I’m writing this article in the hope of shedding light on why some people seem to have quick and successful results with tattoo removal, and why others are slow to remove, ultimately to provide realistic expectations, and to suggest what individuals can do, if anything, to decrease the number of sessions that they will need and to reduce the possibility of unwanted side effects.
Successful tattoo removal depends on a host of independent factors which are a combination of the quality of the laser along with the expertise and experience of the operator, the depth and age, and quality of the tattoo and the colour and chemical make-up of ink that was applied, and most importantly, the effectiveness of the individuals own immune system.
Optimal Tattoos for tattoo removal.
Amateur tattoos (dependant on type of ink used,) for instance Indian ink scored into the skin at school age have the most successful removal in older clients, this group of people being the most common for first time, one session, complete removal. The downside is that some amateur tattoos have been made with tattoo machines that the applicant, due to inexperience, will have injected the ink below the typical depth that professionals would inject the ink into and below the depth that the laser can be successfully absorbed.
Also some inks sold with these unprofessional kits do not comply with European standards and at times can not be removed at all due to their chemical constitution (although this is quite rare.) You should be advised in your consultation whether it appears you have too much depth for complete removal, however it is not always possible to tell especially if the depth is only apparent in the middle of the tattoo (the rest of the tattoo will hide this depth.)
Professional tattoos can contain a wide range of colour and depth, with the best being applied to purposely sustain the test of time, if all other optimal conditions are met, then you can usually expect to have a black and grey tattoo fully removed within 3-7 sessions, and a coloured tattoo fully removed within 5-10 sessions. Whilst some inks used by professional tattooists can contain undocumented chemical compositions, this is rare in a professional studio that has received some dermal biological education and therefore conforms to European standards.
Adverse effects can occur if materials like chromium green, or cobalt blue that use metal salts are in the ink for instance, and can cause cutaneous reactions when the laser is applied (the worst of which you will see in the various horror photos that are spread around the web,) this is very rare, and if your laser operator is a professional they will notice the signs of this risk and monitor the effects not just during, but also after and the scarring will be minimal.
The size of the tattoo can effect the number of sessions required simply because the ink may have been injected into deeper depths in parts of the larger tattoo as the machine navigates the bumps and shapes of the body. However, this doesn’t mean that a small tattoo will come off much faster.
The different layers of ink are as apparent in smaller tattoo as a larger – just because a tattoo is wider it doesn’t necessarily mean that it is deeper – it is the layers of depth that the different sessions are penetrating, each session covers the same depth regardless of width. It costs less of course to remove a smaller tattoo as there are fewer clicks needed to cover the surface area in each session. It is not possible to cover more than one depth in one session due to the risk of injury to the skin.
Health.
Your immune system plays as much of a part in removing the tattoo as the machine itself. The laser works by shattering the scar tissue surrounding the tattoo and the solid wall that the inks have formed – it attacks the ‘wall’ in layers and in each session we reach a deeper layer until there are no layers left.
The shattered ink from each session can be imagined as ‘dust’ – this ‘dust’ is constantly falling from your tattoo as it begins to break down naturally, and as it does your immune system is triggered that there is a foreign agent in the body and it activates to remove it, this is why tattoos fade as they get older, and can appear blue after the top layer has almost completely disintegrated naturally and the layers of new skin above it begin to blur the ink beneath.
The laser speeds up this process. If your immune system is weak then it does not react as it should to foreign particles. It can be weakened with an unhealthy diet, medications, illnesses (both diagnosed and undiagnosed,) herbs, recreational drugs, alcohol, and many other factors.
It is also possible to have an over active immune system, effects from this can cause reactions in different parts of the body including hives, rashes, and stronger (sometimes life threatening,) reactions – this is rarely undiagnosed as the patient will usually have been bothered by over reaction by other treatments, foods, or chemicals before applying for tattoo removal. It is important to be honest in your consultation so that you can have the best prognosis and the safest treatment.
Your age most often than not effects the procedure in a positive way if you are older, this is simply because older people tend to have older tattoos – tattoos over 10 years old come off quicker than new tattoos, this is because the ink has already started the process of breaking down beneath the skin. A 20 year old tattoo most often comes off in just 1-3 sessions. This of course is providing that you are in good health. Very active or sporty younger people can also have increased positive results even with newer tattoos.
Aftercare plays a huge part in your bodies capability to remove the ink, you should be well advised how to take care of your tattoo after your sessions. The laser causes some trauma to the skin causing it to swell, and swelling is not optimal for the separation of the ink particles from the main body of the tattoo and so ice should be applied to reduce the swelling directly after the session and you should continue to apply ice in the hours following the session. The area should be kept dry for 24 hours after the session, as the weight of damp skin is also not optimal for the separation of the shattered ink – if dry skin appears this is usually four or five days after the session in which case follow your laser operators advice on which creams are suitable for moisture. Blisters are unusual but if they do occur you should contact your operator for the best advise to take care of them to reduce the likelihood of scarring as scarring not only defeats the objective of obtaining clear skin, but it gives the laser an extra task in following sessions. You should wear loose clothing and your practitioner should advise you during each session on how best to take care of the tattoo filling the session.
The Laser.
The Laser has a lifespan in the number of clicks it can use before it starts to weaken and finally stop working all together (lasers are not cheap and this is the main factor into the expense of your sessions.) If a laser is operated every day, the average lifespan for maximum results is around 5 years. An experienced operator will notice when the laser is being to lose its effects, new practitioners can sometimes be naive on this factor.
The type of laser used can effect the results. If you have a blue tattoo that you need removing then you need to see a ruby laser operator, an Alexandrite (slower,) or picosecond laser. I have operated 2 YAG lasers and a picosecond laser – there is not much difference in the time they take to remove black ink.
The picosecond is notably faster with red ink, but the black is around the same – however the Yag had a more dramatic effect early on and slowed down as sessions proceeded, and the pico gets more dramatic as the sessions proceed. The logo on the machine is irrelevant – regardless of advertising propaganda put out by some companies and their practitioners.
Guaranteed removal before a certain amount of sessions is impossible. There are some studios that guarantee removal within 10 sessions and therefore sell a 10 session bundle. From my experience the majority of tattoos are removed within 7 sessions with a YAG or pico-second laser, however this can not be guaranteed due to undiagnosed, or unpredictable factors – some factors are yet unknown. So the studios that guarantee within 10 can usually gain (or stretch out to) 3 paid sessions per the majority of customers, making it financially feasible to give free sessions to the rare customers that require over 10.
Summary. Many different aspects can effect the duration of sessions that a person will require to fully remove a tattoo, some tattoos can not be fully removed (extremely rare,) and sometimes it is impossible to gauge this before sessions begin (undiagnosed immune issues, unpredictable depth, unconfessed lifestyle choices to name a few.)
However, with an experienced practitioner, using the correct equipment, having an in-depth consultation to examine all factors, and giving advice towards maximising the efficiency of the laser throughout this consultation can help you to decide whether tattoo removal is feasible for you, and can sometimes give an average approximation of the length of time it will take but there is no guarantee.
Tattoos are injected to be permanent, tattoo removal can take time, it is expensive, and the procedure is quite uncomfortable .. these are factors that you must consider before committing to removal.
Your first session must include a consultation to investigate the factors above, you should be given the information regarding the process and confirmation that the operator knows the science behind laser tattoo removal technology and has adequate knowledge of the skin.
It is important that you manage your own expectations of the possibility of complete removal – that tattoo removal can take time, and that there are things that you can do to maximise each laser session, and that a good consultation can prepare you for the possibility that your tattoo may take longer. Thank you for reading.
