Excision is one of the older forms of tattoo removal that involves cutting the artwork from the skin. The invasive method is fast and works best for small tattoos. It can be removed in one outpatient session if small enough, but more excision appointments are necessary for larger tattoos. It is inexpensive (around $150 for a small tattoo) and is about 95% successful. Those with uneven diabetes or auto-immune diseases are not good candidates for the procedure.
The procedure starts with local anesthesia injected to numb the area. The section of skin with the tattoo-including the exposed (epidermis) and lower (dermis) skin-is removed with heated needles via electrocautery that closes off blood vessels near the tattoo removal area. Sutures are used to stitch up the gap edges from the tattoo removal.
For large tattoos, the specialist starts by injecting local anesthesia. They initiate the procedure by removing skin from the tattoo's middle, moving outward in bits in secondary sessions as the wound heals. A skin graft may be needed at the end, taken from elsewhere on the body to place over the exposed wound.
Excision provides immediate effects for those wanting their tattoos removed. It results in minimal blood loss due to the use of heated needles. The affected area will be tender and needs to be covered to avoid infection, as excision brings the most risks of germs. Patients can go back to normal activities soon after the procedure. Direct sunlight must be avoided before and after the procedure on the vulnerable area to prevent pigmentation. Scars fade over time. Ensure that the excision is done by a qualified specialist. Take prescribed antibiotics before and after the excision.
There are several types of laser tattoo removal to break down tattoo pigments. Modern methods involve Q-switched lasers, creating light pulses with high peak output, lower pulse duplication, higher pulse power, and longer pulse intervals. Another form laser tattoo removal includes continuous-wave lasers, which uses electromagnetic waves of constant volume and abundance for infinite periods. (Both methods can be used at the same time.) One of the first uses of lasers in tattoo removal involved an argon laser in 1979 with inadequate results.
Laser tattoo removal uses selective photothermolysis. This depends on the laser light's color being able to breach the skin to target the tattoo's pigment; the laser color being absorbed at a higher rate by the pigment than adjacent skin; the pulse (time) period of the laser to fragment the tattoo pigment without the heat affects neighboring skin; and ample energy in each laser pulse to heat the pigment particles. The lasers in tattoo removal break down the ink by passing through the skin and heating up the colored particles, breaking them into smaller bits. Because tattoo pigments have unique light absorption range, the laser needs to emit enough energy within that field to be effective. This ink is absorbed into the body-similar to natural exposure to the sun and resulting fading-and discharged through the lymphatic system.
Q-switched laser treatments average eight sessions. Post-treatment changes may include a white discoloring of the skin (heat-formed gas or steam exposure) and possible pinpoint bleeding-vascular trauma brought on by the laser's exposure to the tattoo pigment. Possible edema or erythema of nearby skin goes away after a day, and a crust on the tattoo subsides after about two weeks. Recovery also includes taking care of the wound and applying dressing to block it from air exposure. Do not use topical antibiotics, as they may bring on allergic reactions.
Side effects from Q-switched laser treatment includes changes in skin pigmentation (likely to return to normal within 12 months), hyperpigmentation (skin darkening due to increased melanin), textural changes (resolved within several months), allergic reactions, ruptured blood vessels (rare), erythema (inflammation), pruritus (itching), and even inflamed nodules, verrucous papules, enlarged bulla (vesicle), or granulomas (unique inflammation of bacteria, fungi, suture or keratin fragments) may present and aerosolized tissue. Do not expose the tattoo site to sunlight.
This older form of tattoo removal is simple in nature. The person administering the treatment shaves the area that contains the tattoo. Local anesthesia is sometimes used before the treatment for pain. The ingredients (tap water, table salt, an object covered by an abrasive material) are then applied. The salt and water are mixed together and placed on the tattooed skin. The abrasive material is rubbed on the area until it turns deep red. The treatment should take about 30-40 minutes.
Antibiotics and a gauze covering are applied for about three days, followed by salt for a few hours. The wound is given ointment and covered for three days to heal.
Dermabrasion is the removal of dead skin by abrasive means to remove tattoos via surgery. This leaves the skin red and raw. Rudimentary ways (also called microdermabrasion) include sandpaper, rocks, shells and aluminum oxide crystals. Dermabrasion includes Erbium: YAG lasers (which use infrared light), chemicals, scrubbing products, and CO2 treatments. It is non-invasive and can be done by a trained skin care expert or at home.
Before dermabrasion, the specialist will inform you of the potential complications and risks of the procedure. Photographs will be taken prior to and after treatment for comparison. Anesthesia is administered. At the procedure, anesthesia is given and the tattooes area is cleansed with antiseptic. A skin-freezing spray is then used. A rotary tool attached to an abrasive instrument removes outer epidermis layers.
Side effects from dermabrasion include dryness, irregular skin color changes, skin pigment changes, momentary bruising, scars, infection, and sensitivity to sunlight. Do not expose the wound to sunlight for 3-6 months. Recovery time varies between weeks to months. The specialist can give you medication to lessen pain. The affected skin will regain color within eight weeks. Normal activity can resume within 1-2 weeks. Do not use aspirin or ibuprofen for up to a week after the procedure. Alcohol is prohibited for two days after surgery, and smoking should be avoided.
Intense Pulsed Light Therapy (IPL)
Intense pulsed light therapy (IPL) uses light at a broad spectrum that infiltrates the skin and filters unnecessary wavelengths to treat tattoos. Those with problems with scars, keloids, skin burns or diabetes should not get IPL because of the lack of wound-healing capabilities. Consult a specialist before IPL to inspect the skin and your scars, and you will be given a patch test to gauge your skin's reaction; the test area should be watched for redness, blistering, pigment issues and rashes. You might be recommended to do certain things before your IPL treatment, including sun and particular medication avoidance-such as ibuprofen and aspirin-to lessen bleeding risk.
For the procedure, the specialist will give you a topical anesthetic. A cold gel will then be placed on the area and a glass prism is applied to channel intense light. Several treatments will follow every 3-4 weeks, all more aggressive than the first.
The skin will be pink or red after your procedure. Side effects from IPL include blistering, small bleeding, scarring, swelling and changes in pigment. You should use sunscreen with high SPF on the affected area.
There are several types of chemical peels for tattoo removal. Trichloroacetic acid (TCA) removes skin layers as deep as the tattoo pigments, applied on the skin and left for approximatel five minutes. The resulting inflammation causes it to peel, lifting the tattoo ink closer to the epidermis surface. TCA should be done in seven-week shifts, and completion is based on your skin type-with the disappearance of the tattoo marking the end of treatment.
Phenol Chemical Peel is another form of tattoo removal treatment. It is more painful due to its use of phenol seeping deeply into the skin. The treatment time is short (about 10 minutes) but it requires several weeks for recovery and new skin growth. Side effects include pigment changes in darker skin, scarring, and need for pain medication.
A Jessner chemical peel goes deeper than normal peels. It contains several chemicals-including lactic acid, resorcinol, and salicylic acid. It is good for people that have skin irregularities and effective if done properly. It takes approximately 45 minutes to administer the treatment. A positive in favor of Jessner chemical peel is a lack of downtime or surgery. You should see results within a week. Side effects include swelling, itching, infection, hyper- or hypo-pigmentation, allergic reactions, redness and pain.
Cryosurgery uses very cold temperatures to remove unwanted tissue. For tattoo removal, ice crystals form on skins with tattoo pigments, fragmenting them. It can be done with liquid nitrogen, carbon dioxide, argon or a combination of dimethyl ether and propane to freeze the skin. The epidermis peels and comes off; tattoo ink residing underneath the skin should come off as well. Several cryosurgery sessions will be necessary.
Patients may experience some pain and redness at the site, which can be dissipated by pain relief medication. Blisters go away after a few days. Small white spots may form around the area and are most likely permanent. This form of treatment is minimally invasive and comes with a lack of pain and scarring. Risks include nerve tissue damage.