Since the 1990’s, laser tattoo removal procedures have greatly increased in popularity. The rise of laser tattoo removal specialty clinics attests to the popularity of this procedure. Even so, myths about tattoo removal still abound. This article will attempt to debunk or confirm some of these myths.
Myth #1: Laser tattoo removal works by burning off the tattoo: This may have been true of older lasers, such as CO2, that burned off the superficial layers of the skin. Newer Q-switched lasers, such as the YAG and ruby, work differently. They photothermically fracture the tattoo pigments and rely on the body’s immune system to clear them from the tattoo. Although scarring is possible if too much energy is applied by a Q-switched laser, it is not necessary or common.
Myth #2: Fading creams work better than laser: Tattoo removal fading creams are plentiful on the internet. There is no data published in scientific journals to support them, as opposed to laser processes. This author has tried one of these creams personally and found no effect on his own tattoo. Unless a harsh acid is present in a fading cream, such as glycolic acid, that burns off the skin and leaves a scar, there is no conceivable “fading cream” that would remove tattoos. Tattoos are made from a myriad of inks with different chemical compositions. It is not clear what chemical in a cream would make these chemicals “dissolve” when applied over the skin.
Myth #3: Multicolor tattoos cannot be removed: It is well known that black tattoos tend to respond better to laser removal than some other colors. Certain tattoo inks are very difficult to remove, such as yellow, pink, and white. Certain colors do not come off well with a YAG laser, such as green and blue, and are more easily removed with a ruby or alexandrite laser. Also, even a black tattoo can be very difficult or impossible to remove if it contains metal-based inks, while a red tattoo might come off very easily. However, the more ink pigments that are contained in a multicolor tattoo, the more likely it is that one of them will not come off well.
Myth #4: Cosmetic tattoos cannot be removed: This is sometimes true. Some flesh-colored cosmetic tattoos contain iron pigments. When these are treated with laser, they may convert to a different chemical form that becomes black. These iron-containing inks are also very hard, if not impossible to remove. On the other hand, if they contain pigments that are non-metallic, they are as easily removed as other tattoos. Eye-liner tattoos pose a special challenge due to the proximity to the eye and require special laser eye shields to prevent damage to the globe. Also, there is the risk of losing eyelashes, though usually not permanently, from the laser treatment. Tattoos on lips can be treated but the teeth must be protected.
There are many more myths about laser tattoo removal. These four are some of the most commonly held misconceptions.