Laser tattoo removal

Tattooing the skin as a means of personal expression, religious practice or simple skin decoration has been around for many centuries. As ones attitude changes throughout life, people might feel the need to remove unwanted tattoos.
Today, in developed countries, about 10% of people have at least one tattoo, but almost half of them want to remove them after a certain time.

Tattoos are created by injecting coloured pigment particles measuring 0.1-10 microns into the third skin layer (on average, at a depth of 2mm), which remain in the skin throughout life enveloped in defensive particles — macrophages.
Tattoos can be effectively removed with Q-switch lasers, without damaging the surrounding skin.

What is the principle of tattoo removal with a Q-switch laser?

Q-switch lasers delivers energy in very short bursts, lasting for a billionth of a second.
The released laser energy is concentrated into short high-energy pulses shatter the tiny pigment granules into even smaller fragments.
Since the beam is emitted in nanosecond durations, it does not damage the surrounding structures of the skin, except for the targeted pigment.
Laser beams of following wavelengths: 755nm, 532nm or 1064nm affect the corresponding colour of the pigment, which is divided into the smallest particles and then eliminated by skin scaling or removed through lymphatic pathways.

Removal of tattoos before and after laser treatment
Removal of tattoos before and after laser treatment

Can tattoos be removed completely?

Candela Q-switch laser, which we use in our clinic, can remove all colours of tattoos, but at least 6 months after tattooing, since this time is necessary to stabilize the pigment in the skin. It is possible to remove them even before that period, but without the guarantee that no scar will remain. Treatment can only be performed on skin that has not been sun exposed, in order to prevent the development of hypo- and hyperpigmentation.

Monochrome tattoos are most easily removed, as well as professional tattoos due to the quality of the pigment and even depth.
Tattoos with mixed pigments are harder to remove, as well as deeper and denser and pre-tattooed — placed one over the other. The yellow pigment is the most difficult to remove, as are tattoos on the peripheries of the body, for example the ankles.
Black, blue and red colours respond best to laser treatment.

After removing the tattoo, a barely visible outline of whitish hypopigmentation may remain on the skin, but it will acquire its normal colour over time.

Is tattoo removal painful?

During the treatment, the laser beam hits the pigment shattering it into smaller pieces, causing discomfort like burning sensation and slight pain similar to the pain felt during tattooing. In hypersensitive patients, a local anaesthetic cream can be applied before the treatment or the treated area can be cooled to reduce the pain sensation.

The duration of treatment depends on the size of the tattoo, it is necessary to pass the entire tattoo surface with a laser beam.

How many treatments are needed to remove a tattoo?

The number of treatments required to remove a tattoo depends on the colour and the type of pigment, the amount and the depth at which the pigment was injected, as well as the region where it is located. Most often 5 to 7 treatments 2 months apart are necessary.
During first treatment, the initial pulse strength is used in order for the dermatologist to assess the tattoo pigment and the skin reaction.
With each subsequent treatment, the pulse strength increases and the tattoo fades away.

How to behave after laser treatment?

After the treatment, the skin becomes darker, mildly swollen, and the burning sensation can last for 30 minutes.
In the following days, the skin scales, so the patient needs to apply regenerating creams.
It is not allowed to exfoliate and peel the treated area.

Rarely, in some patients, an allergic reaction to the decomposed pigment can develop manifested as blisters, and can be treated with creams in the same way, until the skin recovers completely.

After laser tattoo removal, the skin is even more sensitive to the sun, so UV protection is necessary for the following 3 months.
There is a small possibility of reduced pigmentation on the skin, which will resolve 6 months after the treatment.

In people prone to keloids, a keloid may form during tattooing and tattoo removal.

Svetlana Đurišić specijalista dermatovenerologije

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