Laser tattoo removal not working! (photo)

Question

This is my 9th session over the close of 50 something weeks. I feel I am making no progress. The tattoo is not fading and is still clearly there. I'm thinking about giving up !!! Help !

Anil R. Shah, MD · Answer

Greetings, the only safe and effective practice to remove tattoos is to see an expert with the latest technology laser.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.

Jason Emer, MD · Answer

There is an alternative treatment called the Eclipse Micropen TR that can treat all colors. It will take a series of treatments, but you may get better results. I suggest a formal consultation with a tattoo removal expert. Best, Dr. Emer.

Hardik Soni, MD · Answer

You did not mention what laser has been used. To successfully remove this tattoo, different wavelengths need to be used, such as 1064nm for black ink, and 755nm for blue ink. I would suggest you to seek an experienced provider with Pico lasers that deliver results in fewer number of treatments and minimize side effects and complications. Good luck!

Mark Taylor, MD · Answer

The blue ink in this tattoo my need treatment with a 755nm red light laser such as the Picosure or a Q-Switched alexandrite laser or the 694nm red-light ruby laser.  Some of the black ink may be very deep.  This ink can be removed better with FracTat a process where a fractional erbium laser (e.g. SP Dynamis) is used to make deep holes in the tattoo before treatment with a 1064nm Pico or Nanosecond tattoo removal laser.  Black ink will usually respond better to 1064nm laser such as the PicoPrima, PicoWay or Enlighten Lasers or a Q-Switched 1064nm laser.  The FracTat (Fotona Sp Dynamis fractional erbium laser and Qx-Max Laser, a  2 nanosecond 1064nm Q-Swtiched laser) method can be added to any of these lasers.

Laura Riehm, MD · Answer

Thanks for your question.  You did not mention what kind of laser you have been using.Q-Switch or nanosecond lasers came out about 20 years ago.  Picosecond laser came out about 3 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 lasers (like the Enlighten, PicoWay & PicoSure) fire 1000 times faster, using a pressure wave rather than heat to shear the ink molecules apart.  After using the PicoSure for almost 2 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 6 to 8 weeks initially.  If they have more time than money, we encourage them to come every 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.

Steven F. Weiner, MD · Answer

I think it is time to try a different laser/provider. You should have made more progress. At least the black should be significantly better than is. Success is dependent on the laser and the settings.

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