Laser tattoo removal has dramatically grown in popularity over the last decade.  This is partly due to the unprecedented increase in the prevalence of tattoos.  It is also due to the advent and wider availability of reliable technology for laser tattoo removal.

Prior to the 90’s there were methods of tattoo removal, such as non-q-switched lasers, surgical excision and abrasion and chemical burning.  Although they were all reliable, they also had such severe side-effects of burning and scarring that the end result was often more distressing than the original tattoo.

Q-switched lasers  were different from previous lasers in their extremely short, high-energy firing of laser light.  This is driven by a fast shutter, similar to rapid-fire photography.   Rather than burning off the tattoo, the q-switched laser fractures and breaks up the tattoo pigments particles into smaller and smaller pieces.  These are eventually small enough to be removed by the body’s own immune system.  The process takes multiple treatments and results are gradual.  In most cases, people are patient with the time in exchange for a better long-term outcome.

Dr. Kaplan just got his 3rd laser tattoo removal of his tattoo.  Below is a photo of the tattoo just before it got lasered.  The bottom photo is how the tattoo looked originally.  As the tattoo gets lighter, there is less and less ink to absorb the laser heat, so the power of the laser can be gradually turned up (to a limit).  As you can see, there is fading that occurs with each treatment, not all of which is obvious right away.  The M & D were especially dark since they had extra passes done on them but are also fading.  Notice that there are no changes on the skin or evidence of any scarring.  The fading occurs without the need for blistering simply through the action of the q-switched laser.

At Tattoo MD, we ask our clients whether their tattoos are professionally-made or the amateur variety.  We ask this because there are certain common differences between the two types that affect the ease of laser tattoo removal with the q-switched laser.

Professional tattoo artists are expert tattooists.  That means that they know how to make a tattoo last.  An artist does not want a tattoo to fade away after placing it just months earlier.  That means that he or she will place enough ink, deep enough and of the right composition to make it last for years and decades.  That means that the tattoo ink tends to be dense and adequately deep in the skin.  Also, tattoo artists have access to certain inks, such as metal oxides, that an amateur probably wouldn’t.  The more ink that is in the skin the more laser treatments are required.  Also, certain inks, such as those containing iron oxide, are harder to clear with laser tattoo removal.

Amateur tattoos can be made in all sorts of ways.  Someone may make a tattoo gun using a guitar string and a battery.  Or they may simply use a needle by hand.  The ink could be pen ink, charcoal, or soot.  It is unusual to see colors other than black in amateur tattoos.  Since these tattoos are usually light and made of organic ink, they tend to be quite easy to remove.  A caveat to this is that if the ink was placed extremely deeply in the skin, such as with a deeply penetrating needle, it may be below the range of the laser.  However, as long as the tattoo is visible to the eye, it should also be visible and affected by the q-switched laser.

This is a trying time of the year for Southern Californians.  The annual fire season is challenging and we owe much to our brave firefighters.  This past weekend saw multiple fires in the greater LA area.  In appreciation of our fighters, Tattoo MD is offering a free treatment this week for any Los Angeles area firefighter who has a tattoo that violates policy and wants to have it removed.  We normally have a 15% off discount for firefighters, but we are increasing it to 30% off if you start this week (call for details).  Take that with the first laser treatment being free, and you’ve got an amazing deal!

A sleeve tattoo is one where the forearm, or even the upper arm as well, is tattooed all the way around.  The sleeve tattoo may have been a single project or may evolve over years as the recipient continues to add work to the area.  These tattoos take a substantial investment of time and money to create, so it’s unusual for someone to want an entire sleeve to be removed.   What we more often see is that someone has one of the sleeves that has evolved over time, and now the person wants part of it that they don’t like anymore removed.  Usually they are making room for another tattoo in the cleared area.  In that case, it’s sufficient to lighten the area rather than to completely remove the tattoo.  Sleeve tattoos often contain multiple colors, not all of which are easily removed, so removing an entire multicolor sleeve without a planned cover-up may be a daunting task.  Also, if someone is getting an entire sleeve tattoo lasered off, then the per square inch pricing is too expensive.  We come up with a custom price that is affordable and suitable according to the individual and the complexity of their tattoo removal project.   Contact us to schedule a free consultation for your sleeve tattoo.

Since last year, there has been news about Freedom-2 Inc., a company on the East Coast that has been developing tattoo inks that are more easily removable than typical tattoo ink.  Their ink brand is Infinitink.  A product launch is expected late this year.  Initial reports focused on Freedom-2’s micro-encapsulation technology, where biodegradable inks are encapsulated in microspheres that can be disrupted by laser.  The released ink would then be gone in very few treatments.

Dr. Kaplan spoke today with the Freedom-2’s Director of Research, Peter Morello, regarding their upcoming product launch.  Mr. Morello said that the first ink to be released will be black and will probably be released in November or December to a limited initial market.  He also said that that ink will not be micro-encapsulated but will be composed of an ink compound that is more easily removable by laser.  He recommended the Q-switched Nd:YAG laser for the treatment of tattoos made with this ink.  A tattoo made with this is supposed to be able to be removed 2-3 times as quickly as a similar tattoo made with india ink.

We have many patients that come to us for removal of cosmetic tattoos.  The most common are eyebrow tattoos but we also get requests for lip liner and eye liner tattoos.  They may have been placed at a medical office or by an esthetic tattooist, or they may have been created by a primarily artistic tattooist.  The most straight-forward for laser removal are eyebrow tattoos.  One issue that has to be addressed is whether iron oxide pigments were used in the tattoo.  If so, laser treatment could cause the tattoo to change color from a rust/brown to a black or gray.  Although the tattoo may still be removable, it takes more laser treatments than otherwise and may be an unacceptable color during the laser process.  Usually, the patient does not know and is unable to find out whether the ink contained iron oxide.  For this reason, we perform a tiny test spot at the first treatment to make sure that the tattoo doesn’t change color unacceptably.
Eye liner tattoos are difficult to deal with since lasering over the unprotected eyeball is dangerous.  Therefore, we don’t perform eye-liner tattoo removal as it requires intra-ocular protection and is much more uncomfortable.  Our approach to lip-liner tattoos is similar to that of eyebrow tattoos.

Otherwise, cosmetic tattoo removal is similar to removal of artistic tattoos.  Treatment intervals and aftercare are essentially the same.  Pricing is set based on the location of the tattoo, rather than by the square inch.  It is best to come in for a free consultation to have the tattoo evaluated and discuss the pros and cons of cosmetic tattoo removal.

Our standard recommendation is for people to wait at least six weeks, and preferably four, between their tattoo removal treatments.  This is not because of time needed for healing - usually there is no burn or blistering, so very little “healing” needs to occur.  The 4-6 week figure comes from the theory that tattoo removal doesn’t just happen because the ink gets blasted away by the laser, rather it relies on an active process in the skin that involves the immune system.  It is thought that ink particles are taken up by immune cells and moved away from the tattooed area through lymphatics.  Any such complex process takes time, and it correlates with our observation that the longer people wait between laser tattoo removal treatments, the more fading there is.  There is a point of diminishing returns, though.  With each passing week there is less and less additional fading, so if time is of the essence, then getting a treatment every 4-6 weeks is best, but you may in the end get more treatments in total than if you waited, say, at least 6 weeks.

If the tattoo is very dark to begin with or is a cover-up, there may not be any noticeable difference after the first treatment or two.  Even if ink is actively being taken out of the tattoo after a laser treatment, the tattoo may stilll contain so much pigment that it may not look lighter.  So don’t despair if your tattoo falls in this category - it may simply require more treatments than a lighter tattoo.

At Tattoo MD, we often get patient inquiries regarding treatment during pregnancy or breast-feeding.  Patients want to know if they can get a tattoo removed during pregnancy or get Botox while breast-feeding, etc.  The answer to this is often “no,” but not for obvious reasons.  Laser tattoo removal, for instance, is avoided during both breast-feeding pregnancy.  Research has generally not been done to prove that any such procedures are not safe or vice-versa.  We generally follow the principle that if any chemicals could be produced or added that are not normally present in the body, then we avoid the procedure during this time.

For instance, laser tattoo removal breaks tattoo pigments into smaller components and mobilizes them to distant sites away from where the tattoo is.  Although it is not known whether these pigments could cross the placenta or enter breast-milk, we assume that it’s possible.  Laser hair removal by itself does not introduce any foreign chemicals but topical anesthetic cream is used, so it is avoided for that reason.  Botox injections are avoided also, although the chance of causing a problem with a fetus or nursing child is extremely low, since it has never been tested in that setting, and probably never will be.  Injectable fillers, such as Juvederm and Radiesse are composed of natural ingredients, hyaluronic acid and calcium hydroxyapatite.  However, lidocaine is injected or applied topically, so these are also not used during pregnancy and breastfeeding.

So what services can we offer during this period?  Actually, quite a few.  Microdermabrasion is completely safe.  It does not introduce anything and works on the surface of the skin.  Sclerotherapy of spider veins is also safe, since it uses natural salt water in minute amounts that are only active locally at the site of injection.  Most of the other estheticiain services, such as waxing, facials and eyelash extensions are safe, but Vi Peels are not done.

To the pregnant or nursing mothers out there - just hang in there!

In appreciation of our country’s law enforcement officers, Tattoo MD offers a 15% discount off all our laser services, including laser tattoo removal and hair removal, and esthetician services.  At Tattoo MD, we welcome relationships with local law enforcement officers.  We know that these brave men and women put themselves in harm’s way on a daily basis and would like to express a small thank you in return.