Have you reached the regret phase of a years-old tattoo—or just want to fade your tattoo enough to cover it up? Whatever’s led you to laser tattoo removal, there’s good news: technology has come a long way. With this guide inspired by the most common questions the RealSelf community has about laser tattoo removal, you can understand the process accordingly. Here, 10 tips and things to know from New York City board-certified dermatologist Dr. Michele Green, to help you prepare.
1. Set your expectations
Before you start the process, it’s important to realize that no tattoo removal is guaranteed. Set expectations by speaking with a laser treatment expert—or three. Some tattoos only partially fade after several treatments and may leave behind a ghost image or permanent raised scarring. So the big question is: Would you rather do a cover-up or be left with a ghost image or partial tattoo?
Related: 6 Women Share Their Most Regrettable Tattoo—and How Much They Paid to Remove It
2. It’s not a one-and-done treatment
In just about every tattoo removal case, multiple treatments will be required. Unfortunately, the number of sessions isn’t something that can be predetermined during your initial consultation. Be cautious if your technician gives you a standard answer of 6 to 10 treatments, since that number could be much higher. “It is difficult to estimate the number of laser tattoo removal treatment sessions required before evaluating the tattoo, due to the many factors that are involved with the procedure,” says Dr. Green. “The age of the tattoo, the size of the piece, and the colors and the types of ink used all impact the overall response to treatment and can influence how many total sessions are required.”
Downtime between treatments is another key factor. Getting a laser treatment again too soon can increase the risk of side effects, like skin irritation and open wounds. The average time between sessions is 8 to 12 weeks, says Dr. Green, meaning that it can take up to two years to remove a tattoo.
3. Location matters
Fading is generally slower for tattoos located further down the arms or legs, as they are further from the heart. Tattoo location can even “influence the amount of time and potentially the total number of treatments required to completely remove it,” says Dr. Green. “Tattoos in areas of the body with a good amount of circulation and blood flow, such as the chest and neck, will be diminished more quickly than areas with poorer circulation, like the feet, ankles, and hands.”
4. Professional and amateur tattoos are not the same
The success of removal depends largely on the tattoo itself—for instance, the colors used and how deeply the ink is embedded are two major considerations. Professional tattoos penetrate deeper into the skin at uniform levels, which can make it easier to treat. However, professional tattoos are also more saturated with ink, which is a significant challenge. Amateur tattoos are often applied with an uneven hand, which can make the removal challenging, but overall, they tend to be easier to remove.
Related: I Got an Ephemeral Tattoo That Disappears in a Year. Here’s How the Revolutionary Ink Works.
5. Not all lasers are created equal
There are several options for tattoo removal, with different laser wavelengths treating different colors. Laser tattoo technology has significantly improved in recent years, headlined by the PicoSure laser applicator; it operates on three wavelengths, depending on the colors being removed. Newer lasers have also hit the market, to varying success. “The AlexTrivantage laser is advantageous for use in laser tattoo removal because of its ability to effectively diminish the appearance of tattoos of varying colors, including black, red, green, and blue,” says Dr. Green. “The most difficult colors to remove are orange and pink, though the laser can be adjusted to minimize these tattoos as well.”
6. Learn what to expect after a treatment
There are a handful of symptoms you might see post-treatment, including blisters, swelling, raising of the tattoo, pinpoint bleeding, redness, and temporary darkening. These are common and usually subside within a couple of weeks. As always, consult your doctor with concerns.
7. Watch for potential side effects
The most common side effect is a darkening or lightening of the skin, known as either hyperpigmentation or hypopigmentation. This usually corrects itself within 6 to 12 months after treatment. Scars (including keloid scarring) are also a potential risk as well as infection, burns, and textural changes of the skin.
8. The darkening effect is real
Some of the ink used in cosmetic tattoos, including colors containing white ink, may darken immediately after treatment because of titanium dioxide. “Laser tattoo removal can cause a release of chemicals within the skin that oxidize upon release, potentially causing the area to appear darkened or even gray in color,” says Dr. Green. Fortunately, this can usually be corrected with additional treatments.
9. There’s a higher risk of hypopigmentation with tattoo removal on dark skin tones
People with dark skin can remove a tattoo with lasers; however, there is a higher risk of hypopigmentation, as the laser may remove pigment from your skin along with pigment from your tattoo. Your doctor should proceed with caution and always do a test spot, to minimize risk.
10. Ask questions and see before and after photos
Laser tattoo removal is generally safe when performed by a qualified technician or doctor. During your consultation, don’t be afraid to ask about all the potential side effects and risks based on your situation. You should always ask to see before and after pictures from other clients with similar skin types and tattoos too. Doing so will help you set realistic expectations—and ensure the best possible results.
