Tattoo removal

What is tattoo and pigment removal?

The “Q” in Q switched laser treatment stands for “quality”. A Q switched laser pulses high power laser beams with such precision that they don’t have any thermal interaction with tissues. This means that it produces minimal damage to surrounding tissues internally and targets only tattoo ink pigments. An added benefit of this is a quicker and less complicated healing time. The Q switched laser has been determined as a gold standard for tattoo removal. It works by producing extremely short pulses of high energy light. The light is then absorbed by the particles of the tattoo pigment but doesn’t get absorbed by the surrounding skin. The tattoo pigment then heats up and starts to break down into small particles. A Q-switch laser may also be used to treat pigmented lesions including age spots, freckles, sunspots, and some birth marks, it targets the melanin in the superficial layer of your skin. When the pigmented lesion absorbs the light energy from the Q-Switch laser it gets converted into heat. 

What is unique about Q-Switched tattoo removal?

A Q-switched laser is the only technology that is able to penetrate down to the dermis and shatter tattoo ink (via photo acoustic waves) without causing damage to the surrounding skin tissue. All other methods either aren’t capable of reaching and destroying the ink or cause too much damage to the skin, resulting in scarring. The 1064nm and 532nm cover over 80% of tattoo colors.

What are some indications for Q-Switch?

Tattoos, pigmented lesions including age spots, freckles, sunspots, and some birth marks.

What color tattoo’s can be treated?

Good- Black, blue, dark blue, dark green, brown, red, purple, orange

Difficult- Tan, yellow, bright green, sky blue

What to expect?

The laser tattoo removal itself may not be comfortable but discomfort is a normal response during treatment and recovery. The targeted areas will feel tender and sensitive to touch due to swelling and blistering thereafter. Once these effects subside over the next few days, so does the pain. Immediately after treatment, you will notice frosting on the area where the laser came in contact with the ink. It is caused by the rapid local heating of skin pigment releasing carbon dioxide on the surface of the skin which resembles white frosting. This signals the first stage of healing and it lasts for only a few minutes. More frosting occurs with dark ink compared to lighter ink. This is accompanied by swelling around the treated area. Redness, tenderness, and swelling usually subside a day or two after treatment. Blisters start forming within 24 hours after treatment and they may appear alarming, but these indicate that your body is healing as it should. Avoid picking your blisters because they will drain on their own and dry into scabs. The crust will eventually fall off within 10-14 days after treatment granted thar the area doesn’t get irritated. One may even return to your usual activities shortly after treatment. The area will be bandaged to keep it dry for a few days following the treatment. 

How does it feel?

Laser tattoo removal typically does involve some level of pain. That said, many say that it hurts less than they expected. It’s a common belief that tattoo removal is excruciating, yet most patients say that the sensation of removal is comparable to having a tattoo applied. Common descriptions include the sensation of a rubber band snapping against the skin or bacon grease- basically its uncomfortable but bearable. 

Pre-Treatment:

Avoid sun exposure/tanning beds for 2 weeks pre and post. Avoid pain medicine such as Aleve, Aspirin for 3-7 days. Topical numbing cream or local anesthetic may be used and cold compress may be applied prior to treatment. 

Post-Treatment:

Keep out of the sun, out of pools/lakes/bath water until healed. Apply recovery balm and keep it covered for 5-6 days while healing. Apply ice 10 minutes post treatment. 

Basic Reminders:

· Use sunscreen to protect the treated skin which is particularly sensitive to sunlight following treatment

· Don’t apply makeup or any potentially irritating product on treated skin while it heals

· Avoid shaving treated areas unless the skin is healed

· Don’t soak in baths, hot tubs, or pools unless the skin has healed completely

How long does a treatment take?

Depending on the size of the treated area(s), after numbing, treatments can take several minutes up to an hour. The number of sessions needed to remove a tattoo depends on three factors: the age of the tattoo, the color of the ink, and the density of the ink.

· Age: older tattoos can be removed within fewer treatments than newer tattoos. A black ink tattoo that is 10 years old may take one or two treatments fewer than a 1 year old black tattoo. A 20 year old tattoo may take two to three treatments fewer than a 1 year old tattoo, but it's easy to remove if your tattoo is brand new (1 month old).

· Color: certain colors are more easily removed than others. Black and red tattoos are the easiest to remove. Orange, yellow, pink, and other shades are slightly more difficult to remove. The most difficult colors to remove are light green, light blue, and teal/turquoise.

· Ink Density: Shading in a tattoo is easily removed. Some tattoos with letters use shading to fill in the outlines of the letters. Some tattoos with certain designs use shading for clouds or other visual effect. Shading will be removed in only a few sessions in most cases.

When will I see results? How long do they last?

The sessions are spaced eight weeks apart, which allows your skin to process the treatment. Many people start to see their ink fade slightly after each subsequent session and greater improvement after three appointments. Given eight weeks between each session, you can expect the results to start showing a few months after the process starts.

How many treatments will I need?

Recommended 6-10 treatments.

Can I exercise?

Yes.

Are there any side effects?

There are a handful of symptoms you might see post-treatment such as blisters, swelling, raising of the tattoo, pinpoint bleeding, redness, temporary darkening, hypopigmentation, hyperpigmentation, and bruising. These are common and usually subside within a couple weeks. As always, consult your provider with concerns.

Who is a good candidate?

Patients with realistic expectations with tattoo’s or pigment that mirror the optimized colors above.