Tattoo Removal

Tattoo Removal Options

On this page, Dr. Loftus explains the various options for tattoo removal and explains why some colors are notoriously difficult to remove.
Many people choose to have decorative tattoos in youth but live to regret this decision. Options for tattoo removal include surgical excision, dermabrasion, and laser, with the latter being the treatment of choice is most cases.
Laser tattoo removal has become the treatment of choice. Laser Tattoo Removal lasers target tattoo ink and rapidly heat it. Heat causes ink to expand and break up into smaller particles. These smaller particles are more easily absorbed by the body. Each treatment will likely cause mild discomfort, similar to a small rubber band snapping against skin. Most patients are able to tolerate the mild discomfort when it is within a small area. When a larger area, like a full arm or back is being treated, the discomfort may interfere with the procedure. Discomfort can be minimized by the use of ice, sedatives, pain medications, or injections of local anesthetic. Talk with your surgeon about ways to minimize the discomfort if this is an area of concern for you.
Each laser targets a different family of colors. To completely remove a family of colors, two to four sessions may be required. Because most tattoos are comprised of multiple color families, several lasers may be required. For example, if three-color families exist in one tattoo, and each family of colors must be targeted three times; a total of nine laser sessions will be necessary. Some tattoos require 15 to 20 laser treatments for complete removal. Many other factors determine the number of treatments necessary.
Tattoos obtained in a tattoo parlor are difficult to remove because professional tattoos are typically deep, dark, and made with complex ink. Homemade tattoos are variable in their difficulty of removal based on the type of ink used and the depth they were placed. New tattoos are difficult to remove because they have a higher concentration of ink than old ones. Older tattoos have a lower concentration of ink because as a tattoo ages, the body absorbs some of the ink. Turquoise tattoos are particularly difficult to remove, because no laser effectively targets that color. Red, white, and flesh colored tattoos are also troublesome, as they may turn black after laser treatment.
The total number of treatments necessary cannot be established with certainty at the outset. The common range is between six and twelve. Treatments may be performed every one to two months or may be spaced over several years. The tattoo will begin to fade one week after each treatment and will continue to fade for several months. Some choose to save money by discontinuing treatments before the tattoo is completely removed. Others pursue laser therapy until there are no detectable signs of the tattoo.
Some people choose to over-tattoo ("cover-art") to hide an undesirable tattoo. This is especially common when the original tattoo contains the name of a former lover. If you have done this, expect that you will have to have even more laser treatments.

Ask Your Plastic Surgeon About These Potential Complications

Scarring
Bleaching or fading of the skin
Discoloration
Incomplete removal

Cost

The typical cost is $100-300 per session. If your tattoo is extensive, expect to pay more. Since five to twenty sessions may be required, the total fee may range from $1,000 to $10,000.
Surgical excision is best employed for small tattoos on loose skin but always leaves a scar.
Dermabrasion involves sanding the skin with a rotating wire brush and may leave a scar or a pale area. There is a possibility that even after several treatments, the tattoo may still be visible. The results seen by dermabrasion depend on how deeply into the skin layers the tattoo ink was injected. The deeper the injection, the less likely that dermabrasion will have good results.