer looks like anything. It’s a commitment for sure.

Lauren*, Long Beach, CA Lauren got a tattoo on her wrist when she was in her early twenties. She has since become a business owner and regularly presents her products to large groups of people. She found that having visible tattoos affected her confidence, which led her to begin the removal process.

The AEDITION: Why did you decide to have your tattoos removed?

Lauren: I got my tattoos impulsively when I was relatively young. They didn’t particularly have any meaning to me, so I think that made the decision easier. I found that, in the industry I work in, having visible tattoos led to a fair bit of silent judgment. As a business owner, I couldn’t afford to be judged on something that I could have fixed relatively easily.

The AEDITION: What has the removal process been like for you?

Lauren: So far, I have had four sessions, which my practitioner estimates leaves me around halfway towards the final result. The sessions themselves are quick, but I do find them quite uncomfortable. It is a little annoying to have to remember to keep the area away from sunlight as much as possible, but, on the whole, the process feels more like a bit of an inconvenience rather than anything dramatic or painful.

The AEDITION: Do you have any advice for people considering having a tattoo removed?

Lauren: I actually consulted a couple of practitioners before settling on the one I am going to now. I wanted to find someone who had a decent amount of experience dealing with tattoos similar to mine, which were quite colorful. I also made sure we were clear on how much pain I should expect and asked them to explain how they would minimize that. If you’re nervous about the pain, definitely have a discussion with your practitioner about what they can offer to help. And, finally, don’t expect miracles. I’m told mine have a good chance of being more or less completely removed, but it’s definitely not a quick fix.

Josh*, Newark, NJ Josh had a tattoo removed from his upper arm because it was a reminder of a past relationship. His removal process was completed a few months ago, and he is generally pleased with the results.

The AEDITION: What was the removal process like for you?

Josh: I consulted with a dermatologist who practices in the same office that I go to for Botox®, so I was already confident in the level of care I would receive. I had done some research ahead of my consultation and asked them about the PFD patch that can be used to reduce the number of visits you need. They offered that, so I was happy to go ahead. The tattoo was relatively small — a couple of inches by about half an inch — so the sessions didn’t take long. There was a bit of discomfort the day after, but, other than that, it was straight forward.

The AEDITION: Are you pleased with the result?

Josh: I’m pleased with what my dermatologist was able to achieve, but I did have to lower my expectations to an extent. In my mind, they were going to be able to completely erase any trace of the tattoo. In reality, the skin still looks different in the area. I am hoping with time the area will continue to heal and look more normal, but it’s still better than the situation I had before.

The AEDITION: Do you have any advice for people considering having a tattoo removed?

Josh: Honestly, I think if you’re just getting rid of it because you don’t like how it looks anymore, I would consider looking more into either cosmetics to cover it or getting a cover with something else. In my experience, the area won’t go back to being ‘normal skin.’ If there are more profound reasons, then I would say it’s worthwhile. My advice would be to find a doctor you feel you can trust, talk through any concerns you have, and take the process at your speed. It’s not the most comfortable, so remember there’s no real rush and it will look better with time.

*Patient names have been changed