Tattoo Removal: what is the best laser to remove the shading in my tattoo?

Question

Which type of laser [e.g. PicoSure, Quanta Q-Plus C, etc.] would be most effective in removing the gray shading around the lettering in this tattoo? (the tattoo is 6 years old if that makes a difference)

Anil R. Shah, MD · Answer

Thanks for your question and photo. A Pico laser will do a great job removing the shading. Find a trustworthy doctor in your area with the highest technology available. Good luck.Tattoo removal, if not done correctly, can result in either scarring or ghosting.  Here are some tips:
Find a reputable office with a Pico laser. It produces faster results with less scarring than a nano alone.  Tattoo removal shops are not as reputable as a Doctor. Many of these shops close as quickly as they open, leaving you out of luck on pre-paid packages.Stay out of the sun— sunlight can be harmful to healing in after any laser procedureAvoid infections- This means keep your tattoo area clean (i.e. don’t garden right after a tattoo removal on your arm, etc), don’t pick scabs or blisters if they occur.  Follow our post procedure instructions.  Avoid swimming for 48 hours as water can infect the treated areas.Allow healing between treatment sessions- typically 4-8 weeks.Be healthy- while the tattoo laser breaks up the tattoo particles, your body will actually eliminate the particles. Being healthy will help achieve this process faster and allow for consistent healing. Drink lots of water, get adequate sleep, and eat vitamin enriched foods.In our practice we utilize the currently most powerful Pico laser on the market called the PiQo4 by Lumenis.  The main advantage of a stronger tattoo laser (combining nano and pico wavelengths at greater power) is faster breakup of the tattoo.  The science of tattoo removal is complex but essentially the greater power will photo acoustically break up tattoo particles in smaller pieces.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question in regards to laser tattoo removal. Shaded areas of a tattoo respond very well to laser. It's recommended for a q-switch 1064 nm laser to be used to achieve best results. To be sure what is best for you, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

Monika Soni, MD · Answer

Thank you for your question. I like to use the Picosure laser which can remove 95%+ of a tattoo. It works best to remove dark colors such as black, blue, purple and green. It can take up to 6-10 sessions to remove a tattoo and the average cost per session to remove a medium to large tattoo is $250-$1000. I recommend having a consultation with an expert to determine the best treatment plan for you. Best of Luck!

Laura Riehm, MD · Answer

Thanks for your question and posting pictures.  Tattoo regret is very common.  Almost every tattoo can be completely removed with enough time and treatments.  The most important factor is patience.  You have to give your body time to absorb the ink.  For laser tattoo removal you have two routes.The older nanosecond or Q-Switch lasers that came out about 20 years ago.  The majority of former Q-Switch patients we see have significant hypopigmentation (ghosting) around and under their tattoo.  The Q-Switch lasers have trouble differentiating between the melanin in your skin and ink.  The technology uses heat to burn the pigment out of your skin.  In addition, we have seen patients with raised scars as if they have been branded.  Both of these condition are irreversible.  Picosecond laser came out about 4 years ago.  Every laser manufacturer has a different marketing hook to make you choose their laser.  At the end of the day, it's about the technology and experience of the clinician.  All PicoSecond lasers (like the Enlighten, PicoWay & PicoSure) fire 1000 times faster per second, using a pressure wave rather than heat to shear the ink molecules apart.  The hype of extra wavelengths does not make that much of a difference.  The 755 nm will get rid of most of the ink colors.  For red and pink ink, you would need to make sure they have 532 nm.  After using the PicoSure for 3 and half years, we have only seen pinpoint hypopigmentation in a very small number of patients usually of darker skin tones.  We cannot say it is impossible to get burned with a Picosecond laser, but it is highly unlikely.  We tell every PicoSure tattoo patient to expect at least 6 treatments, but don’t be surprised if it takes 10 to 12.  Patience is the key for our patients.  We typically see our tattoo removal patients every 8 to 12 weeks initially.  We eventually encourage them to wait up to 6 months as the tattoos seem to continue to fade while they wait.Treatment prices vary by market. The cost for picosecond treatments will be higher, but you should need less than half the treatments compared to a nanosecond laser.  Best of luck

Norman N. Bein, MD, FACS, RVT · Answer

Tattoo shading responds very well to laser removal as the ink molecules are small.  We use the 1064 picosecond Cutera Enlighten with good results.  It may still take several treatments spaced about 8 weeks apart plus good skin conditioning between.

Richard Rosol, MD · Answer

Our PicoSure laser will usually remove shading like yours in the very first treatment, if it’s carbon-based and doesn’t contain titanium dioxide. Sometimes a second treatment is needed.

Jared Mallalieu, DO · Answer

Thanks for posting your photo. Black ink will respond well to any 1064 wavelength laser. You can use anything from the newer picosecond lasers (PiQo4) or an older model medlite. They will all work - the caveat being that the picosecond lasers may remove it more quickly. Best of luck, Dr. M

Tattoo Removal: what is the best laser to remove the shading in my tattoo?

Answers (7)

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