When I remove a tattoo the thing I first take into consideration is the color of the tattoo itself. The dark green and black are the easiest to
remove. The colors that are much more complicated and take longer to remove are the red, orange or blue tattoos. The pigment in those colors does not react with the laser as well. The hardest to remove is the aqua marine or sky blue color tattoos. Often times they will not respond to the typical laser, which is the Q-Switch MD YAG Laser. It will only respond to the Q-Switch Alexandrite Laser. When a tattoo is removed there is the size, skin type and age of the tattoo to consider. The older tattoo’s that have faded are easier to remove whereas the newer tattoo is not as easy to remove.  

Let’s talk pain; it can be painful to remove the tattoo. The laser works by reacting with the ink causing it to explode in the skin causing the pigment to micronize or become smaller so the skin cells called macrophages can digest it. When you explode the pigment in the tattoo that can be painful. I can administer local anesthesia where injections of lidocaine are placed into the skin using a needle. Topical anesthesia or numbing cream can also be applied on top of the skin. The topical cream is not as strong as the local lidocaine injections. I have had patients that I have had to give vicodin or valium to because they had a lower pain tolerance. These patients need to have a driver to drive them home. 

When I start the procedure I often times use a chiller caller the Zimmer Cooler that helps to alleviate some of the pain by blowing cold air onto the skin. The treatment itself does not take that long. A 1-inch by 1-inch tattoo takes about 15 minutes to treat completely. The pigment (ink) turns white; there may be some bleeding. The white resolves over the course of two to three weeks. You may notice some of the pigment coming to the surface of the skin then pushing out. With each treatment you are treating the top portion of the tattoo. As the top portion comes up to the surface the bottom portion comes up to replace the top portion. So, you are removing the tattoo in layers or stages. All that being said, the deeper the tattoo the more treatments you will need. Often times you will need 6 to 12 treatments to remove the tattoo. 

After the tattoo laser treatment is finished there can be some blood and oozing or mild discomfort.  

Post Tattoo Removal Care:

• Tylenol for mild discomfort
• Vicodin for extreme discomfort
• Antibiotic ointment
• Bandage until skin closes
• Keep out of the sun
• BioCorneum or Kelo-Cote to improve healing

An interesting observation that I have made is that in some cases I have seen the onset of Psoriasis at the tattoo site. I have also seen granuloma annulare, in rare cases a patient may get a wart or molluscom in areas of previous tattoos.