Tattoos have become increasingly popular over the past few decades, with studies estimating that up to 40% of 18-29 year olds having at least one tattoo. However, many people later regret their tattoo and want to have it removed. Fortunately, technological advances have led to the development of laser tattoo removal, which is an effective method for fading and removing unwanted tattoos.
How does laser tattoo removal work?
Laser tattoo removal uses high-intensity laser energy to break up the tattoo pigment in the skin. The laser targets the ink with pulses of highly concentrated light that pass through the top layers of the skin and are selectively absorbed by the tattoo pigment.
The laser breaks the pigment into tiny fragments, which are then removed from the skin by the body’s immune system. The number of treatments needed depends on the age, size, color, and depth of the tattoo. On average it takes about 6-10 treatment sessions spaced 4-6 weeks apart to significantly fade a tattoo.
Types of lasers used
There are three main types of lasers used in tattoo removal:
- Q-switched lasers: The most common lasers used are Q-switched Nd:YAG, Ruby and Alexandrite lasers. They produce high-intensity beams in nanosecond pulses that specifically target the tattoo pigments.
- Picosecond lasers: An advanced version of Q-switched lasers. Picosecond lasers deliver energy in one-trillionth of a second pulses, shattering ink more effectively than nanosecond lasers.
- Fractional lasers: These lasers use many small microbeam dots to treat the skin. Fractional lasers penetrate deeper into the skin causing more inflammation and skin turnover to remove ink.
The process of laser tattoo removal
Here is a general overview of the tattoo removal process using lasers:
- Consultation – The patient meets with a dermatologist or laser specialist for a consultation. The doctor assesses the tattoo, skin type, medical history, and expectations to determine if the patient is a good candidate for laser removal. If so, a treatment plan is created.
- Laser settings – The laser technician determines the optimal laser settings based on the tattoo’s colors and depth. Settings such as wavelength, pulse duration, power and spot size are tailored to treat the specific ink colors.
- Local anesthesia – A topical anesthetic cream is often applied prior to laser treatment to numb the skin and minimize pain/discomfort from the laser pulses.
- Laser treatment – Pulses of intense laser light are precisely aimed at the tattoo. As the laser breaks down the tattoo pigments, some dark ink fragments may be visibly expelled from the skin.
- Cooling – The skin is cooled before and after each laser pulse to help absorb excess heat. Cooling minimizes risks of burns and helps soothe discomfort.
- Repeat sessions – Complete tattoo removal requires multiple treatments (usually 6-10 or more depending on the tattoo) spaced 4-6 weeks apart for the body to flush out the shattered ink particles.
Stages of tattoo removal
Tattoo removal with lasers does not happen instantly after just one session. It happens gradually over the course of treatments as the ink is slowly cleared from the skin. Here are the general stages of how tattoo removal progresses:
Initial fading
The first 1-3 sessions lighten up the tattoo considerably. Up to 60% of the original ink is broken down and starts fading after the initial treatments.
Fading continues
Over successive treatments, the density and crispness of the tattoo continues to fade. The edges start to blur as the outline degrades.
Ink becomes patchy
With additional treatments, the tattoo looks very faded and only partial patches of ink remain. The tattoo becomes lighter and increasingly “blurry.”
Almost complete removal
After additional sessions, only traces of the original tattoo pigment remain. At this point the tattoo is barely recognizable compared to the original.
Full clearance
Eventually after multiple treatments, the tattoo completely resolves with no traces of residual pigment. The skin returns to its natural appearance as if no tattoo was ever there.
Results timeline
On average, you can expect the following tattoo fading/removal timeline with laser treatments:
| Session # | Stage of Removal |
|---|---|
| 1-3 sessions | Noticeable lightening and initial fading of tattoo |
| 4-6 sessions | 50-75% removal; tattoo very light and faded |
| 8-12 sessions | Over 75% removal; only small traces remain |
| 12-15 sessions | Complete removal; tattoo fully resolved |
Note that the number of sessions depends on the tattoo size, location, age, colors, and depth of ink.
Factors affecting number of treatments
Several factors impact how many laser sessions will be required to fully remove a tattoo:
- Age of tattoo – Older tattoos that have been in skin longer require more treatments.
- Ink colors – Darker pigments like black, blue and dark red are the easiest to remove. Lighter colors like yellows, greens, flesh tones and light orange are more challenging.
- Amount/density of ink – The more dense and heavy the tattoo, the more sessions needed.
- Layering – Overlapping multiple layers of ink requires more treatments.
- Location on body – Tattoos on hands, feet and areas far from heart/lymph nodes take longer.
Can all tattoos be fully removed?
In most cases, tattoos can be safely and effectively removed with laser treatments. However, there are some instances where tattoos may not be able to be completely erased:
- Certain ink pigments like greens, yellows, flesh tones that don’t respond as well to laser removal.
- Traumatic scarring or ink granulomas within a tattoo may remain visible.
- Tattoos with dense layers/heavy ink particles too large to be fully absorbed.
- Professional tattoos deeper in skin vs. amateur, surface-level tattoos.
- Older tattoos that have been in skin for decades.
While not all tattoos can be 100% removed, most unwanted tattoos can be significantly lightened and faded to the point of being barely visible or unrecognizable.
Side effects and risks
Laser tattoo removal has minimal risks and side effects when performed correctly by an experienced provider. Potential side effects include:
- Pain – Some discomfort during treatment. Topical anesthetics are used to reduce pain.
- Redness, swelling – Temporary redness and swelling after treatment subsides within 1-2 days.
- Blistering – Mild blistering may occur, which goes away quickly.
- Scarring – Rare, but poor technique can cause textural changes and scarring.
- Hyperpigmentation – Darker skin is at risk of temporary hyperpigmentation or hypopigmentation that gradually fades over weeks to months.
- Infection – Very rare. Practitioners use sterile technique to prevent infection.
Choosing an experienced doctor who is highly trained in laser tattoo removal minimizes the risks of complications occurring.
Home tattoo removal methods
Attempting DIY tattoo removal is extremely dangerous and not recommended. Methods like using acid, bleach, salabrasion (skin abrasion), or picking at a tattoo will cause serious skin damage, scarring, infection, and poor results.
Laser tattoo removal is the gold standard for safe, effective tattoo removal. Home removal methods are best avoided due to risks like:
- Chemical burns – Acids/bleaches cause painful burns and scarring.
- Skin necrosis – Damage can kill skin cells and require surgery.
- Scarring – Abrasion and picking leads to poor healing and permanent scars.
- Uneven results – DIY methods can’t evenly fade ink leading to blotchiness.
- Infections – Unsterile at-home removal raises infection risks.
- Allergic reactions – Harsh chemicals provoke rashes and reactions.
It is always best to have your tattoo removed by an experienced medical provider using proven laser technology.
Preparing for laser tattoo removal
If you decide to get laser tattoo removal, here are some tips to prepare for your first session:
- Pick an experienced provider – Research and pick a dermatology clinic with highly-trained laser technicians.
- Avoid sun exposure – Stay out of sun and tanning beds for 4-6 weeks pre-treatment to minimize risks.
- Stop blood thinners – May need to stop blood thinners like aspirin, ibuprofen, fish oil, etc. for 1 week prior.
- Shave treatment area – Shave hair in treatment area to maximize laser penetration.
- Limit caffeine – Avoid coffee, tea, energy drinks before treatment to minimize discomfort.
- Hydrate – Drink extra water the day before and day of procedure.
- Arrange transportation – Plan for a ride home as you may experience temporary swelling/discomfort.
Aftercare do’s and don’ts
Proper aftercare helps minimize risks and improves healing between sessions:
Do:
- Apply antibiotic ointment – Use thin layer of antibiotic ointment to treated area for 3-5 days.
- Use cool compresses – Apply cool compresses for 10 minutes several times a day to relieve swelling.
- Moisturize – Keep treated skin moisturized while healing using recommended lotions.
- Protect from sun – Avoid sun exposure and use SPF 30+ sunscreen on treated areas for 6 weeks.
- Follow provided aftercare – Carefully follow all prescribed aftercare from your treatment provider.
Don’t:
- Pick scabs – Let any scabs naturally flake off, no picking.
- Scratch – Avoid scratching or rubbing the treated area.
- Use saunas, hot tubs – Avoid hot tubs, swimming pools, saunas for 1-2 weeks.
- Harsh skin care – No skin bleaching creams, chemical peels, retinoids, etc. until healed.
- Re-bandage – Don’t re-bandage treatment area unless instructed by provider.
Costs and pricing
On average, tattoo removal costs approximately $200 to $500 per treatment session. However, pricing varies significantly based on factors like:
- Laser device used – Advanced picosecond lasers are more expensive per session than nanosecond lasers.
- Tattoo size – Larger/more complex tattoos require more laser energy and time to remove.
- Office/provider – Pricing varies between providers and geographic locations.
- Number of sessions – The more sessions needed, the higher the total cost.
- Add-ons – Additional costs for topical anesthetics, cooling devices, etc.
Many practices offer package pricing and volume discounts for purchasing multiple sessions upfront, which lowers the per treatment cost. Laser centers and medspas tend to have lower pricing compared to some dermatology clinics. Always get a written cost estimate upfront so you know the total price and don’t incur unexpected charges.
Is tattoo removal covered by insurance?
Unfortunately, laser tattoo removal is considered an elective, cosmetic procedure and not medically necessary. Therefore, it is not typically covered by health insurance plans.
In rare cases, tattoo removal may be partially covered by insurance if the tattoo causes significant documented psychological/psychiatric symptoms or if dark ink needs removal prior to a surgery or treatment in the same location.
But in most cases, patients need to pay 100% out-of-pocket for their tattoo removal treatments and costs are not reimbursed by insurance.
How to choose a provider
To find a highly-skilled tattoo removal provider, consider these tips:
- Board-certified dermatologists – Look for dermatologists specifically board-certified in laser medicine.
- Photographs – Reputable providers will show real before/after photograph examples of tattoo removal patients.
- Modern devices – Seek clinics using the latest generation Q-switched or picosecond lasers.
- Specialized training – Ask about the specific laser tattoo removal training and experience of the technician who will perform your treatments.
- Consultations – Choose a provider who provides in-depth consultations to evaluate your tattoo rather than quick, sales-focused consults.
- Reviews – Check online reviews from other patients about their experience, results and the level of care.
Take time researching to find an ideal provider for your particular tattoo. An experienced professional using advanced technology and proper techniques gives you the best chances of optimal fading with minimal risks.
Conclusion
Laser tattoo removal provides an effective method for permanently fading or removing unwanted tattoos through successive treatments. Each laser session breaks up and removes more tattoo pigment until little or no ink remains.
While complete tattoo removal requires multiple treatments over weeks or months, the vast majority of tattoos can be significantly lightened or erased given adequate sessions. Take time to choose an outstanding provider to ensure the best and safest possible removal results.