Removing Tattoos: Ink Doesn't Have to Be Forever

By Rebecca Sklar, RPA-C

There are as many reasons for wanting a tattoo removed as there are for wanting a tattoo in the first place. Times change, tastes change, tattoos may fade or blur, or an allergic reaction or infection may develop. Tattoos are intended to be permanent, but in most cases they can be safely and completely removed. Your first step in considering tattoo removal should be to consult a dermatologist. A licensed physician will tell you what results to expect and the best method of treatment and will be able to deal with any possible complications.

Some tattoos are more difficult to remove than others and results may differ based on factors such as skin tone. Older tattoos and amateur, single-color tattoos are easier to remove than newer, brightly colored designs that were applied in a professional tattoo parlor and in which the ink is deposited more deeply into the skin. Professionally applied, multi-color tattoos are more challenging to remove, and will require multiple treatments to achieve complete or even near-complete removal. The size of your tattoo, the kind of ink used, and your skin tone will all be taken into account in determining the best removal method. The most common techniques for tattoo removal are laser removal, surgical removal, and dermabrasion.

Laser removal is generally considered the most successful and cost-effective way to remove tattoos. Most removal procedures are performed with a “Q-switched” laser which emits a single, strong pulse that heats the ink in the skin and dissolves it, usually in multiple treatments over weeks or months. A complex, multi-colored tattoo may have to be treated with different lasers and wavelengths. Laser removal is most effective on lighter skin. Since the laser targets the pigment in the ink, it can also target the melanin in the skin making laser removal more difficult and results more unpredictable on darker skin that has higher levels of melanin. Amateur tattoos in which the ink is placed closer to the surface and older tattoos in which the ink has already partly diffused are easiest to remove with a laser. Risks with laser removal include scarring and skin discoloration.

Surgical removal cuts out (excises) the tattooed skin and stitches the remaining skin together. It is the most invasive technique for removal but also the one that will most assuredly remove all of the tattoo. Surgical removal will leave a scar and is most often used on small tattoos. Careful aftercare of the surgery site is important to minimize scarring.

Dermabrasion, which uses a sanding device to remove the tattooed layers of skin and allow the ink to leach out, produces unpredictable results and is the least often used technique for tattoo removal.  

If it is simply the design of a tattoo that is no longer wanted, it is possible to “cover up” a tattoo by adding more ink to the area to modify its appearance, essentially disguising the original tattoo with a new one. However, if you are intent on removing a tattoo, a dermatologist will help you determine the most effective treatment. As tattoos have become more popular and moved into the mainstream, removal techniques have also become more sophisticated and successful. Despite your original commitment to have a permanent tattoo, you don’t have to live with the consequences of that decision forever.

Rebecca Sklar, PA-C is a certified physician assistant through the National Commission of Certification of Physician Assistants.  

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. www.advanceddermatologypc.com.