What are the effects of tattoo removal?

From the Guidelines

Tattoo removal using Q-switched lasers is the current state-of-the-art method, with the laser wavelength adjusted to match the absorption pattern of different color pigments, and it is essential to have the requisite training in the use of the Q-switched laser for tattoo removal to avoid significant burns and scarring 1.

Overview of Tattoo Removal

Tattoo removal can cause temporary side effects, including redness, swelling, blistering, and scabbing at the treatment site, which usually resolve within 1-2 weeks following each laser session. More significant effects can include hyperpigmentation or hypopigmentation, which may be temporary or permanent in some cases.

Laser Treatment

The Q-switched laser pulse is delivered over nanoseconds with extremely rapid heating, leading to fragmentation of tattoo pigment particles, and subsequent treatment should be performed after at least 4 weeks 1.

Potential Risks and Complications

Scarring occurs in approximately 5% of patients, particularly those with darker skin tones or when improper laser settings are used. Pain during the procedure can be managed with topical anesthetics like EMLA cream applied 1-2 hours before treatment.

Effectiveness of Tattoo Removal

Complete tattoo removal typically requires 6-12 sessions spaced 6-8 weeks apart, with professional tattoos generally requiring more treatments than amateur ones. The effectiveness varies based on tattoo color, with black and dark blue pigments responding best to treatment while yellow, green, and fluorescent colors being more resistant 1.

Key Considerations

It is crucial to consider the cost of laser tattoo removal, which can range from $49 to $300 per square inch per treatment, and the Kirby-Desai score, which takes into account the skin type and complexion of the individual, the colors involved, and complexity of the pattern, to estimate the number of sessions required and the total cost 1.

From the Research

Tattoo Removal Effects

• Tattoo removal by Q-switched nanosecond laser devices is generally a safe and effective method, albeit a time-consuming one 2
• Incomplete removal remains one of the most common challenges, particularly when treating multicoloured tattoos 2
• Frequent adverse effects include:
  • Hyper- and hypopigmentation 2, 3
  • Ink darkening, particularly frequent in permanent make-up 2
  • Scarring, although rare when treatment is performed correctly 2, 3
  • Allergic reactions and malignant tumours in tattoos, requiring a nuanced approach 2
• Laser tattoo removal uses the physical properties of photoselective thermolysis to remove tattoo pigment, with overall good results and a relatively low degree of adverse effects 3
• Q-switched laser is the most effective method to remove tattoos with minimal adverse outcomes 4

Treatment Considerations

• Precautions need to be taken and pitfalls avoided before starting the procedure of laser tattoo removal 3
• Patient considerations and contraindications should be addressed, including patient expectations and treatment procedures 4
• Accurate preoperative assessment is necessary, taking into account both patient and tattoo characteristics, especially for cosmetic tattoos 5
• Personalized treatment based on preoperative assessment is required for cosmetic tattoos 5

Treatment Outcomes

• Complete tattoo removal can be obtained with Q-switched Nd:YAG laser, even in the case of cosmetic tattoos 5
• Adverse events are typically mild, with erythema being the most common 5
• High level of patient satisfaction can be achieved with proper treatment and preoperative assessment 5
• Combined pulsed dye laser and Q-switched Nd:YAG laser can achieve complete clearance of traumatic facial tattoos without significant side effects 6