Getting your tattoo seemed like a good idea at the time. You may have done it to symbolize something that was meaningful to you. Or maybe you just liked the body art. Regardless of the reason, over time you may realize that your tattoo is something you prefer to live without. Don’t worry, you aren’t alone: according to a 2015 Harris Poll, 23% of Americans ages 18 to 29 regret getting their tattoo! Fortunately, advances in removal procedures have made it possible to get rid of unwanted tattoos. But is tattoo removal permanent?

TATTOO REMOVAL PROCEDURES

Laser removal is now the gold standard of tattoo removal procedures. Before the development of this technique, options included dermabrasion, trichloroacetic acid (TCA), salabrasion, cryosurgery, and excision. Due to the significant scarring and residual pigmentation with these procedures, laser removal has become the standard of care.

After the first laser application for tattoo removal in 1963, the scientific community focused on developing lasers based on the familiar concept of tissue destruction by ablation. The result was continuous wave lasers, which only partially removed the tattoo pigments and ultimately caused significant scarring. A solution to these drawbacks was found when Q-switched lasers became commercially available in the early 1990s. 

A Q-switched laser is a pulsed laser that removes tattoos by shattering the ink pigments into particles that are cleared by the body’s lymphatic system. There are three types of Q-switched lasers: Nd:YAG, alexandrite, and ruby. According to a publication in Seminars in Plastic Surgery, these are the only devices that should be used to selectively remove tattoos. 

The laser technique can safely remove only one layer of ink at a time, but a tattoo is created by injecting layers of insoluble ink into the dermis. Consequently, laser tattoo removal can take between six and twenty treatments depending on the amount and color of ink. Treatment sessions must be spaced at least one month apart to prevent adverse effects.

Black ink is the easiest to remove. Yellow, green, or blue tattoo ink is difficult to remove and can typically only be faded. Results also depend on the depth of the tattoo. According to William J. Hedden, MD, a Birmingham plastic surgeon, sometimes the laser can’t be absorbed deeply enough to remove the tattoo, which can leave a bruise-like area in place of the tattoo.

SCARRING AFTER LASER TATTOO REMOVAL

After laser treatments, patients need to be aware of the possible side effects, which include scarring, changes in the skin’s texture, burning, and light or dark spots on the skin. The incidence of scarring depends on three main factors:

• The medical training of the person removing the tattoo
• The type of device used
• Using excessive laser energy

According to the American Academy of Dermatology, side effects from tattoo removal procedures are more common when performed by someone who lacks medical training, such as a tattoo artist or an aesthetician. You should always seek a dermatologist for your tattoo removal needs as they have medical training in the techniques of tattoo removal and also prioritize the safety and health of your skin.

Scarring after a laser tattoo removal procedure is also extremely likely if the wrong device is used. Pulsed nanosecond and picosecond lasers are the most effective for tattoo removal. This was first described in a landmark paper by Anderson and Parrishin 1983, which described selective photothermolysis—the ability to selectively remove target tissues using pulses of laser energy. (Semin Plast Surg.) Unfortunately, while this theory was published more than 30 years ago, devices that emit pulses in the millisecond domain, such as IPL sources, are still sometimes used to treat tattoos. These devices heat ink granules for too long, allowing excess heat to damage the surrounding tissue. The result is a high incidence of scarring, which appears in the exact shape of the tattoo while still leaving most of the tattoo behind. Therefore, to achieve optimal results for tattoo removal only Q-switched lasers should be used. While scar formation after removal with a Q-switched laser is still possible, the incidence is very low.

Another common pitfall of laser surgeons is using excessive laser energy in an attempt to remove tattoo ink that no longer fades with a particular laser. A publication in Seminars of Plastic Surgery reports that a tattoo may not be able to be completely removed by a single laser without producing a scar. In fact, some tattoos must be treated by a combination of all three types of Q-switched lasers.

WHAT TO DO ABOUT SCARRING

When you have a tattoo removed, you expect the results to be permanent. It can be disappointing to see a scar in place of the tattoo, which can still serve as a reminder that the tattoo was once there. So what can you do about scarring after a tattoo removal procedure?

Clinical studies have shown that silicone gel and sheeting are considered the first-line therapy to manage and minimize scarring, including scars after tattoo removal procedures. In fact, silicone gel products are the only topical treatments recommended by the scar experts who create scar treatment guidelines for other doctors.

NewGel+ offers the widest variety of silicone scar treatment products available, ranging from silicone strips, sheets, shapes, and two tube sizes of topical silicone gel. All of these products have been demonstrated to be a successful treatment for a variety of scar types, both old and new. Whether you’ve just had a tattoo removed or you’ve had a scar from a tattoo removal for quite some time, NewGel+ has a product that will be the perfect fit for your unique scar needs. Find your perfect match by browsing our product collection now.

July 24, 2017