Will laser tattoo removal leave any scarring? (Photo)

Question

I got this tattoo on my hand a little over a month ago, but it didn’t heal probably. I accidentally scratched it twice and I can see the two small scars on it. Will the scars be a problem? Can I still get my tattoo removed without the scarring getting worst? Also how many treatments will it take?

Harold J. Kaplan, MD · Answer

Hi PH.  It's difficult to see the scarring you reference, but with your skin type and tattoo color, it should be very straightforward to remove the tattoo with no scarring.  A q-switched Nd:Yg (1064) laser is ideal and there are many types.  We encourage you to attend a consultation or two and evaluate before and after photos of the practice to get an idea of whether or not they can accomplish the removal.  Best of luck.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question in regards to tattoo removal. Scars from getting a tattoo will not pose a problem when getting laser tattoo removal. Once the ink is gone, the scarring will typically be more pronounced, but should not become any worse. Several treatments are required for complete removal. The location of the tattoo, your skin type, amount and color is ink are all factors that will determine how many sessions will be required. 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.

Douglas Wu, MD · Answer

The PicoWay laser uses high bursts of energy to shatter tattoo pigments so that your body can flush the particles away over time, and will not scar your skin if performed by a board-certified dermatologist who’s an expert in tattoo removal. You should not begin removing your tattoo for at least another month. Your skin needs two months to heal after a new tattoo or a tatto-removal session— otherwise, you will scar. As for the scars you already have, if they don’t resolve over time, your dermatologist can hep you with them, too, using lasers or microneedling. Consulting with a board-certified dermatologist will get you the best and safest results.

Jason Emer, MD · Answer

This can be removed with laser tattoo removal with minimal risk of scarring. Tattoos should be removed with q switched or pico lasers. We also use the pfd patch to help speed up the process. It will take a series of treatments, but it's difficult to determine how many sessions will be needed. I recommend getting a formal evaluation with a laser tattoo removal expert. Best, Dr. Emer

Brian Citro, MD · Answer

Thanks for posting with a photo. Scarring can occur with tattoo removal which is why you want to make sure you are seeing a professional. The most likely way to get a scar is from an overzealous treatment with a Q-switch laser. Pico lasers are best for tattoo removal especially if they have nano second and pico second settings. Please choose a reputable professional before starting treatment. Best of luck.

Tariq Ali Khan, MD · Answer

Thank you for your question.  Laser will remove your tattoo very nicely and effectively without scarring or pigmented changes if it is done correctly in the hands of an experienced provider.  If you already have scarring from the tattoo process itself, the laser should not make this worse.  
The most common technology used is Q-switch lasers which have been effective for many years now.  The newest technology which is PICOsecond technology aims to break the ink into smaller particles using partially nonthermal energy.  This however has shown plus and minus results in head to head studies as far as time to clearance of the tattoo and safety.  If a q-switch is used properly, it is just as effective as a PICO laser, in pretty much the same duration of time.  A lot of the effectiveness and time to removal has way more to do with the location of the tattoo, ink density, ink quality and your overall health.  The safety for risk of pigmentation and scarring has more to do with your provider.  Thanks! - T.Khan MD

Laura Riehm, MD · Answer

Thanks for your question and posting a picture.  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 typically 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.  The patch is only used with the older nanosecond lasers.  Best of luck

Mark A. Blair, MD · Answer

Hello, thank you for your question and for including a photo.  The way a laser rids the skin of unwanted ink is, it shatters the ink into tiny particles and your body absorbs those particles. The latest technology in laser tattoo removal is the pico-second technology. The PicoWay Laser (Candela/Syneron) uses photoacoustic
impact/pressure waves rather than photothermal/heat.  This process has less heat, therefore it is
more comfortable and the chances of hyperpigmentation are less.  The Pico-second pulse shatters the ink into
even smaller particles, allowing the body to more easily absorb the ink.  This type of device can usually remove unwanted ink in about half as many treatments as the traditional Q-switch device.  Your tattoo appears pretty simple, just line art and only black,  It should be fairly easy to remove this tattoo and scarring is very rare with the pico technology due to it being less heat.  If I had to guess how many treatments, I might say 4-7 treatments.  The hand, being at the end of your limbs, has less sufficient blood flow than other parts of the body like the trunk of the body.  The further away from your blood source (the heart), usually more treatments will be necessary.  You can click on the weblink below and put in your zip code to "find a provider" of this technology in your area.

Richard Rosol, MD · Answer

Find a medical professional with a picosecond laser, and you won’t have to worry about any additional scarring. Your practitioner should be able to give you a reasonably close treatment estimate after examining the tattoo in person.
Good luck!

Will laser tattoo removal leave any scarring? (Photo)

Answers (9)

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