Pinpoint Bleeding/scabbing Laser Tattoo Removal?

Question

I went for a laser tattoo removal consultation and was told that there wasn't going to be blistering but there would be pinpoint bleeding and that some of the ink pigment would come off in a scab. Is the scabbing normal or does it sound like I will have a lot of scarring?

Harold J. Kaplan, MD · Answer

Hi T5.  Blistering can sometimes occur in the beginning stages of tattoo removal when the patient has dense, dark ink in the tattoo.  While we try to avoid this response, in some cases it happens regardless.  

	Pinpoint bleeding is a different issue.  We do avoid pinpoint bleeding at all cost because it can lead to a higher chance of scarring.  Pinpoint bleeding is often related to a "hot spot" at the center of the laser beam and this issue may not be so much related to user error but to the type of machine.  Some tattoo removal lasers are less likely than others to cause this problem and generally newer ones have something called a "flat top" beam profile with no hot spot in the center.  

	Good luck.

Michele S. Green, MD · Answer

If the correct settings and laser are used there should not be any scaring.You would be a great candidate for the Alex Trivantage laser. This laser is the only one on the market that can target colors.  The multiple wave lengths can target all the colors in the tattoo with 4-6 sessions.  You should should contact a board certified dermatologist to be evaluated.

Michael H. Gold, MD · Answer

As noted with some of the other docs answering this question, we strongly recommend you have these kinds of procedures done in a board certified dermatologist or plastic surgeon’s office where they keep up with technology and what is right and what is wrong with certain procedures, and how to deal with complications when, and if, they occur. Blistering following a laser tattoo removal can occur, and we should be able to handle that without muchdifficulty and you should not be too concerned with this. Pinpoint bleeding – no and no – we do not want this and we know from experience that if pinpoint bleeding occurs, we are increasing the risk of scarring to the area of the tattoo. Find the right doctor and have it done correctly.

Omar Ibrahimi, MD, PhD · Answer

I would recommend you have your laser tattoo removal done in a physician office setting. Often these medical spas and other laser service practices do not have the advanced know how to treat these lesions efficiently and they often buy the cheapest possible laser to do the job. I would say that blistering is a very possible thing to expect. Scarring is also a risk of laser tattoo removal.

Jeffrey C. Poole, MD - Account Suspended · Answer

When treating a tattoo with laser, we try to avoid a fluence (energy level) that causes pinpoint bleeding, as this is often too aggressive and can result in scarring.  12-15 years ago we thought the proper treatment level was to get pinpoint bleeding, but we learned over the years that it is important, and just as effective, to stay BELOW this threshold.

	Some oozing and crusting, similar to what happened when you first got the tattoo, is expected after laser therapy, and generally starts a few days after treatment and clears by 1 week.

Pinpoint Bleeding/scabbing Laser Tattoo Removal?

Answers (5)

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