Tattoo Removal Is Not Always Perfect

By Benjamin N. Rosenberg, MD FAAD | Dermatology 

If you are considering a tattoo, my best advice is don’t.

Some 30 percent of Americans have at least one tattoo, but, with age and lifestyle changes, many of them – up to 25 percent — at some point will admit that they now regret the skin art. In fact, the demand for tattoo removal is becoming an emerging trend.  Unfortunately, while tattoo removal techniques have advanced, they still are not perfect. A patient can be left with a blemish or even a scar in place of what was a colorful design or an ode to a former flame, even when the removal procedure is carefully performed by a certified physician.

Tattoo Removal is Not a Do-It-Yourself Process 

If you already have a tattoo and are trying to get rid of it, don’t be sold on using home removal kits and topical creams marketed as inexpensive solutions.  Some of these kits can be downright dangerous because they can contain high levels of acid that may cause serious skin burns.

Do not have your procedure performed at a spa or tattoo shop where removal procedures performed by non-certified personnel could leave you with scars, burns or changes to your skin texture.  Contact a dermatologist to review your options and improve your chances for complete removal of the tattoo with the smallest risk of permanent scarring.

In the majority cases, laser techniques will remove unwanted tattoos with few side effects.  The high-intensity beam of light emitted by lasers can break up the pigment colors in the skin. Lasers have been proven more effective than such removal methods as excision, dermabrasian, in which the superficial layers of skin are scraped away; and salabraisan, a centuries-old technique that simply requires salt, tap water and use of an abrasive device rubbed across the tattoo.

But, No Guarantees

In a study published in the December 2012 journal, JAMA Dermatology, researchers found that multiple treatments with a specific type of laser – the Q-switched laser – effectively removed tattoos without adverse side effects in nearly three-quarters of the 352 patients analyzed.  However, study authors concluded that guaranteeing “complete clearing of a tattoo in any given patient” is not possible.

Treatment results will vary depending on the size, pigmentation, age and location of tattoo.  For example, blue and black pigmentation in a tattoo respond much better to laser treatment than other colors.  This is especially true of black ink tattoos. The general color of a person’s skin and the skin depth of the tattoo’s pigmentation also will affect the success of tattoo removal.

Patients who undergo even the most comprehensive and careful tattoo-removal procedure may be left with an area of skin that is paler than the skin surrounding it or experience a darkening of the skin where the tattoo had been.  Some of these skin blemishes may disappear within a six- or 12-month period.

Tips to Ensure Safe Tattoo Removal

• As the FDA recommends, have your tattoo evaluated by an experienced dermatologist. A dermatologist will examine the health of your skin and your general health before advising next steps.
• Drink plenty of water before and after a removal procedure to speed recovery
• Keep all your appointments. Removing a tattoo takes time and, usually, requires multiple procedures, even when a laser is being used.  Skipping sessions or stopping treatment early will likely affect the final results.
• Follow your dermatologist’s instructions for at-home care of the tattoo site. The skin in that area may feel uncomfortable or painful and is at risk for infection. You will be wise to wash the tattoo site and apply the recommended antibiotic ointment to it for several days after a procedure.  Putting a moisturizer on the treated skin and keeping the area covered also are helpful steps.
• Protect your treated skin from the sun between procedures and for at least three months following the final session. Wear clothing or a covering that completely blocks the sun’s rays from the treated skin.