Laser tattoo removal no longer working. Any suggestions?

I have a tattoo that is all black ink. I am fair skinned, so I should be getting optimal results. I am healthy, do not smoke, etc. The tattoo is about 10 years old. I have had 8 treatments over 3 years. The last 2 or 3 treatments yielded minimal fading. I even switched locations to see if another place would do it better. Any idea why I might not be getting better results?

Doctor Answers 6

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. No matter the device it will take several treatments to see the outcome depending on your response and the technology. Please see a laser expert. Best, Dr. Emer

Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 158 reviews

Laser Tattoo Removal

It would be helpful to know what kind of technology is being used. Pico lasers are the most advanced. I utilize the PiQo4 laser which has 4 Pico wavelengths making it possible to remove 96% of ink in as little as 4-6 treatments. I also utilize the Picosure for a total of 5 Pico wavelengths. Tattoos are removed faster and safer with Pico lasers and there is less risk of scarring. It is important not only to seek the best technology but an experienced laser tattoo removal provider. 

Daniel J. Ritacca, MD
Chicago Oculoplastic Surgeon
4.5 out of 5 stars 18 reviews

Have Patience, Laser Tattoo Removal Takes Time

It is hard to answer your question without knowing what type of laser has been used.  There are 2 types of laser technology available.  Q-Switch or nanosecond lasers came out 15 to 20 years ago.  They use heat to burn the ink out of your skin.  Picosecond laser were introduced about 2 years ago.  They fire 1000 times faster and use a pressure wave to destroy ink particles.  The technology difference is comparable to sending a text with a flip phone vs. a smartphone.  The chances of complications are dramatically less with a picosecond laser.

We utilize a PicoSure laser from CynoSure.  Even using the latest technology and techniques, we tell our patients to expect a minimum of 6 treatments and don't be surprised if it takes 10 to 12.  We generally see patients every 6-8 weeks.  We advise our patients if they have more money than time that it's ok to wait 6 months in between treatments.  We see ink clearing for many months after each treatment.

It is not unusual for the ink to look unchanged or even darker between treatments.  This is usually caused by the ink moving closer to the surface.  It is important that you find a provider that has the best technology available and has experience using it.  An experienced laser technician will know how to adjust settings to keep the tattoo moving.

Best of luck and have patience.

Laura Riehm, MD
Fort Worth Physician
5.0 out of 5 stars 1 review

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Sessions with PicoSure

Thank you for your question. What laser treatment is being used? I would suggest you seek a certified dermatologist who is familiar with the PicoSure laser.  The PicoSure laser is the most effective laser for tattoo removal. There are many factors that determine how many sessions of the PicoSure will be effective for your tattoo removal. Sessions vary depending on how large your tattoo is, the color of the ink and how densely the ink has been placed. It can take up to 12 treatments for some patients. Please schedule a consultation with a qualified provider.

Bruce E. Katz, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 17 reviews

Laser tattoo removal

Thank you for your questions.  My recommendation would be to look for a picosecond laser, such as the Enlighten laser.  Picosecond lasers are the latest lasers for tattoo removal and are far superior to the older Q-switched laser.  The Enlighten laser specifically is best for black tattoos due to its 1064 wavelength.
Good Luck!

Sejal Shah, MD
New York Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Resistant tattoo

Part of what determines effectiveness of tattoo removal is the power of the laser being used, and there is a lot of variety there. You may also have a type of ink that is resistant. I suggest you visit the Astanza Laser website and ask their assistance (you can send them an email) in finding someone near you with the Astanza Trinity (Duality laser + Eternity Laser= the Trinity because it offers three wavelengths)- this system has the highest peak power available (more than picosecond lasers) and the Ruby laser (the Eternity) is effective on resistant black ink.Best,Lisa Vuich, MD

Lisa Vuich, MD
Nashua Physician
4.7 out of 5 stars 9 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.