Laser tattoo removal

Laser tattoo removal is the most effective way of removing unwanted tattoos.

Tattoos may not be wanted anymore for a variety of reasons: young age when getting it, personality change, employment, family pressure, change of lifestyle or partner, poorly done or non-meaningful tattoo, medical indications like tattoo reactions.

Tattoo removal is a multi-treatment process, for a good result most people need between six and 12 treatment sessions, sometimes more if the tattoo includes colours that are difficult to treat. Laser treatments are typically administered at monthly intervals or longer to permit adequate clearing of ink and appropriate skin healing between treatments.

Can all tattoos be removed by laser?

Amateur tattoos are normally made using single colour Indian ink and sits close to the top layer of skin; they generally respond more quickly to treatment than professional tattoos.

Professional tattoos are usually multi-coloured tattoos made using a machine and maple ink, they are more difficult to remove completely as the ink tends to be deeper in the skin. Black, blue and red colours are not too difficult to remove, however brighter colours such as green, yellow and purple do not absorb the energy as well and take longer to break down, meaning they may need more treatments.

Cosmetic tattoos, as eyebrows, eyeliner and lip liner which are permanently tattooed onto the skin, are difficult to remove because of oxidative reactions that darken the ink when irradiated with laser light. Scarring is also possible.

Traumatic tattoos are caused by some forms of trauma such as lead pencil wound or an accident where the skin has made contact with gravel. These tattoos can be difficult to remove. Q-switched laser treatment of traumatic tattoos caused by fireworks is contraindicated due to the risk of particulate micro explosions upon laser impact resulting in cavitation and the development of atrophic scars.

How does the treatment work?

The energy from the laser causes the tattoo particles to heat up and break down into tiny fragments. Then over a period of 8-12 weeks the body’s scavenger cells ‘mop up’ these fragments causing the tattoo to gradually fade over time.

What are the risks of laser tattoo removal?

  • Complete removal of a tattoo can sometimes be difficult, particularly for people who have dark coloured skin or who want to remove a tattoo with colour.
  • Common transient reactions include redness, blistering, scabbing, swelling, pain, itching, bruising and tenderness at the treatment site.
  • Skin infection can sometimes occur, particularly when an area of the treatment is neglected. It is important for patients to protect the area of skin that has been treated – this will reduce the risk of bacterial entry and subsequent infection. Adequate aftercare following the treatment is essential for this reason.
  • As with all laser treatments, scarring is a small possibility.
  • Skin hyperpigmentation / hypopigmentation, more common in darker-skinned patients.
  • No laser treatment should be attempted in tattoos with active inflammation (e.g. eczema or psoriasis), infection (e.g., verrucae, herpes simplex), or concomitant disease (e.g. sarcoid). These conditions have been shown to worsen in intensity, slow postoperative healing, and cause scarring in laser-treated tattoos.

How to prepare your skin before laser treatment?

  • Strict sun protection before and after treatment is critical to reduce the risk of complications:
    • Avoid sun exposure to the treatment area;
    • Do not use UV tanning beds at all for four weeks before treatment;
    • Use a broad-spectrum sunblock with an SPF 50+ several times every day.
  • Do not use any topical products that cause photosensitivity (e.g. hydroxy acids, salicylic acid, retinols, and benzoyl peroxide) in the treatment areas for three days before treatment.
  • Use a gentle cleanser and lotion on areas to be treated.
  • If you are taking (or recently took) any medications, including antibiotics, inform your doctor prior to your appointment.
  • Let your doctor know you have a history of herpes infection on the treatment areas. You could need a preventive treatment.

What to expect during treatment?

  • You will be required to wear protective eyewear.
  • The procedure can be uncomfortable and may cause the individual to experience pain in the area treated. To minimise this, a numbing cream (EMLA®) may be applied two hours before the procedure under an occlusive dressing. Local infiltration of lidocaine is rarely necessary.
  • The session should take about 15-30 minutes, depending on the size of the tattoo

How to take care of my skin after the treatment?

  • After a laser tattoo removal treatment, there is immediate whitening of the treated area, and then the area treated may look red or inflamed for the next 24-48 hours. Many patients then develop blisters or scabs within 24-48 hours, which may last for 1-2 weeks.
  • You will be treated with antibacterial cream and a dressing for protection.
  • Clean the treated area twice a day with mild soap and water, and gently pat it dry.
  • When scabbing appears in the next couple of days, apply the cream prescribed by your doctor to the area regularly to keep the skin moist. This will also encourage the scabs to fall off after 7-14 days.
  • It is important to leave the scabs to heal naturally and not to attempt to remove it so DO NOT pick, scratch or aggravate the area as this could lead to infection or cause a scar. Avoid using any makeup, medicated cream, perfumed soaps or lotions on the treated area for 48 hours after treatment.
  • Avoid any strenuous physical activities for a couple of days after treatment and avoid swimming and using a sauna until the scab has dropped off, as this may slow down the healing process.
  • Avoid exposure to the sun and ultraviolet light in between treatment sessions and for 6 months after your last treatment, by covering the area with clothing. If you can’t avoid sun exposure, use a broad-spectrum sunblock with an SPF 50+ several times a day.

If the area looks infected (honey-coloured crusting, oozing, spreading redness) or you have an extreme reaction, immediately come back to the Skin & Laser Clinic.

Healing is usually complete in about 4 to 8 weeks.

Scarring, which can be hypertrophic or even keloid, can occur but is very rare. Loss of skin pigment (or excess gain of skin pigment) in the treated area may occur, but is temporary in almost all cases.

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