Please recommend the best co2 laser and settings for removing eyebrow tattoos with iron oxide.

Tattoo removal is too slow due to iron oxide ink. Please recommend the best laser and settings for fractional dermal ablation. If the hair follicle is at 4mm and tattoo is in the dermis (2mm??) then how deep and what density to avoid scarring? It must ablate the tattooed tissue. Must not destroy hair follicle....

Doctor Answers 3

Tattoo removal

Thank you for your question nearlynatural. Tattoos are very common nowadays and tattoo removal has become more popular. It is important to understand that tattoos are designed to be permanent so I tell my patients to think hard about whether they really want a permanent tattoo. Given that they are designed to be permanent it is no surprise that tattoo removal can be difficult and require many treatments. Now with picosecond technology we are able to remove tattoos in fewer treatments. The type, color, and depth of tattoo removal is highly variable, and this can affect the treatment. Different wavelengths of lasers are used for different colors. However some inks are combinations of different materials which makes it difficult to remove. In these cases more treatments and/or different treatments may be required. The R20 technique is one in which the tattoo is treated with the laser four times in one session with 20 minute intervals between. Cold compresses are applied between the treatments. The R20 technique has been shown to improve tattoo removal, and fewer treatments are required. Sometimes tattoo removal treatments are combined with fractional lasers, this allows the pigment to be extruded or targeted better. Fractional resurfacing can be done with CO2, Erbium:YSGG, and Eribium:YAG. CO2 generates the most heat while Erbium:YAG generates the least heat. Heat is great for skin tightening, improving wrinkles, and reducing acne scars. For tattoo removal it is not necessary and may actually make the treatment worse. This is because tattoo removal lasers (Q-switched lasers) generate a great deal of heat on their own.
As an aside, Q-switched lasers use for tattoo removal are now also being used for facial rejuvenation and treatment of melasma.
Fractional laser treatment is not a first line treatment for tattoo removal. It is designed for other treatments as discussed above. Settings are adjusted for each person's skin type and goals. Since fractional lasers do not ablate the entire surface, hair follicles are generally not affected. Such treatments are performed on the face regularly and their is no issue with facial hair in men. I hope this helps. Good luck!


Encino Physician
5.0 out of 5 stars 1 review

Tattoo Removal -- Pico/Q Switched Laser

Tattoos should be removed with q switched or pico lasers, we will often combine with fractional lasers to help speed the process.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 166 reviews

Permanent Makeup Removal

Hi NN.  Permanent makeup removal is not typically placed at 2 mm (2000 microns).  If we are using our fractional laser, we will typically treat at 300-500 microns.  In fact, we do not know of fractional lasers that have an ablation depth of 2000 microns.

For permanent makeup removal before and after photos, see the link below.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

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.