I decided to write this article due to a recent increase in the number of questions I’ve received regarding tattoo removal. I don’t offer tattoo removal at my office, but I gained extensive experience removing tattoos while working at a dermatology clinic several years ago.
How laser tattoo removal works in a nutshell:
Lasers are a safe and effective method for removing tattoos because they can target certain structures in the skin (in this case a tattoo) without damaging the surrounding area. This ability is called selective photothermolysis. When the laser light makes contact with the tattoo, the ink particles under the skin absorb the laser energy and convert it to heat. If the heat is sufficient, the ink particles are destroyed and are then removed by the immune system. It is common (and a good sign) to see a temporary whitening of the skin following a tattoo removal session. For selective photothermolysis to occur, the device must have a pulse duration in the nano- or pico- second range. If instead the device has a pulse duration in the millisecond range, the tattoo is exposed to the laser energy for too long and heat diffuses into the surrounding area. If enough heat is produced, some clearance of the tattoo ink may occur but damage to the skin (scarring) is likely!
Now for the scary part….
It is not uncommon to see clinics around the country attempting to remove tattoos using devices with pulse durations in the millisecond range! Despite overwhelming evidence that it is extremely dangerous to do so, clinics still offer tattoo removal using Intense pulsed light (IPL).
What is Intense pulsed light (IPL), and why SHOULD IT NOT be used for tattoo removal?
Intense pulsed light (IPL) devices emit high-intensity light. Unlike lasers, which are composed of only one wavelength, IPL’s contain many wavelengths. They are able to limit the number of wavelengths delivered to the skin by using filters (for example, they could block out wavelengths that aren’t in the 400nm to 1200nm range), and can be used for hair removal in people with very fair skin. However, they are a very poor choice for tattoo removal. IPL’s deliver pulses in milliseconds, meaning that when an IPL device is used selective photothermolysis does not occur. As I stated above, this results in damage to surrounding tissue and often causes scarring. IPL’s deliver pulses at relatively low intensities, resulting in incomplete clearance of the tattoo. Furthermore, after scarring occurs and the skin undergoes textural changes, it can be difficult or even impossible to fully remove the tattoo.
What other devices MUST BE AVOIDED when inquiring about tattoo removal?
Avoid any device with a pulse duration in the millisecond range! This includes typical hair removal lasers such as the Nd:YAG 1064 nm and Alexandrite 755 nm lasers (non Q-switched). These lasers are excellent for hair removal and other procedures such as skin rejuvenation (Nd:Yag 1064 nm) but are bad for tattoo removal.
What devices ARE BEST for tattoo removal?
Right now Q-switched lasers are the safest and most effective devices for tattoo removal. Only Q-switched lasers can provide high-intensity light with very short pulse durations (in the nanosecond range), making them the best choice for tattoo removal. There are several types of Q-switched lasers, including but not limited to the Q-switched Nd:YAG 1064 nm the Q-switched Alexandrite 755 nm. The type of Q-switched laser used depends on the client’s skin type and the color of the tattoo ink. Research is currently focused on developing lasers in the picosecond range, and they may replace Q-switched lasers as the best lasers for tattoo removal in the near future.
When shopping around for a tattoo removal clinic, MAKE SURE you ask about their devices. Avoid clinics that remove tattoos with anything other than a Q-switched laser. Make sure that the laser operator is knowledgeable about tattoo removal and that your expectations are realistic. Not all tattoos can be removed completely, and some are better left alone. Make sure you have a thorough consultation with a reputable clinician to discuss your options prior to beginning treatment. In the meantime, if you have any questions, feel free to contact me. I’d be happy to help.