Worsening "Ghosting" vs. Hyperpigmentation with PicoSure? (Photo)

I have received 4 treatments with PicoSure for an unwanted deltoid tattoo, with 2-9 months between treatments. Much to my dismay, I seem to be experiencing worsening "ghosting" or hyperpigmentation with each treatment (thoughts on this?). The overlying skin reddens with light exfoliation and feels slightly raised. I have recently been using silicone sheets to promote healing, and am hesitant to get more treatments due to this problem. What is the best way to resolve this issue? Thank you!

Doctor Answers 2

Laser tattoo removal gone wrong

I would advise you to discuss this with your provider since it may be hyperpigmentation or reaction of your skin to the laser, maybe due to the type of ink that was used for your tattoo. Make an inquiry to your tattoo artists regarding what colors and type of ink he has been using, then go back to your provider and discuss your concerns and create your treatment plan. I believe that Picosure will be able to remove your tattoo in more number of treatments. Good luck!


Summit Emergency Medicine Physician
5.0 out of 5 stars 47 reviews

Laser tattoo removal gone wrong

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I would advise you to discuss this with your provider since it may be hyperpigmentation or reaction of your skin to the laser, maybe due to the type of ink that was used for your tattoo. Make an inquiry to your tattoo artists regarding what colors and type of ink he has been using, then go back to your provider and discuss your concerns and create your treatment plan. I believe that Picosure will be able to remove your tattoo in more number of treatments. Good luck!


Summit Emergency Medicine Physician
5.0 out of 5 stars 47 reviews

PicoSure effects

It does not appear to be ghosting. It appears to be consistent with hyper pigmentation or can be a result of the laser treatments on a particular tattoo ink color. Just wondering if your original tattoo artist may have used white tattoo ink? If so, it may contain titanium dioxide  which can be reduced to black pigmentation with the subsequent PicoSure laser treatments. This has occurred with several of our patients in the past. Thankfully, with continued PicoSure treatments, we were able to remove the tattoos. 

PicoSure effects

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It does not appear to be ghosting. It appears to be consistent with hyper pigmentation or can be a result of the laser treatments on a particular tattoo ink color. Just wondering if your original tattoo artist may have used white tattoo ink? If so, it may contain titanium dioxide  which can be reduced to black pigmentation with the subsequent PicoSure laser treatments. This has occurred with several of our patients in the past. Thankfully, with continued PicoSure treatments, we were able to remove the tattoos. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.