How Does Tattoo Removal Work?

February 6, 2019

Tattoo removal being performed with a laser

Tattoo removal is not as quick or as fun as getting the tattoo in the first place. While 30% of Americans have at least one tattoo, according to the Statistic Brain Research Institute, about 11% of these people will end up seeking removal. The majority of those people who have tattoos removed (about 70%) are women. Many people have the inaccurate belief that laser tattoo removal is a quick and painless process, but as your dermatologist will tell you, this is not the case. Dr. William Cothern of U.S. Dermatology Partners Fort Worth Cultural District likes to start off his tattoo removal consultations by saying, “Tattoos are much harder to remove than to put on.” He believes in the importance of setting appropriate expectations, so clients know they need to be prepared to partner with him and his team for the long haul. Below, we’ll walk through the tattoo removal process with Dr. Cothern to help you build expectations before reaching out to the U.S. Dermatology Partners team near you.

How Your Tattoos are Placed Matters

No matter what, your tattoo removal will require several visits, but there are many factors that may impact the process, including:

  • Ink colors – lighter and more reflective colors are typically more difficult to remove than darker, more saturated ink colors.
  • Type of ink – inks usually contain heavy metals, and the types of materials that make up the ink will impact how quickly your body can remove it.
  • Amateur vs professional application – both types of tattoos lead to challenges during removal. Amateur tattoos usually don’t penetrate as deep into the skin, but they are also likely to be unevenly applied. Professional tattoos are set deeper into the skin, but they are usually at an even depth.

Answers to Frequently Asked Questions About Tattoo Removal

Before you start your laser tattoo removal plan, you probably have some questions. Dr. Cothern or another experienced dermatologist can provide you with answers to the majority of your questions during a tattoo removal consultation, but below, you’ll find the answers to some of the questions we hear most often.

How long will it take?

Your body will determine the length of time it takes to remove your tattoo. Laser removal relies on white blood cells to carry the ink into the liver to be processed out of the body. This process can take a year or longer and require anywhere from five to ten (or more) laser sessions. It all depends on how quickly your body gets to work carrying off the ink particles.

Does it hurt?

Almost every patient will tell you that having a tattoo removed hurts about the same amount as it did to have it applied. If your tattoo placement was very painful, you can expect the same experience during removal. People describe the sensation as being like the skin singe that can occur from grease while cooking bacon. While it’s definitely not pleasant, the majority of people are able to bear the discomfort. In some cases, especially for large tattoos, you may want to ask your dermatologist about topical numbing agents to make the process a little more comfortable.

What are the side effects of tattoo removal?

Almost every patient will experience some side effects of treatment in the first few days after receiving their laser treatment. Not surprisingly, the skin will be red, irritated, and sensitive. In some cases, there will also be blistering and bruising. Something many people aren’t prepared for is the way their skin’s natural pigmentation changes. Tattoo removal lasers are designed to target and breakup pigments, and sometimes, this includes the skin’s natural pigments. This can lead to either hyperpigmentation (skin darkening) or hypopigmentation (skin lightening). Changes to skin color as well as the other immediate side effects are temporary. As the skin recovers it should return to normal. This is why you need to wait six weeks or longer between treatments to ensure the skin is completely healed before retreatment.

Will I have a scar?

It is extremely unusual for the laser tattoo removal process to scar the skin if you follow your aftercare instructions carefully. However, many people aren’t aware that the placement of their tattoo caused scarring. While the lasers will break down the pigment within the scar tissue, they won’t remove the scar itself. Any already existing scars will remain after your tattoo is removed, but it isn’t likely that you’ll have new scars.

Can a dermatologist revise my tattoo?

Most dermatologists will work with you to remove parts of a tattoo if you want to have it revised. Revision may include completely removing part of a tattoo that extends too far or didn’t turn out the way you’d hoped. It may also include lightening a tattoo, so your artist can cover the area with a new image. Make sure to clearly state your desired outcomes before beginning the revision process with your dermatologist.

How much does it cost?

The cost of removal varies. A good rule of thumb is that your tattoo removal will cost ten times more than the cost of application. In most cases, the smallest, postage stamp-sized tattoos will cost about $50 to place, so you should budget at least $500 for removal. However, there are other factors that influence the cost, so you really need to schedule a consultation with a professional to get an accurate estimate. Many providers offer free consultation appointments and tattoo removal packages to help offset the costs of the removal process.

The Laser Tattoo Removal Process

So, how does it actually work? It’s pretty interesting. If you have a tattoo you likely noticed a few things directly after getting it. First, your skin healed. Then, within the first year, your tattoo probably got a little lighter. Both of these things happen because your body recognizes tattooing for what it is – the introduction of foreign matter into your body. When the tattoo ink is deposited deep into your skin, white blood cells take off, attacking the ink in an attempt to remove the foreign particles and heal the skin. While the skin heals, the bulk of the ink will remain in place. This is because ink particles, for the most part, are much too large for the white blood cells to carry away. The tattoo will fade a bit as the smaller particles are removed, but the bulk of the ink remains.

In order to remove a tattoo, the larger ink particles need to be broken up into pieces small enough for the white blood cells to remove. That’s where the lasers come in. Using state-of-the-art Q-Switch lasers, the dermatologist can control settings matched to remove the specific ink color. These lasers are both extremely hot and extremely fast. Newer tattoo removal lasers are often referred to as pico-lasers. This is a reference to their speed because the lasers work in picoseconds. A picosecond is one trillionth of a second.

Here’s what happens during a laser tattoo removal session:

  1. The laser is set to strike pigments that match your ink coloring
  2. The laser zaps the ink particles
  3. The heat splits the ink particles into smaller pieces
  4. The speed causes part of the ink particles to remain cool
  5. The opposing heat and cold pushes the particles apart
  6. The white blood cells surround and absorb the smaller ink particles
  7. These ink particles are transported to the liver
  8. The liver processes the particles out of the body

Work with U.S. Dermatology Partners

If you’re interested in learning more about laser tattoo removal, you should start by setting up a consultation appointment with a U.S. Dermatology Partners provider near you. If you live in Fort Worth or the DFW Metroplex, you may have an opportunity to work directly with Dr. Cothern. To find a U.S. Dermatology Partners location in your area, simply complete our online request form, and one of our experienced dermatologists will be in touch with you soon.

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