Thinking After Inking - The Skinny on Tattoo Removal

Tattoos are a very popular form of self-expression. Often, people get tattoos as a reminder of someone special, an achievement in life, their heritage or simply as a form of individual expression. Don’t worry – I’m not here to tell you that tattoos are unsafe. In fact, they are generally very safe if done by a professional. But what if you change your mind after the fact?

Thankfully, tattoos can be removed. However, it‘s not a quick trip to the doctor’s office, and your skin won’t look the same as it did before. It takes time, money, discomfort and a lot of Neosporin. Even then, your tattoo is not guaranteed to fade away. After going through the tattoo removal process, it is important to consider taking further steps to help with the scarring.

What is laser tattoo removal?

The most popular and effective method for removing tattoos is with laser tattoo removal. Most doctors use a quality-switched (or Q-switched) laser that uses light and energy to create high-power pulsing, which goes into the skin and breaks up the ink into smaller particles. The body can then dissipate the particles. The procedure is not guaranteed, but it is the best available option for removing a tattoo.

Are there any other procedures to consider?

Before laser removal was a common practice, doctors performed dermabrasion, salabrasion, surgery and cryosurgery to get rid of unwanted body art. None of these procedures are recommended today, and all of them are unpleasant, potentially skin-damaging processes. If you’re trying to remove a tattoo, I’d avoid any of these older methods.

Additionally, there are lots of over-the-counter fading creams available online that are inexpensive when compared to laser treatments. The sales pitch is quite tempting, but the FDA does not recommend this at-home DIY treatment, as the creams are likely to cause skin reactions from chemical irritants in the products that are used to erode the skin.

Are some tattoos are easier to remove than others?

Yes. It is easier to remove tattoos from parts of the body that have more circulation. For example, tattoos in distal extremity regions (where there is little body fat) such as hands and ankles, are more difficult to remove. Tattoos in the proximal extremity regions, such as upper arms and torso, are easier to remove.

A larger contrast between skin and ink helps speed up the removal process. Darker colored tattoos like black and grey are the easiest to treat, while colors like red, green and purple can be a bit more challenging. For example, black tattoos on fair skin are the easiest to treat. Just like how sunlight is attracted to darker pigments, lasers can pick up darker ink colors more easily. 

How long will it take?

Generally, tattoo removal can require anywhere from four to 12 sessions. The number of sessions required depends on how old the tattoo is and the size, placement, depth and color of the tattoo.

Patients will need to wait about a month between each session to give the body a chance to absorb the ink. Expect the entire process to take from about six months to a year and a half, not including the healing of the scar.

Are there complications?

It’s possible. Tattoos are meant to be permanent. Although it’s less abrasive than older procedures, even the state-of the-art laser technology we have today can be painful and may not result in complete removal. As with all laser treatments, laser tattoo removal may cause allergic reactions for some people. Additionally, tattoo composition fluctuates and the pigment may not respond as expected to the treatment.

How much will tattoo removal cost?

Treatment sessions do add up, and can be costly. Each session can cost $350 or more.

Is it possible to prevent or treat scars?

Pre-and post-laser care is critical for all laser treatments, including tattoo removal. Immediately following treatment, the skin may resemble a healing burn for a couple of days. The newly bare skin should be treated like a burn, too, frequently applying Neosporin and keeping the skin bandaged.

As with many of my blog posts, I mention that the sun is a major contributor to skin problems. A good SPF is even more important for vulnerable skin and should be applied daily around the treated area to avoid discoloration and infection.

Please refer to my recent blog post here for more information on the best ways to help with scarring. 

Have any questions about getting or removing a tattoo? Leave them in the comments and I’ll address them there! 

The Scar Solution

Scars are like tattoos but with better stories. Have you ever heard that quote? It’s so true. Scars are the result of a change to the skin as it heals from a wound. Scars can result from just about any type of wound, from abrasions to incisions. (For more info on the types of wounds, read my blog post here.) This blog post will give you some basic info on scars, as well as how to prevent them or make them less noticeable.

What is a scar?

Scar tissue is comprised of collagen, which is the same tissue content as normal skin. What makes it look different than the skin around it is that collagen fibers in scar tissue will form a different pattern. Where normal collagen has a woven pattern, scar tissue exhibits a “cross-stitch” type of pattern.

Scar tissue is weaker than normal skin tissue. It is more susceptible to damage caused by the sun’s ultraviolet rays, and sweat glands and hair follicles do not grow back after the wound heals.

Are there different types of scars?

Yes. While all scars are composed of the same type of tissue as the once-healthy skin they occupy, not all scars are created equal.

• Hypertrophic scars are a result of the body producing too much collagen. They present as red bumps on the skin on the scarred area. They typically take shape a month or two after the wound heals.
• Keloids are a type of hypertrophic scar. They also present as red bumps on the skin, but can grow beyond the original wound site and do not go away over time. Keloids are most common in people with darker skin. While they are often the result of a wound, some people do form them spontaneously. It is important to note that keloids are not dangerous, although they are a cosmetic issue for some people.
• Atrophic scars make the skin appear sunken. They are generally the result of losing fat or muscle in one area, causing the skin to sink a little. Acne scarring or surgical scars are generally atrophic.
• Stretch marks are a result of the skin stretching rapidly and for prolonged periods of time. Often caused by quick weight gain or loss, growth spurts or pregnancy, stretch marks are also more of a cosmetic issue than a medical concern. For more information on preventing stretch marks, read my blog post here. 

Can I prevent scars?

Not really. Not all wounds will form scars. For example, a simple knee scrape or a scratch will generally not cause enough damage to form scar tissue. A deeper wound will form scar tissue. A general rule of thumb is that the longer it takes your skin to heal, the more likely you are to develop a scar. If you want to prevent a scar, prevent any injury or wound on your skin.

Can I treat a scar or make it less noticeable?

Absolutely. There are a variety of treatments available for scars, some more effective than others. It’s important to note that no treatment will result in complete restoration of your healthy skin, but there are several options for reducing the scar’s appearance. Some options include:

• Over-the-counter treatments – Creams like Mederma often advertise their ability to reduce the appearance of scars. To be honest, it isn’t going to speed up the process a whole lot, if at all. Most scars will become less noticeable over time anyway, particularly things like stretch marks. If you don’t want to break out the big guns and visit a dermatologist, you should consider waiting before trying anything from the drugstore.
• Collagen induction therapy – Often referred to as “skin needling,” this procedure is performed by a doctor and is meant to introduce normal collagen into the scarred area.
• Exfoliation, chemical peels or dermabrasion – Removing the scarred layer of skin can often result in a lighter appearance for a scar. Traditional at-home exfoliation is probably not enough, depending on the depth and size of the scar. I recommend visiting a trusted dermatologist to discuss whether a chemical peel or dermabrasion procedure can help you.
• Fillers – Like collagen induction, fillers will introduce normal collagen into an atrophic scar, helping raise them to the level of surrounding healthy skin. You can read my post on fillers here.  It’s important to note that fillers are not permanent, so if this is your chosen solution you may need to have the procedure done every few months to maintain your desired results.
• Laser treatments – Different types of laser treatments are available for all types of scars. You’ll need to meet with a dermatologist to understand your options and which treatment, if any, is right for your scars. Like chemical peels or dermabrasion, most lasers work by burning or removing the most scarred layer of skin to reduce the appearance of a scar.

Have any more questions about scarring? Leave them in the comments and I’ll try to help if I can. Additionally, if you’d like to make an appointment at Advanced Dermatology to discuss your treatment options, click here.