Laser Removal of Tattoos

Overview

What should I know about tattoos and tattoo removal?

Tattooing is an ancient art. The word is derived from the Tahitian word tattau, meaning “to mark.” It’s estimated that more than 25% of the U.S. population has a tattoo, and nearly half of millennials have one.

While the popularity of tattoos is on the rise in recent years, so too is the number of people seeking to remove them, according to the American Society for Dermatological Surgery. Reasons for removal range from a change in job or lifestyle or because they simply no longer like the tattoo.

But here’s the rub: because the permanent ink granules from professional tattoos were injected below the skin’s surface when it was applied, removing a tattoo is far more complicated than applying one. It will normally take a few sessions of laser therapy to do the trick.

How does laser tattoo removal work?

Laser beams use concentrated bursts of energy to heat up the ink beneath the skin, which breaks the ink into smaller particles. Tattoos with different colors might require the use of multiple lasers operating at different frequencies. Those smaller ink particles can then be eliminated naturally by the body’s own immune system.

Will laser treatments completely remove my tattoo?

Your tattoo may not be completely removed, which is relatively common. Some colors of tattoo dye resist laser removal, and some pigment is too deep to be reached with the lasers that are currently available. Certain colors may be easier to remove than others. Blue/black tattoos respond particularly well to laser treatment, because they are better at absorbing light. The response of other colors is being studied.

Is laser tattoo removal painful?

People who have tattoos removed have reported varying levels of discomfort. Some said that it feels the same as getting a tattoo, while others liken it to the feeling of a rubber band being snapped against your skin.

You may prefer to use some form of anesthesia, such as a topical cream or local injection, depending on the location of the tattoo and your ability to endure pain.

How do I find a doctor to remove my tattoo?

If possible, get a recommendation from your family physician for a dermatologist that specializes in tattoo removal.

Procedure Details

What can I expect during the laser tattoo removal?

Depending on the size and color of your tattoo, the number of treatments will vary. Your tattoo may be removed in three to eight visits, and sometimes more. Schedule a consultation, during which a trained professional will evaluate your situation and inform you about the process.

Treatment with lasers varies from patient to patient depending on their age and the size and type of their tattoo. It also matters whether the tattoo was applied by an amateur or professional. The color of your skin, as well as the depth of the tattoo pigment in the body, will also affect the removal technique.

In general, this is what will happen during an office visit for tattoo removal using the newest generation of lasers:

  • You’ll wear protective eye shields.
  • Your skin’s reaction to the laser is tested to determine the most effective energy for treatment.
  • The treatment itself consists of placing a handpiece against the surface of the skin and activating the laser light repeatedly over the surface of the tattoo.

Smaller tattoos require fewer pulses, and larger ones require more. In either case, the tattoo requires several treatments and multiple visits. After each treatment, the tattoo should become lighter.

Why does it take more than one session to remove a tattoo with lasers?

Professional tattoo artists apply ink in layers, so it takes more than one session to remove them. Because lasers break the ink pigment into smaller particles, it then takes some time between sessions for your body to flush out the ink. Your skin also needs time to heal, as laser treatments can sometimes cause swelling, blistering, and can temporarily alter the color of your skin.

What kind of after-care should I expect if I have laser tattoo removal?

Immediately after treatment, an ice pack will be applied to soothe the treated area. You’ll be told to apply a topical antibiotic cream or ointment. You should use a bandage or a patch to protect the site.

You can shower the next day, but it’s best to avoid scrubbing the affected area. The treated area should also be covered or protected with sunscreen when you’re in the sun. You shouldn’t pick at the area because picking makes scarring more likely.

Risks / Benefits

Who can benefit from laser tattoo removal?

Your healthcare provider will work with you to determine how best to remove your tattoo. In the past, tattoos could be removed by several methods, but many of them left scars. Some people felt that the scar was more unattractive than the tattoo itself.

If you have a tattoo that has been treated with other methods, you may benefit from laser therapy. These treated tattoos may respond well to laser therapy as long as there is not a large amount of scarring.

People who have had laser tattoo removal cite these benefits:

  • The procedure can be done on an outpatient basis, with no overnight stay.
  • It reduces the risk of scarring and infection.
  • It’s generally safer than other options.

What are the possible side effects?

If you go to a reputable professional referred by your doctor, there are minimal side effects to laser tattoo removal. However, you should consider the following factors in your decision:

  • The tattoo removal site can become infected.
  • There is a slight chance that the treatment can leave a permanent scar. In some cases, they have been known to develop three to six months after the procedure.
  • Some degree of skin discoloration is possible. The treated skin may either be paler than the surrounding skin (hypopigmentation) or darker than the surrounding skin (hyperpigmentation).
  • Cosmetic tattoos, such as lip liner, eyeliner and eyebrows may get darker after initial laser treatments. You might have to have additional treatment to achieve fading.

You should never try to remove your tattoo yourself or use any form of home remedy for removing tattoos. At best, they will be ineffective. At worst, they could be dangerous to your health.

Tattoo removal at a tattoo parlor or spa, while perhaps safer than home remedies, still carries some risks. A trained dermatologist can better consider your overall health and more responsibly guide you on the safest treatment plan.

Is laser tattoo removal safe?

Thanks to newer technology, treatment of tattoos with laser systems has become much more effective, with very little risk of scarring (again, assuming you use a reputable provider). Laser treatment is often safer than many methods used previously, such as excision or dermabrasion. Laser treatment works on the pigments. Excision cuts out the tattoos using a surgical knife (a scalpel). Dermabrasion uses tools to sand off the upper layers of skin.

Just remember, that this advice is general, and should not replace your doctor’s guidance. For details about your specific case, please arrange a meeting with a healthcare provider who is experienced in the use of tattoo lasers.

Additional Details

Does insurance usually cover laser tattoo removal?

In most cases, tattoo removal is a personal choice and therefore considered a cosmetic procedure. Most insurance carriers will not pay for tattoo removal unless it is medically required.

How much does it cost to remove a tattoo?

Cost can depend on the size of your tattoo, how colorful it is and where you live. The American Society for Aesthetic Plastic Surgery puts the average price tag of removing a tattoo at $463 per session. Other estimates range from $200-$400 per session, depending on your location.

Healthcare providers that remove tattoos might ask you to pay the full amount at the time of the procedure. If you are considering tattoo removal, be sure to talk to the provider about all related costs before having the procedure.

Are there any promising new methods on the horizon?

In 2020, the FDA approved a new device that uses rapid pulses of acoustic shock waves to remove tattoos. It will be used as an accessory to laser surgery.

A note from Cleveland Clinic

The old saying “think before you ink” remains good advice for anyone considering getting a tattoo because body art is more permanent than perhaps you might realize at first. But modern laser surgery methods, when overseen by qualified medical professionals, are safer and better than previous alternatives.

Last reviewed by a Cleveland Clinic medical professional on 09/25/2020.

References

  • American Academy of Dermatology. Tattoo Removal: Lasers outshine other methods. (https://www.aad.org/public/cosmetic/hair-removal/laser-tattoo-removal) Accessed 9/25/2020.
  • American Society for Dermatologic Surgery. Laser Therapy for Unwanted Tattoos. (https://www.asds.net/skin-experts/skin-treatments/laser-light-therapy/laser-therapy-for-unwanted-tattoo) Accessed 9/25/2020.
  • U.S. Food and Drug Administration. Tattoo Removal: Options and Results. (https://www.fda.gov/consumers/consumer-updates/tattoo-removal-options-and-results) Accessed 9/25/2020.
  • Adatto M. Laser Tattoo Removal: Benefits and Caveats. Medical Laser Application 2004; 19(4): 175-185.
  • Bernstein, EF. Laser treatment of tattoos. Clinics in Dermatology 2006; 24(1):43-55.
  • Laumann A. Body art. In: Wolff K, Goldsmith LA, Katz SI et al, editors. Fitzpatrick's Dermatology in General Medicine. 7th ed. New York, NY: McGraw Hill Medical; 2008:Chap 100.

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