Six Factors to Consider When Planning Tattoo Removal

Approximately 38% of adults in the US between the ages of 18-40 have at least one tattoo. And, approximately 17% of these adults regret getting their tattoo. For some, they’ve reached a point in their life when the tattoo’s meaning is no longer relevant. Or, maybe their tattoo is preventing them from reaching a career goal. Whatever the situation, there are safe, effective options for tattoo removal.

How is a tattoo created? 

A tattoo is created by the use of multiple needles puncturing the skin in order to drag the ink particles, both big and small, through the epidermis and down into the dermis. Your body immediately recognizes this foreign substance in the skin and your immune system begins to try and break it down, to no avail. Tattoos are permanent because the ink particles are so much larger than our white blood cells so they, the ink particles, cannot successfully be broken down and defeated. Tattoos do naturally fade over time. In fact, from the moment the ink enters your body, all the way through the life of your tattoo, your white blood cells will eat away at smaller bits of ink and send them away through your lymphatic channels to your liver and out your body. For those wishing to permanently remove their tattoo, laser tattoo removal is often the answer.

How does laser tattoo removal work?

Lasers are used to break tattoo ink large particles up into smaller, manageable sizes for our white blood cells to defeat. While this seems fairly simplistic, many factors affect the outcome of tattoo removal. Some of the most common questions I get are How many treatments will it take? Will my tattoo be completely gone when we are finished? I’m preparing for a special event, how long will the entire process take? During a skin care consultation, there are six factors that I focus on in order to answer these questions.

1. Skin tone 

The patient’s skin color is an important part of planning any laser treatment. One of my first steps is to determine what laser wavelength is safe for the patient’s skin tone.

2. Location of the tattoo

Ink that is successfully broken down moves through the lymphatics in the dermal layer. A tattoo will be removed much quicker if it’s located in an area of the body that maintains the larger amounts of regional lymph nodes and a larger vascular supply. The easiest way to think about it is this – the closer the tattoo is to your heart, the less stubborn it is to remove. So, tattoos on the extremities, such as the hand, may take longer to remove.

3. Scarring or tissue change

Often times, getting a tattoo can cause collagen disposition with the potential for scar formation. If this occurs, it is much more difficult to remove the tattoo due to the congestion of cells because the white blood cells cannot penetrate the area of tattoo ink.

4. Color(s)

A tattoo’s color has a big impact on its removal. Each ink color has a different size granule which factors into the removal process. These differences lead to the difference in the amount of treatments needed. For example, colored pigments have been noted to have a molecular size up to twice the size of the black pigment, so colored inks always take longer than a traditional black ink.

5. Amount of ink

Professional tattoos that are multicolored are going to have the most amount of ink because of their precision and depth. Unfortunately, the more ink, the lengthier the tattoo removal process.

6. Layering (to cover up a previous tattoo)

Layering a larger, darker colored tattoo over an unwanted tattoo is quite common. In order to remove a layered tattoo, we must first treat the top, darker tattoo. Once the top tattoo begins to fade, we can go after the original tattoo. Layered tattoos can be removed, but typically take twice as many treatments as a non-layered tattoo.

Laser Tattoo Removal Device

Just as there are important factors to focus on while determining the success for tattoo removal, there are equally important factors when determining which technology to use to do so. The laser energy needs to be targeted to the right depth in the skin, with the right amount of energy and for the right amount of time. This combination allows us to breakdown the ink particles while leaving the surrounding skin tissue unharmed. Up until last year, our owner and on-site medical director, James Mirabile, M.D. questioned the efficacy of most older generation laser tattoo removal devices. Our team had yet to be ‘wowed’ by anything on the market, until the invention of the Cutera enlighten®. We are very pleased about the results our patients are getting with this gold-standard laser tattoo removal device.

We have such great success with the Cutera enlighten® laser because it is a dual wavelength (1064nm + 532nm) and dual pulse duration (750ps + 2 ns) laser system making it optimal for choosing treatment parameters and customization. We are able to treat with precise settings that will cause the ink to heat up rapidly and break down so the white blood cells can begin their work. Because the Cutera enlighten® is dual wavelength and both nanosecond and picosecond, we are able to target the treatment based on those six key factors. The Cutera enlighten®allows us to target at the right depth in the skin, with the right amount of energy, for the right amount of time.

Christina Ammon, LE