New tattoo removal, haven't seen much changes after 3 sessions. (photos)

Question

I made the decision to remove a tattoo I got in may or this year. I started the removal process late august and just had my third session a few weeks ago. I haven't seen a lot of changes and I was wondering that is normal. I've spent a lot of money thus far and if I could find something better and more effective elsewhere I would definitely do so.

Adaeze Okeke, MD · Answer

Thanks for posting these great pictures. I can see some fading, especially the shading at the bottom of the trees. I'm not sure what your provider told you, but tattoo removal takes time and you'll need a series of treatments. I would estimate at least 8 sessions for this tattoo. The good news is that it is black and located on your torso. Black ink is the easiest color to remove and the ink will clear faster as it's located closer to your heart.

Other considerations are the laser your provider is using. If it is a nanosecond laser make sure they are using the 1064 wavelength. If they are using a picosecond laser, there may be difficulty clearing out some of the darker lines. Many clinics also provide a guarantee. Meaning that after you've paid for a number of treatments they will continue the removal process free of charge. Don't be afraid to advocate for yourself and address all your concerns at your clinic. Good luck!

Jeffrey Gosin, MD, FACS · Answer

It always takes multiple treatments to remove tattoos.  However, I would have expected to see a bit more movement in your tattoo after 3 treatments.  With a tattoo like yours, I would recommend a 1064nm laser.  That is most effective for dark ink.  A combination of pico and nano laser should be most effective.  The Enlighten laser (Cutera) would be an excellent choice for that tattoo.  I recommend that you inquire as to what type of laser is being used on your tattoo.  My other suggestion is to wait a bit longer between treatments.  Three treatments between the end of August and early December is a more than I generally recommend.  Usually 8-12 weeks between treatments yields good results and is also cost effective.  With that spacing, you would have only paid for 2 treatments instead of 3 up to this point.

Jason Emer, MD · Answer

Newer tattoos can take longer to remove. However, laser tattoo removal always takes a series of treatments for complete removal. I recommend getting a formal evaluation with a laser tattoo removal expert. Best, Dr. Emer

Monika Soni, MD · Answer

Thank you for your question and photographs. It’s good that you ask your technician about the laser that was used for the removal. Picosure laser works faster and removes the ink better than Q-Switch lasers. In my office, I like to use Picosure laser which has a short pulse duration that exceeds photothermal action and results in an intense photomechanical impact. It works best on darker inks such as black and blue and on all types of skin. The number of sessions required to remove a tattoo can range from 6-10 sessions. I recommend you consult an expert in laser tattoo removal to determine the best treatment plan for you. All the best!

Hardik Soni, MD · Answer

Thank you for your question and photographs. It’s good that you ask your technician about the laser that was used for the removal. Picosure laser works faster and removes the ink better than Q-Switch lasers. In my office, I like to use Picosure laser which has a short pulse duration that exceeds photothermal action and results in an intense photomechanical impact. It works best on darker inks such as black and blue and on all types of skin. The number of sessions required to remove a tattoo can range from 6-10 sessions. I recommend you consult an expert in laser tattoo removal to determine the best treatment plan for you. All the best!

Steven F. Weiner, MD · Answer

It should have more change than you are seeing. Either the wrong wavelength is being used, not enough power is used, or the wrong laser. I would treat this with a 1064 laser that has both nano and picosecond capabilities. The Piqo4 laser is perfect for this because it is very high power with large spot sizes to give the safest and most effective treatment of this. Also, for the resistant inks, the pico pulse duration can help eradicate it.

Susan Fox, DO, RPVI · Answer

I would ask your tattoo removal professional are they using nano or pico technology. Pico is much faster and clears the ink better than the old Q switch lasers. I would recommend the Picoway 1064 for dark/ black ink. That being said it takes longer the newer the tattoo is.  Since yours was a recently placed tattoo it will usually take longer to remove.  The tattoo looks lighter but will take several sessions to fade completely

Daniel J. Ritacca, MD · Answer

Thank you for your question. I am curious to know what type of technology was used. Pico lasers are the most advanced. I utilize the PiQo4 laser which has 4 Pico wavelengths including the 1064 wavelength ideal for black pigment. The amount of treatments can vary based on several factors such as the location of your tattoo, your skin tone, how sharp the ink is, and how quickly your body eliminates the ink. Even with advanced lasers and multiple wavelengths complete removal is not always possible. I believe that tattoos are removed faster and safer with Pico lasers and there is less risk of scarring. I think it is important not only to seek the best technology but an experienced laser tattoo removal provider.

Richard Ort, MD · Answer

Q-switched YAG laser is my treatment of choice for a black tattoo.  It does take a number of sessions for best results.  We have been treating tattoos for over a decade in the Denver area.  By the way, the after picture looks lighter than the before picture so there has likely been some improvement.Regards,Dr. Ort

Laura Riehm, MD · Answer

Thanks for your question and posting pictures.  Your tattoo does appear lighter in the second picture.  You did not mention what kind of laser treatment you had.  We have treated several multi-color ink tattoos with great success.  We utilize a PicoSure with 755nm & 532nm.  Patience is the key to any laser tattoo removal plan.  We tell every Pico tattoo removal patient to expect at least 6 treatments and don't be surprised if it is 10-12 or more with thick tribal tattoos.  We see some patients twice a year and their tattoos seem to clear up to 6 months.  After using the PicoSure for 2 years, we have found it is best to wait 2-6 months between treatments.  There is a limit to how small the laser can break up the ink.  It's up to you and your body to take the ink away.  We encourage our patients to drink plenty of water, sweat it out and eat a healthy diet between treatments.We recommend finding an experienced physician in your area.  Treatment prices vary by market.  You are trying to reverse permanent ink.  Good Luck and have patience!

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