Tattoos have been used for several thousand years to adorn beauty, provide healing, declare ownership, and castigate or punish. Termed “stigmata” in ancient Rome or Greece, they identified criminals, slaves, and religious sects. Nowadays certain designs signify a specific prison or gang in the USA. Up to 25% of young or middle-aged adults in North America have at least one tattoo, since with electric needling, even complex decorative tattoos have become easily available and affordable.
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The removal of tattoo pigment requires the delivery of a certain colour light in a very short time or pulse duration (nanoseconds or millionths of a second). Modern Quality-Switched (QS) lasers produce intense heat and acoustic shock waves that smash pigment. The smaller fragments move from within cells to be removed gradually by the lymphatic and immune system.
The type, location, and colours, will determine the best choice of laser. Many physicians will perform a test in a less conspicuous area if possible. A detailed history is required including allergies, medications, and any tendency to scar or heal poorly.
You must advise your doctor if you have ever had gold salts for the treatment of rheumatoid arthritis as lasers turn gold salts to black in treated skin.
Amateur tattoos require an average of 2-3 treatments, and professional tattoos can require up to 8 or more treatments for satisfactory clearing. A few patients may develop resistance to treatment which can lead to incomplete pigment removal. Most patients achieve virtually complete fading of blue, black, or green ink, by cumulative gradual fading with each treatment.
Red is difficult to remove and yellow, orange, pastel or earth tones respond poorly to selective lasers.
Various types of anaesthesia are used depending on the location and individual patient tolerance.
The risk of scarring is low, usually observed as a loss of pigmentation or a change in the texture of the skin. Atrophic scars (a depression in the skin) and hypertrophic (raised) scars occur infrequently.
The treated skin may lighten in colour but usually returns to normal within a year. Permanent loss of pigment can occur in dark skin or Caucasians who tan easily. Protection of the treated area and specific measures are required after treatments. Failure to comply may affect healing and the ultimate result.
Moles or even cancers may be obscured in a tattoo. Laser dermatologists are experts in the diagnosis of all skin conditions.
Expertise and training achieve optimal results for patients, and enable proper laser selection, judicious treatment, or a decision not to treat.
