Tattoo removal has been performed with various tools during the history of tattooing. While tattoos were once considered permanent, it is now possible to remove them with treatments, fully or partially. The expense and pain of removing tattoos will typically be greater than the expense and pain of applying them.
Pre-laser tattoo removal methods include dermabrasion, salabrasion (scrubbing the skin with salt), cryosurgery and excision which is sometimes still used along with skin grafts for larger tattoos. Some early forms of tattoo removal included the injection or application of wine, lime, garlic or pigeon excrement. Tattoo removal by laser was performed with continuous-wave lasers initially, and later with Q-switched lasers, which became commercially available in the early 1990s. Today, "laser tattoo removal" usually refers to the non-invasive removal of tattoo pigments using Q-switched lasers. Typically, black and darker colored inks can be removed more completely.
Motivation for tattoo removal
In the United States, about 17% of people with tattoos experience some regret. According to a poll done in 2008, the most common reasons for regret are "too young when I got the tattoo" (20%), it's "permanent" and I'm "marked for life" (19%), and I just "don't like it" (18%). An earlier poll showed that 19% of British people with tattoos suffered regret, as did 11% of Italian people with tattoos Surveys of tattoo removal patients were done in 1996 and 2006 and provided more insight. These patients typically obtained their tattoos in their late teens or early twenties, and just over half were women. About 10 years later, the patient's life had changed, and more than half of the patients reported that they "suffered embarrassment." A new job, problems with clothes, and a significant life event (wedding, divorce, baby) were also commonly cited as motivations.
Some wearers decide to cover an unwanted tattoo with a new tattoo. This is commonly known as a cover-up. An artfully done cover-up may render the old tattoo completely invisible, though this will depend largely on the size, style, colors and techniques used on the old tattoo and the skill of the tattoo artist. Covering up a previous tattoo necessitates darker tones in the new tattoo to effectively hide the older, unwanted piece.
Methods
Tattoo removal is most commonly performed using lasers that react with the ink in the tattoo and break it down. The broken-down ink is then absorbed by the body, mimicking the natural fading that time or sun exposure would create. All tattoo pigments have specific light absorption spectra. A tattoo laser must be capable of emitting adequate energy within the given absorption spectrum of the pigment to provide an effective treatment. Certain tattoo pigments, such as yellows, greens and fluorescent inks are more challenging to treat than darker blacks and blues. These pigments are more challenging to treat because they have absorption spectra that fall outside or on the edge of the emission spectra available in the tattoo removal laser.
Widely considered the gold standard treatment modality to remove a tattoo, laser tattoo removal requires repeat visits. The newer Q-switched lasers are said by the National Institutes of Health to result in scarring only rarely and are usually used only after a topical anesthetic has been applied. Areas with thin skin will be more likely to scar than thicker-skinned areas. There are several types of Q-switched lasers, and each is effective at removing a different range of the color spectrum. Lasers developed after 2006 provide multiple wavelengths and can successfully treat a much broader range of tattoo pigments than previous Q-switched lasers.
Another type of tattoo removal is the manual, or machine method. This practice is very unpredictable and uses a specialized type of gel, commonly mixed with saline, which is tattooed into the skin over the tattoo causing the ink in the dermis to bond with or be displaced by the gel and migrate to the surface of the epidermis. The incidence of scarring, tissue texture changes, keloids, prolonged healing, pain, discoloration (hyper- and hypopigmentation) and ink retention is extremely high with non-laser removal method; the person performing this treatment modality exposes him or herself to considerable liability. Methods like this are now only very rarely performed and in modern countries have been replaced by Q-switched laser treatment. Still other methods including thermal injury, dermabrasion and cryotherapy, are used but with the same unpredictable results and adverse side effects.
