Black tribal tattoo, 13 Picosure treatments and it has stopped working, should I carry on with treatments? (Photos)

I have a tribal tattoo on my right upper arm that is 12 years old, I have had 13 Picosure treatments on it over 3 years and the last 3 treatments have seen very little effect, I have had the clinic in the UK contact Picosure to have them advise on the settings and the last treatment had a small amount of success as seen in the photos, before I would see large areas fading. Should I carry on with Picosure and what advise can you give me please?

Doctor Answers 3

13 Picosure Treatments and It Has Stopped Working

Thank you for your question. Picosure has a short pulse duration that exceeds photothermal action and results in an intense photomechanical impact. It works best on dark colors, such as blue black and purple and green. It is possible that additional treatments may improve the outcome but there is no guarantee. Picosure does have a new 1064 hand piece which does penetrate deeper and may afford better results. 


Summit Emergency Medicine Physician
5.0 out of 5 stars 24 reviews

Picosecond and nanosecond 1064nm lasers are more effective on black ink.

Black ink is treated more effectively with a 1064 picosecond or nanosecond laser such as the Prima Pico, PicoWay or Enlighten lasers, QX-Max or Revlight.  Picosure is a 755nm red light laser that is more tuned for greens and blues than black.

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.1 out of 5 stars 17 reviews

​Patience is the Key to Laser Tattoo Removal

Thanks for your question.  We have treated several black/blue ink tattoos with great success.  We utilize a PicoSure with 755nm for this color ink.  You did not mention how long you have been treating it.

We tell every Pico tattoo removal patient to expect at least 6 treatments and don't be surprised if it is 10-12 and longer for thick tribal tattoos.  We see some patients twice a year and their tattoos continue to clear up to 6 months.  After using the PicoSure for 2 years, we have found it is best to wait 2-6 months between treatments.  There is a limit to how small the laser can break up the ink.  It's up to you and your body to take the ink away.  We encourage our patients to drink plenty of water, sweat it out and eat a healthy diet between treatments.


I believe you probably had effective treatments with good laser settings.  You are trying to reverse permanent ink.  Good Luck and have patience!

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

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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.