How Tattoos are Remove

Possibility of removing Tattoos

Most dermatologic surgeons caution that complete tattoo removal is not possible ( in some cases). Tattoos are meant to be permanent, so removing them is difficult. Few surgeons guarantee complete removal. Having said that, there are several methods of tattoo removal which have proven effective. The degree of remaining color variations or blemishes depends upon several factors, including size, location, the individual's ability to heal, how the tattoo was applied and how long it has been in place. For example, a tattoo applied by a more experienced artist may be easier to remove since the pigment was evenly injected in the same level of the skin. New tattoos may also be more difficult to remove than old ones.

Doctors say they can't predict the exact degree of removal because they generally don't know which of the 100 tattoo inks available today were used. (The U.S. Food and Drug Administration currently lists tattoo pigments as "color additives," which are intended only for application to the top layer of the skin.) Consult with a removal specialist -- be sure to take a list of questions along.

Methods Used for Tattoo Removal

Before lasers became popular for tattoo removal starting in the late 1980s, removal involved the use of one or more of these often-painful, often scar-inducing surgeries:

**   Dermabrasion, where skin is "sanded" to remove the surface and middle layers

This is a surgical procedure that involves the controlled abrasion (wearing away) of the upper layers of the skin with sandpaper or other mechanical means. Nowadays it has become common to use CO2 or Erbium:YAG laser as well. The procedure requires a local anaesthetic. Afterward, the skin is very red and raw-looking, and it takes several months for the skin to regrow and heal.

The purpose of dermabrasion is to smooth the skin and, in the process, remove small scars (as from acne), moles (nevi), tattoos or fine wrinkles. The mechanical method remains popular because it is the most affordable and has practically the same results as the laser method.

One of the disadvantages of dermabrasion is that it can exfoliate skin only 15-25 micrometers deep, which means that it cannot be used for deep wrinkles. Dermabrasion treatment carries few possible side effects or complications. However, some patients may experience dryness, sun sensitivity, and temporary bruising in the area of skin treated.

**   Microdermabrasion

Microdermabrasion is a cosmetic technique that uses a mechanical medium for exfoliation (removal of dead skin cells on the skin's outermost surface) to remove the outermost layer of dead skin cells from the epidermis. It is a non-invasive procedure and may be performed in-office by a trained skin care professional.It may also be performed at home using a variety of products which are designed to mechanically exfoliate the skin. Many salon machines and home-use machines use adjustable suction to improve the efficacy of the abrasion tool. Recently cosmetic scrub products that contain fine grit made from the pits of various fruits and from other materials are using the term microdermabrasion in their marketing.

Dermabrasion is generally used to refer to a surgical procedure that abrades away the top layers of the skin. The term microdermabrasion generally refers to a non-surgical procedure that abrades less deeply than dermabrasion. Although the mechanism of the two procedures is similar, the difference in the depth of the abrasion results in different recovery times. Dermabrasion recovery time may take as much as several weeks to several months whereas microdermabrasion recovery time may be as little as one to two days.

Microdermabrasion may be performed to decrease the appearance of superficial hyperpigmentation, photo-damage, diminish fine lines, wrinkles, and shallow acne scars. Removing the dead skin will aid in the penetration of skin care products by up to 50% and make-up will go on much more smoothly.

The first microdermabrasion unit was developed in Italy in 1985, using small inert aluminium oxide crystals to abrade the skin. In 1986, other European markets had introduced the technology, which was immediately adopted by physicians for mechanical exfoliation. There were 10 microdermabrasion units on the market in Europe by the end 0f 1992. In 1996, Mattioli Engineering partnered with one of the Italian designed machines and started working towards meeting FDA requirements for the USA. By the end of 1996, the FDA issued the first approval letter for microdermabrasion machines. In January 1997, the first microderm machine was being sold and marketed in the US. The diamond tip was introduced in 1999 and the bristle tip was introduced in 2005.

Microdermabrasion has evolved from rocks, stones and shells to crystals, particle-free diamond tips and particle-free bristle tips. Once the desired amount of exfoliation has been reached, some microdermabrasion units will then infuse a skin specific solution into the skin.

**   Cryosurgery (where the area is frozen prior to its removal or application of extreme cold to destroy abnormal or diseased tissue)

Cryosurgery is a minimally invasive procedure, and is often preferred to more traditional kinds of surgery because of its minimal pain, scarring, and cost; however, as with any medical treatment, there are risks involved, primarily that of damage to nearby healthy tissue. Damage to nerve tissue is of particular concern.

Patients undergoing cryosurgery usually experience minor-to-moderate localized pain and redness, which can be alleviated by oral administration of analgesics such as aspirin, ibuprofen or acetaminophen (paracetamol). Blisters may form, but these usually scab over and peel away within several days.

Methods Used

Liquid nitrogen

A common method of freezing lesions is using liquid nitrogen as the cooling solution. The super-cooled liquid may be sprayed on the diseased tissue, circulated through a tube called a cryoprobe, or simply dabbed on with a cotton or foam swab.

Carbon dioxide

Less frequently, doctors use carbon dioxide "snow" formed into a cylinder or mixed with acetone to form a slush that is applied directly to the treated tissue.

Argon

Recent advances in technology have allowed for the use of argon gas to drive ice formation using a principle known as the Joule-Thomson effect. This gives physicians excellent control of the ice, and minimizing complications using ultra-thin 17 gauge cryoneedles.

Dimethyl ether - propane

A mixture of dimethyl ether and propane is used in some preparations such as Dr. Scholl's Freeze Away. The mixture is stored in an aerosol spray type container at room temperature and drops to −41 °C (−42 °F) when dispensed. The mixture is often dispensed into a straw with a cotton-tipped swab.

**   Excision(removal by cutting)

This is where the dermatologic surgeon removes the tattoo with a scalpel and closes the wound with stitches (In some cases involving large tattoos, a skin graft from another part of the body may be necessary).

This is an immediate and extreme way to remove a tattoo. The process involves physically cutting out the tattooed skin which of course is below the first layer of skin. That means that the outer layer of skin is going to have to go with it. This method will without a doubt remove your tattoo. It is also the hardest removal procedure to heal and extremely prone to infection as you will have large areas of missing and exposed inner flesh.


The healing process of an excision is not very controlled. One may see extensive scarring that looks worse than any tattoo ever could.



Although the procedures above are still used in certain cases today, lasers (Light Amplification by the Stimulated Emission of Radiation) have become the standard treatment for tattoo removal because they offer a bloodless, low risk, effective alternative with minimal side effects. Each procedure is done on an outpatient basis in a single or series of visits. Patients may or may not require topical or local anesthesia.

As early as the 1960s, lasers had been developed for industrial uses. When researchers developed lasers that emitted wavelengths of light in short flashes called pulses, medical use became viable. These lasers can effectively remove tattoos with a low risk of scarring, according to the American Academy of Dermatology . The type of laser used to remove a tattoo depends on the tattoo's pigment colors. (Yellow and green are the hardest colors to remove; blue and black are the easiest.)The three lasers developed specifically for use in tattoo removal use a technique known as Q-switching, which refers to the laser's short, high-energy pulses:

•  the Q-switched Ruby,
•  the Q-switched Alexandrite,
•  the Q-switched Nd: YAG, the newest system in this class of lasers and particularly advanced in the removal of red, blue and black inks

The unfortunate thing about tattoos is that both getting them and having them taken off can be uncomfortable. The impact of the energy from the laser's powerful pulse of light has been described as similar to getting hot specks of bacon grease on your skin or being snapped by a thin rubber band. (Compare these descriptions to those of how it feels to get a tattoo in How Tattoos Work.) Because black pigment absorbs all laser wavelengths, it's the easiest to remove. Other colors, such as green, selectively absorb laser light and can only be treated by selected lasers based on the pigment color.

In preparation for a laser procedure, doctors recommend that non-aspirin products, like Tylenol, be used for minor aches and pains prior to the procedure, because aspirin and nonsteroidal anti-inflammatory agents such as Ibuprofen can produce pronounced bruising after treatment.

Further pre-treatment steps might include the application of a prescription anesthetic cream two hours before the laser session. It is wiped off just before laser surgery begins. (Some patients say they don't need this. Others prefer to have a local anesthetic injected into the tattoo prior to laser therapy. Pinpoint bleeding is sometimes associated with the procedure.) Then pulses of light from the laser are directed onto the tattoo, breaking up the pigment. Over the next few weeks, the body's scavenger cells remove pigment residues.

More than one treatment, which actually only takes minutes, is usually needed to remove an entire tattoo -- the number of sessions depends on the amount and type of ink used and how deeply it was injected. Three-week intervals between sessions are required to allow pigment residue to be absorbed by the body.

Following treatment, the doctor will apply an antibacterial ointment and dressing to the area, which should be kept clean with continued application of ointment as directed by your doctor. A shower or bath the day after treatment is okay, but the treatment area should not be scrubbed. Your skin might feel slightly sunburned for a couple of days and the treated area may remain red for a few weeks. The site might also form a scab, which should be handled gently. After healing, the site will gradually and continually fade.

**   Lasers Removal of Tattoos

Lasers work by producing short pulses of intense light that pass harmlessly through the top layers of the skin to be selectively absorbed by the tattoo pigment. This laser energy causes the tattoo pigment to fragment into smaller particles that are then removed by the body's immune system. Researchers have determined which wavelengths of light to use and how to deliver the laser's output to best remove tattoo ink. (If you're wondering if the laser might also remove normal skin pigment, don't worry. The laser selectively targets the pigment of the tattoo without damaging the surrounding skin.)

Side effects of laser procedures are generally few but may include hyper-pigmentation (Hyper-pigmentation is a commont condition in which some areas of the skin are darker then others), or an abundance of color in the skin at the treatment site, and hypopigmentation, where the treated area lacks normal skin color. Other possible side effects include infection of the site, lack of complete pigment removal and a 5 percent chance of permanent scarring.