Tattoos no longer have to be forever
In the last few years tattoos have become so popular that more than 10 million Americans have at least one. At some point however more than 50% of those people eventually want a tattoo removed and many people also decide to "fade" part or all of an old tattoo so that they can replace it with a new one.
With recent advances in lasers, specifically the development of Q-switched lasers, tattoo removal has become the most effective, safe method to erase or fade these unwanted tattoos.
Our patient before and after 6 Laser Tattoo Treatments, Photos by C. Elliott, MD
Skinspirations uses a Q-switched laser that can produce different wavelengths to target several colors. The laser targets tattoo ink under the surface of the skin and rapidly heats it, causing the ink to fragment into particles. These particles are then carried away by the body's immune system during the weeks following each treatment. Each treatment breaks up more of the pigment particles that are responsive to these wavelengths to produce eventual fading.
Before & after 5 treatments at Skinspirations, preceded by treatments at another facility Photo by C. Elliott, MD
The colors that can be removed easiest with laser tattoo treatments are black and most reds, but some improvement may be obtained in most other colors except for yellow, aqua and some greens. Because of the variability in pigment ingredients used to produce each color, some reds and purples may be resistant to laser tattoo treatment.
Our patient before and after 8 Laser Tattoo Treatments to a new tattoo, Photos by C. Elliott, M.D
Often other colored pigments that were used to produce the final tattoo are revealed when the pigments most sensitive to the laser fade away.
Before & after 4 treatments, showing underlying pigment colors. Photos by C. Elliott MD
Fading the ink for a new tattoo
Many of our laser tattoo patients want to replace a tattoo they no longer want with a new one in the same area. Replacing a tattoo does not require total removal of the old one and tattoo artists can often cover an old tattoo with a new one after just 1-3 laser tattoo treatments to fade it.
Our patient before & after several treatments, Photo by C. Elliott MD
By targeting darker colors such as black and purple, even large tattoos can be significantly lightened with less cost and discomfort than removing them completely. With ink reduction, tattoo clients can have a better tattoo that would have never been possible before.
What to expect with Laser Tattoo Treatments
You may have heard that tattoo reduction treatments are painful but at Skinspirations, we make sure the treatments are as comfortable as possible. An injection of anesthetic is usually performed before the treatment to make the treatment itself completely painless or a specially formulated anesthetic cream can be applied for about 90 minutes if the patient prefers. With the anesthetic cream there is some moderate discomfort. Either type of anesthetic is included in the price of treatment. Immediately afterwards a dressing is applied and remains in place for at least 24 hours.
"Dear Nurse Rick & Dr. Elliott, Words cannot express my heart's gratitude for helping my son & myself get through his "tattoo dilemma". He's a wonderful child that makes mistakes like the rest of us but at least he'll be able to learn from this one without the daily reminder of a tattoo done at age 16! From the call to make his appointment through his treatments, it was a lesson learned with the love, professionalism & kindness shown by each of you. You all are great! Blessings, Kiersten & Joe Castellano"
Immediately after a laser tattoo removal treatment the tattoo may look red and puffy. In the first 72 hours, the treated area can occasionally blister or form a crust, especially with early treatments or when one tattoo has been placed over another. Over the following weeks the fragmented pigment particles will slowly be carted away by the body's immune system & with heavy pigmentation there may not be visible fading before the 2nd or 3rd treatment.
The number of treatments required for maximum improvement is impossible to predict before starting and depends on the pigments used, size, location, depth, age and colors of the tattoo. Most professional tattoos require anywhere from 5 - 15 sessions with an average of about 12 to see almost complete fading. Treatments are done at least 8 weeks apart. As noted above, some colors may not respond at all to laser tattoo treatments.
R20 Laser Tattoo Removal technique speeds up results
Laser research in the last 2 years has shown that repeating (the "R" in the name) a Laser Tattoo Treatment during the same session improves the amount of fading that will occur with each treatment if the pigment colors are responsive to the laser wavelengths. The "20" is the rough estimate in minutes for the nitrogen bubbles produced by the first laser pass to dissipate so that the 2nd pass can penetrate down to the pigment level. When this technique is used, a patient has a cool compress applied for 20 minutes after the 1st treatment, & then the treatment is repeated. Repeating the treatments more than twice in one session hasn't been shown to significantly improve the results further.
If you want to fade your tattoo as fast as possible then the R20 method may help you see results sooner. Because of the extra time involved, if you want the R20 technique of laser tattoo removal, be sure to request R20 specifically when you call, or enough time won't be scheduled for your treatment. The cost of the R20 technique is 1 1/2 times the price of a single treatment. Therefore, if a single laser tattoo treatment is $150, a double session or R20 treatment will be $150 + $75, or $225.
Possible side effects with Laser Tattoo Reduction
Side effects of laser procedures may include hyperpigmentation, or a darkening in the skin at the treatment site, or hypopigmentation, where the treated area becomes lighter than the surrounding normal skin color. Most discolorations will return to normal color over the following months but there is a possibility of permanent skin color change.
Other possible side effects of laser tattoo removal include a thickening of the skin in the area treated, infection, lack of complete pigment removal, activation of an allergy to one of the pigments used (usually red) & permanent scarring including hypertrophied (extremely raised) scarring.
The swollen aspect of the scarring that sometimes occurs usually decreases over the following months but to help prevent scarring or overgrowth of the treated skin, we recommend that all of our patients purchase & use Kelocote scar preventative cream, available only from physicians and available at Skinspirations. Kelocote contains a silicone wound dressing that when used twice a day, helps healing & decreases scar formation.
Hypertrophic scarring after previous tattoo treatments at another facility was improved to the point seen in the 2nd photo by 4 Profractional
& steroid treatments with diligent use of Kelocote in between. Photo by C. Elliott MD
If previous laser tattoo treatments have produced hypertrophied scarring as in the photo above, we can usually decrease the degree of thickening & reduce the pigment further with Profractional
Aftercare instructions for Laser Tattoo Reduction
Here are our aftercare instructions which all patients receive at their first laser tattoo removal session. Patient must follow these instructions to ensure the safest and most effective results.
- A dressing will be applied to the treated area immediately after your treatment in the office & should be left in place (or replaced with a fresh one) until the next day.
- Exercise after a treatment the first day is permitted if there's no friction on the treated area.
- Cleanse gently twice a day with soap and water.
- If you have ever developed a thickened scar or a keloid, or want to minimize your chances of scarring, purchase & apply Hybrisil twice a day for at least 8 weeks after each treatment.
- If blisters form (this is not unusual, especially with early treatments or tattoos that were done on top of another), do not puncture them. Let them reabsorb or break on their own but keep Vaseline or antibiotic ointment & a bandage over them. Keep the treated area moist 24 hours a day until any crusting is gone and then start applying Kelocote or Hybrisil as above.
- If there is any crusting or oozing from the treated area (this is not unusual, especially with early treatments) continue applying Vaseline or antibiotic ointment after cleansing and then cover with a bandage to help the ointment keep the treated area moist. Keep the treated area moist 24 hours a day until any crusting is gone and then start applying Kelocote (or Hybrisil) as above.
- If you develop crusting or a scab, don’t pick at it or you may cause scarring & avoid swimming or using hot tubs until it is dry.
- If you don’t develop any crusting or blisters you may remove the bandage the morning after the treatment.
- The treated area may feel slightly sunburned for a couple of days and cold packs can be applied as needed for comfort.
- The treated area may remain red & puffy for a few weeks.
- It’s common to develop an itching sensation in the treated area even weeks after a treatment. If applying Vaseline to the area doesn’t decrease the itching, you can apply 1% hydrocortisone ointment.
- Call our office at 727.571.1923 if you develop a temperature over 100.5 F, or increasing pain, redness or oozing after the first 2 days.
- In between tattoo removal treatments, cover the tattoo when outside. Sunscreen alone is not enough protection.
- If you develop redness in the treated areas or stop seeing improvement in the fading of the tattoo, extending the interval between treatments to 12 weeks often provides improvement in results.
Fees for laser tattoo removal are listed below and include the cost of anesthetic. Treatment fees are based on the size of the tattoo measured in square inches (the width of the tattoo multiplied by the length equals the size in square inches) and are listed below. There is a 15% discount for treatment packages of 5 sessions.
Our Q-switched laser removes most tattoos in between 5 -15 treatments (average of about 12) depending on the type of pigments used, the colors and the age of the tattoo. Some colors like green, aqua, yellow & some reds, may not respond.
Terry Bollea (Hulk Hogan) canoodles with Alison during a visit for tattoo removal
Skinspirations Laser Tattoo Treatment Fee List
Under 10 square inches $28/inch (minimum $95)
10.1 – 20 sq. inches $24/inch
20.1 – 30 sq. inches $22/inch
30.1 – 40 sq. inches $20/inch
More than 40.0 inches $18/inch