Laser Tattoo Removal

How do you remove a tattoo? Removing a tattoo requires a laser to remove ink from the skin while preserving the surrounding tissue. Using a Q-switched laser causes a beam of light energy to interact with pockets of ink in the skin that comprise the tattoo. A “photo-acoustic” event occurs and light breaks apart the ink into smaller particles, small enough for the body to absorb. This process is repeated 4-8 times for full removal, and represents the only effective procedure to achieve tattoo removal.

What Exactly Is Going on Here?

Tattoo pigment in the skin is considered a very deep target. Tattoo ink creates “pockets” between the dermis and epidermis, which are deeper targets than others (sun damage, facial vessels), and which can be difficult to treat deeper pigment in skin (melasma). To fully remove a tattoo, the laser needs help from the healing system in the skin. The edema and swelling from tattoo removal treatment create a “wound healing response” in skin to absorb the smaller ink particles that result from treatment. The tattoo then begins to fade.

To complicate matters, different colors react in different ways. Black ink and darker colors are easier to remove with less post treatment healing required. More colorful tattoos will have longer healing times. Wavelengths used to remove more colorful inks interact more aggressively with the skin.

Technique Matters

The laser tattoo removal procedure needs to start with low energy, which is increased in each successive treatment. Practitioners should avoid over-treating. Additionally, R20 still being investigated and is not the “home run” many were hoping for. Practitioners will also want to avoid any epidermal disruption. This increases the potential for complication and long-term pigmentation issues.

Technology Matters

For the most effective treatment, a tattoo removal laser needs to be a high-energy system:

1J pulse energy or better

There are four different manufactures active in the US market, only two that are manufactured in USA

The laser should also be a “Active QS” and not a “Passive QS”

Active QS is a single pulse technology that delivers all energy in one pulse

Passive QS is electronically generated pulses that are delivered in a pulse train, which is made in China technology, not clinically effective and very cheap (in all senses of the word)

Lastly, multiple wavelengths are needed to remove multi-color tattoos.

What Type of Lasers Remove Tattoos?

Q-switched lasers remove tattoos and there are three main kinds: