What is the Best Method of Tattoo Removal?
From the practice of
Brian V. Heil, MD, FACS, board certified plastic surgeon
Published February 27, 2019 · Updated
The best method of tattoo removal is a picosecond laser. It clears the most ink with the least damage to the skin around it: each pulse, a trillionth of a second long, shatters the ink particles into fragments small enough for your immune system to carry away, with far less heat than the nanosecond lasers that came before. It takes a course of sessions, but it clears more colours, suits more skin tones, and does it without the scarring that excision and abrasion leave behind.
Every other method falls short in one of two ways. Surgical excision, dermabrasion and salabrasion remove the tattoo but leave a scar in its place. IPL, creams, cryotherapy and saline fading are gentler but cannot reach ink that sits deep in the dermis, so the tattoo stays. A cover-up hides it without removing it. At Acqua Blu Medical Spa in Pittsburgh the laser is the PicoWay, a picosecond device, and the rest of this article sets out why.
Tattoo removal methods compared
| Method | How it works | Does it remove the tattoo? | The catch |
|---|---|---|---|
| Picosecond laser (PicoWay) | Pulses a trillionth of a second long shatter ink particles mechanically; the body clears the fragments | Yes, over a course of sessions | Several sessions, spaced weeks apart. Some stubborn colours can leave faint shadowing |
| Q-switched (nanosecond) laser | Longer pulses break ink down largely by heating it, along with some of the skin holding it | Yes, for most black and blue ink | More sessions, more discomfort, more heat in the skin, and greens, yellows and reds often will not shift |
| Surgical excision | The tattooed skin is cut out and the edges stitched | Yes | A scar in place of the tattoo; only practical for small pieces |
| Dermabrasion and salabrasion | The skin is sanded or scraped away, with or without salt | Often | Frequently leaves scarring |
| Intense pulsed light (IPL) | Broad-spectrum light pulses through an applied gel | Usually not | Not strong enough to reach ink embedded in the dermis |
| Removal creams | Applied daily for months to fade the ink | No | Cannot reach the dermis; results are rarely satisfying |
| Cryotherapy | The skin is freeze-burned with liquid nitrogen | No | Most experts advise against it for tattoos |
| Saline fading | Saline is injected into the tattooed skin | Partial fading of older tattoos at best | Will not remove a tattoo entirely; effectiveness is disputed |
| Cover-up tattoo | A new tattoo is designed over the old one | No, it hides it | No help if the goal is to be tattoo-free |
What changes how well a tattoo comes off
Two things make ink hard to remove. It is injected into the dermis, well below the surface, so energy has to reach it without harming the layers above. And its particles are too large for the immune system to clear, which is exactly why the tattoo has stayed put. A laser’s whole job is to break those particles down into fragments small enough to be carried away. Beyond that, four things decide how your particular tattoo responds:
- Ink colour. Black and blue absorb laser energy readily and clear most predictably. Reds, yellows and greens are the stubborn end of the spectrum and typically need more sessions. Picosecond technology is the main reason those colours are treatable at all.
- Depth and density. Dense professional work carries the most ink per inch and takes longer to clear than a lighter amateur piece.
- Skin tone. Your own pigment competes for the same energy the ink absorbs, which affects what settings are safe. It is assessed before any treatment is scheduled.
- Where it sits. Circulation does the clearing between sessions, so a tattoo on the shoulder or back clears faster than the same piece on an ankle, where circulation is weakest.
What a laser course looks like
No laser lifts ink out of the skin in one visit. Each session fragments the particles; your immune system carries the fragments away gradually in the weeks that follow, which is why appointments are spaced out and why the tattoo keeps fading after you leave. Sessions themselves are short. Most people compare the sensation to getting the tattoo, though each session is far briefer, and cooling runs throughout. Between sessions the area is kept out of the sun.
How many sessions you need depends on the colours, the density, the location and your skin, and a realistic number comes after someone has looked at your tattoo. Many tattoos clear entirely. Some leave faint shadowing, particularly with stubborn colours or very dense work, and an honest consultation says which to expect for yours.
Common Reasons for Regretting Tattoos
Let’s face it, many of us love tattoos. However, it’s not always a love that lasts, at least for some of us. According to reports, as many as 4 out of 10 American have at least one tattoo, even though many of those who have opted for ink end up having regrets later in life.
Common causes for a change of heart are as diverse as the tattoos themselves, ranging from concerns about looking professional for job interviews to a desire to erase the name of a former boyfriend or girlfriend, whose moniker is now an unwelcome reminder. This is nothing new, either; attempts at tattoo removal have a long history, and it was far from unheard of in earlier decades.
The Benefits of PicoWay® Laser Tattoo Removal
Laser removal is the most popular approach to removing tattoos, and for good reason. With today’s technology, lasers have been refined to effectively remove tattoos without leaving behind any trace of coloration or scarring.
Embodying the latest in laser treatment, PicoWay® is highly successful at fulling removing tattoos for multiple reasons:
- Requires Fewer Treatments PicoWay® laser treatment requires fewer sessions for tattoo removal than traditional treatments, helping you to quickly remove a vast range of tattoos. In contrast to older lasers that operate by the nanosecond, PicoWay® functions at picosecond speeds, delivering pulses of light at a trillionth of a second.
- Delivers Quick Results As a powerful laser technology, PicoWay® works by shattering ink particles, allowing your body to naturally remove the tattoo ink and leaving the skin noticeably clearer. The majority of patients see results in half the sessions of traditional laser treatment for tattoo removal.
- Less Discomfort Because PicoWay®’s high-powered laser pulses are faster than older methods, such as Q-Switch lasers, you’ll experience almost no pain during the procedure. The degree of discomfort will vary from one person to the next, depending on the nature and location of the tattoo.
- Safe for All Skin Types Because it operates at such high speeds, PicoWay® produces less heat, preventing it from causing skin discoloration during treatment and making it ideal for different skin types.
Ouch! Avoid These Other Methods of Tattoo Removal
In another time, many people would remove their tattoos using some rather extreme methods, or at least attempt to. One such technique, known as salabrasion, involved rubbing a salt solution into the skin, heating it up, and scraping it away.
In another removal method known as dermabrasion, the skin was simply scraped off or sanded away. Both salabrasion and dermabrasion were frequently successful in removing the tattoo, but often left scars in its place.
The other route was just to have the tattoo surgically cut out as the surrounding skin was sewn back together, which is also not for the light of heart.
In the realm of tattoo removal, there are other methods that, unfortunately, do not deliver the desired results, particularly for notoriously stubborn tattoo colors, such as green and purple.
Other less-than-effective methods include:
- Intense Pulsed Light Therapy (IPL) IPL works wonders for loads of skin problems; however, IPL’s combination of applied gel and pulses of light are frequently not strong enough for something as deeply embedded as a tattoo.
- Cream Removals The market is filled with gels and creams that, according to claims, can remove tattoos when applied daily for a number of months. While some individuals find success with these methods, the results are less than satisfying more often than not.
- Cryotherapy This procedure involves freeze-burning the skin with liquid nitrogen. Although commonly use for warts and skin tags, most experts advise against using cryotherapy to remove tattoos.
- Saline Fading This involves injecting the tattooed skin with a saline solution and is used to fade tattoos. Although it can be somewhat effective with older tattoos, it will not remove them entirely and the method’s effectiveness is controversial.
- Tattoo Cover-ups Another method of dealing with an unwanted tattoo is to simply cover it up with a new one. Although many tattoo artists are becoming quite skilled in this, it doesn’t provide relief if your goal is to be tattoo-free.
Myriads of tattoo-removal procedures have been devised over the decades, some more effective and worthwhile than others. Whatever your reason for de-inking, the cutting-edge PicoWay® laser technology is your safest route to returning to your tattoo-free days.
To learn more about our tattoo removal or spa services in Pittsburgh, PA, call our specialists today at (724) 933-1800.
FAQ
What is the best method of tattoo removal?
A picosecond laser. It clears the most ink with the least damage to the skin around it: the pulse shatters ink particles into fragments small enough for your immune system to carry away, and it does so with far less heat than older lasers, which is why it clears stubborn colours and suits a wider range of skin tones. Excision and dermabrasion also remove tattoos, but they leave a scar in place of the ink.
Do tattoo removal creams work?
Rarely, and never completely. Tattoo ink sits in the dermis, well below the surface a cream can reach, and the particles are too large for the body to clear on its own. Some people see fading after months of daily use, but the result is usually unsatisfying, and the money is better spent on a laser consultation.
How many laser sessions does tattoo removal take?
Every tattoo takes a course of sessions spaced weeks apart. How many depends on the ink colours, how deep and dense the tattoo is, whether it was professionally applied, where it sits on the body, and your own skin. Picosecond lasers typically need fewer sessions than older nanosecond lasers, but a realistic number comes after someone has looked at your tattoo, not from a chart.
Can every tattoo be removed completely?
Many tattoos clear entirely. Some leave faint shadowing, particularly with stubborn colours such as green, yellow and red, or with very dense professional work. Black and blue ink responds most readily. An honest consultation will tell you what to expect for your tattoo rather than promise a blank slate.
Treatments at Acqua Blu Medical Spa in Upper St. Clair are provided under the direction of Brian V. Heil, MD, FACS, the practice’s founder and medical director. A consultation is the best way to find out what fits your skin and your goals.
This is general information, not medical advice. Candidacy and treatment parameters are determined by a licensed provider at a consultation.
