Laser Tattoo Removal

It is common to get tattoos to remember a loved one, show how much a relationship or friendship means to you or keep a meaningful phrase or symbol with you at all times.

For many people, tattoos may be seen as an expression of personality, creativity or rebellion. Whatever the reason was for once getting a tattoo, you may feel differently about it now.

Perhaps you are embarrassed by it, fear it will make you look unprofessional or are no longer with the person you got the tattoo in honour of. If you feel this way, you are not alone. It is reported that 1 out of 4 people that get tattoos eventually regret them [1].

Fortunately, laser tattoo removal is a safe and effective option to remove your unwanted ink.

How does it Work?

Tattoos consist of many large particles of ink that are too big for your immune system to naturally remove from the body. Laser tattoo removal works by emitting a light of a certain wavelength that targets the ink pigment. The pigment absorbs the light and converts it into heat energy that fractures the ink particles into smaller fragments [2]. The smaller fragments can then be more easily eliminated by the body.

Types of Lasers

Q-switched laser: A laser called the Q-switched laser is the most popular for treatment because of its high intensity and short pulses of light. This allows it to be more powerful and effective, while also resulting in less damage to surrounding skin because of its shorter contact time [3].
Different types of Q-switched lasers emit light of different wavelengths. The type of laser used depends on your tattoo colour and skin type. In some cases, many lasers need to be used if the tattoo contains many colours [1].

Nd: YAG laser: The Nd: YAG laser is the most often used Q-switched laser because it can treat many dark ink colours, such as black, blue, green and violet and also many light colours, such as red, orange, yellow and pink [4]. It is also the ideal laser to use in individuals with darker skin because its longer wavelength allows for the laser to be less attracted to the skin’s pigment. This results in a lower risk for skin pigment changes [1].

Ruby Laser: Ruby lasers are good for treating more stubborn colours of ink, such as some shades of green and blue. However, it may pose a higher risk since the skin pigment may change [1,4].

Are you a Candidate?

A good candidate for laser tattoo removal is someone who has a healthy immune system and is patient. In many cases, laser tattoo removal can take multiple treatments, so it is important to have realistic expectations of what it can do.

Treatment should not be given to anyone with [1,5]:

  • Active skin inflammation such as eczema or psoriasis
  • Active warts or herpes
  • Any other active disease that can slow healing

It also should not be done in anyone pregnant or nursing.

What to Expect Before the Procedure

Before getting the procedure done, you will be asked about your medical history, the medications you currently take, previous surgeries, drug allergies and if you have had a history of scarring [2,5]. You will also need to provide information about where the tattoo is, the depth, composition and colours of the ink and whether the tattoo was done by a professional or an amateur [1]. The answers to these questions will determine how many treatments you will need.

What to Expect During the Procedure

Depending on the size of the tattoo, the whole procedure should take between 10 minutes to an hour [6]. A topical anesthetic or a lidocaine shot will be given before the treatment to prevent you from feeling much pain during the procedure. You will also be given eye protection to wear to prevent the laser from being attracted to pigmented areas of your eye [1]. Laser pulses will be targeted at your tattoo. You should not feel much pain during the procedure, but you may still feel like a rubber band is hitting your body with each pulse [2].

What to Expect After the Procedure

After the procedure, you will have a wound that you will need to clean daily and apply a healing ointment to it [1,2]. You may feel some tenderness, which ice can help facilitate [1]. Your skin should heal within 5 days of the procedure, but you will be expected to wear a bandage for 7-10 days after treatment [1,2]. It is important to use sun protection for 3 months afterwards to avoid further complications with your skin [5].

Potential Side Effects and Risks

Laser tattoo removal is a very safe procedure. It is common to experience some redness or tenderness after the procedure. However, other possible side effects or risks may occur. Some of these risks have a higher likelihood of occurring in individuals with darker skin.

These side effects include [1,2,5]:

  • Incomplete tattoo removal
  • Hyper or hypopigmentation (skin colour changes)
  • Scarring
  • Crusting
  • Swelling
  • Skin texture changes
  • Blistering
  • Burns
  • Poor wound healing

When Should I Expect to See Results?

The number of treatments needed to remove your tattoo will depend on many factors, such as the size, the colour, the depth and density of the ink and the age of the tattoo [1,2]. For example, older tattoos fade and tend to be easier to remove than newer tattoos [1]. Typically you will need more than 1 treatment to see results. The number of sessions needed can range from 1-10, with treatments being spaced apart by 6 weeks [2]. The time between treatments is necessary for healing and for the ink particles to be excreted from the body [2].

Alternatives to Laser Tattoo Removal

Other methods for tattoo removal exist; however, many of these are less effective and result in a greater risk of scarring or damage to the surrounding skin.

Some of these alternatives include:

Chemical peels: This method uses chemicals to remove the outer layers of the skin. The skin takes about 5-7 days to heal after treatment [2]. This method can be used to treat tattoos that do not penetrate as deep, but it is not a method used often [3].

Surgery: This method involves cutting out the tattoo, which can result in scarring and complicated wound closure [3]. For this reason, surgery is best reserved for smaller tattoos rather than larger ones [2].

Dermabrasion: This method involves using a machine with a fast-spinning wheel to abrade the skin to remove the top layer of the tattoo. The deeper layers of the tattoo can then be removed surgically [3]. This method results in a healing time of 10-14 days and may cause scarring [2].

Salabrasion: This is an older method and is not often used today. It involves using coarse salt and gauze to abrade the top layers of the skin. This method can remove more superficial tattoos, but scarring can occur [3].

Cost of Laser Tattoo Removal

Laser tattoo removal is not covered by insurance. The cost of laser tattoo removal depends on the experience of the person performing the procedure, the type of laser used, the size of the tattoo, the time it takes to perform the procedure and the region you live in. On average laser tattoo removal costs $401 per session [6]. However, it is important to remember that the cost can add up with multiple treatments.