Low-cost Options for Removing Small Tattoo?

It may be fairly easy to get a tattoo applied, but it’s safe to say, it’s much harder to get one removed, and, for that matter, much more expensive. Prior to the introduction of light-based therapies, a variety of procedures were used for getting rid of them. These included dermabrasion, salabrasion, cryotherapy, chemical peeling, surgical excision and light-based therapies.

Dermabrasion involved the use of a motor-driven wire brush to abrade the skin surface; salabrasion, the use of coarse salt crystals; cryotherapy, freezing with liquid nitrogen; and medium-depth chemical peels, tha application of caustic materials. Each of these techniques relied upon stripping away the epidermis, the topmost layer of the skin, and exposing the pigment-laden dermis. Following exposure, the ink would be extruded as part of the healing process.

Surgical excision skirted the issue of dealing directly with the embedded pigment. Instead, if the lesion were small, it was cut out entirely and the resulting wound sutured together. If it were very large or its location difficult to work with, the removal was done in stages, allowing each surgical wound to heal before proceeding to excise another part. In general, these methods were successful at obliterating the tattoo, but at least some degree of scarring was inevitable. It was a trade-off--an acceptable scar in place a highly visible and undesirable tattoo.

Lasers and other light therapy devices, such as the Infrared Coagulater (IRC), are the treatments of choice today. Lasers work by emitting short, intense pulses of light that pass through the skin and target the ink. The energy from the laser light fragments the large particles of tattoo pigment enabling the body’s natural immune system to more easily scavenge the pigment and carry it away. This process usually takes several weeks, and multiple treatment sessions are often necessary to achieve maximal clearing.

Since black pigment absorbs all wavelengths of light, it is ironically the easiest pigment to remove. Colors, such as green, do not absorb as well, and sometimes a variety of lasers, with varying wavelengths, are needed to effectively treat a multicolored tattoo.

Potential complications include permanent scarring, temporary or permanent loss of pigment or excessive pigmentation. Fees for laser treatments may range from $1000-$3000 or more, depending upon the number of treatment sessions required, and the size, shape, colors, and location of the particular tattoo.

IRC which is a low-cost, relatively inexpensive treatment, and one that I have been using succesfully for years, employs a non-laser infrared light to heat the area containing the pigment. It is quick and easy to perform, and generally requires fewer treatments than lasers. Most small tattoos can be treated successfully in one to three sessions. IRC’s efficacy also does not depend upon the particular color of the pigments involved. For these reasons, it is my favorite method for dealing with small tattoos.

The procedure is quick and simple. The area is first numbed with local anesthesia. Next, very short pulses of infrared light are directed at the tattoo in a gridlike fashion, leaving tiny spaces between each treated site. Since each burst of energy is just a fraction of second, an entire treatment session requires only a few minutes to complete. It is within the course of the next few weeks, as he wound heals, that the pigment is extruded.

To complete the removal, the intervening spaces are generally treated between two to four weeks later.  As with laser treatments, potential complications include scarring and temporary or permanent pigmentary changes. Most people, however, are quite gratified and relieved to be free finally of their tattoos.

If you don't have the financial ability to remove a tattoo with laser or surgery (the latter may create a bad scar sometimes) it is worth waiting for the future when your financial situation changes than rushing in to a cheaper treatment that can scar you badly. Cosmetic results of salabrasion (salt rubbing) and dermabrasion (diamond wheel sanding) are not very good, whereas laser removal of monotone dark tattoos can be excellent. Surgical scars can be longer than the tattoo diameter, can spread with time and can overheal and raise with more collagen formation (hypertrophic or keloid scarring).

Small tattoo's meaning dime or nickel sized are still best removed with a Q switched laser, as this leaves virtually no scarring.  Another option is surgical removal.  This is a one time step, but it does leave a well healed scar as a trade.  Dermabrasion or chemical peeling will leave more skin change than good, so I would not recommend those.  Best of luck. 

Dr D.