Is this blackout tattoo 100% removable? (Photo)

Question

I recently got a blackout tattoo out of impulse because I was too afraid of laser tattoo removal pain. Surgical tattoo removal didn’t even cross my mind, unfortunately. It came out botched and I deeply regret my decision. The coverup is on the bottom of my wrist which the original design contained a few small lines of white ink. I’ve heard it’s impossible to remove with a laser. Could this be 100% removed with laser and microdermabrasion? I’m fine with scars and hyperpigmentation.

Jason Emer, MD · Answer

yes this can be removed over time but will need many treatments with tattoo removal. Best, Dr. Emer.

Jared Mallalieu, DO · Answer

Luckily, almost all tattoos can be removed. The number of sessions varies depending on many factors including location of the tattoo, color of the ink and the amount and depth to which the tattoo artist placed the ink. Each session is spaced 4 weeks apart. Make sure you find a doctor who has the latest technology including the PIQO4 laser.
Best,
Dr. Mallalieu

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.  Your shading will probably be gone in the first 6-12 months.  The lines will take longer to remove completely.  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 7 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.

Amy Y. Paul, DO, FAAD · Answer

Thanks for your photos, they are helpful.  I think you should try a few test spots with a q-switched 1064nm laser before committing to a series of treatments, but I feel you will have good success without scarring if you take it slow.  I would only treat either the dorsal or ventral (top of wrist or underside of wrist) each time - if you have a robust laser treatment that goes all the way around your wrist, the swelling might be very uncomfortable afterwards.  I would recommend spacing your laser appointments out at least 8 weeks apart.  If you go to a reputable dermatologist to have it removed, they will likely numb the area and use a cooling Zimmer machine or maybe nitrous oxide if it is uncomfortable during the treatment.  I'm not sure microdermabrasion would make any difference as the ink is deeper than what microderm can get to.  Sometimes we alternate between a light resurfacing laser, such as an erbium or CO2 and the 1064.  Please see an expert, and best of luck!

Is this blackout tattoo 100% removable? (Photo)

Answers (4)

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