The history of tattooing is as old as humanity. It is known on all continents and in all cultures, regardless of their development stage. Proof lies in the stone age, painted on cave walls. In the last 5 to 10 years there is an increase of the tattooing trend. Tattooing first had religious connotations but with time it adopted a completely different meaning. We express our personality and opinions with tattoos but as they change with time they often become unwanted. Another reason can be of social nature, after childbirth women are bothered with their tattoos. Until the laser was introduced there was no adequate treatment for tattoo removal, and oftentimes ugly scars would remain. Today tattoos are removed with lasers without scaring.
Tattooing is an insertion of pigment, i.e. substances which give color, under one's skin. Usually it is an intentional injection of pigment although sometimes it can be accidental (for example with explosions gun powder can get under one's skin). Usually metal salts are used although other compounds can be used as well. After injecting the pigment defensive cells in the organism literally swallow it and it stays permanently inside those cells. Immediately after tattooing the pigment penetrates deeper skin layers where it stays, and usually this is the lower part of the second skin layer. Some of the pigment gets transferred into lymphatic nodes and throughout the body by blood. We can say that tattoos last a lifetime. With old tattoos there is a degradation of pigment and it can fade a bit. Only colors red and yellow mostly disappear after 20 years.
Until lasers were put into use various methods were used but with poor results and numerous consequences. Most often big ugly scars would appear along with infections and loss of pigment in the tattoo area.
1. SALABRASION – The oldest method used in ancient Greece. Crystals of salt were used to peel the skin until it started to bleed. After that salt is applied to the wound in order to pull out the pigment with osmosis. This method gives fairly good results but there is no reason to discuss how painful and uncomfortable it is since salt is kept on an open wound.
2. ABRASION – Various crystals and diamonds are used at great rotating speed to peel of layers of skin. Pain and discomfort is followed by big scars and deformities and the tattoo is not removed completely. After that the wound takes weeks to heal with swelling.
3. SURGERY – Can be used only for small tattoos. Oftentimes big scars are left behind because they are almost always in areas of enhanced skin tension where it is difficult for the skin to heal.
4. PEELING – Various chemicals are used to mechanically or through an inflammation remove the pigment. Even after a large number of painful and uncomfortable treatments the results are poor. There is a high possibility of poisoning while your tattoo will remain.
5. LASERS -Various lasers were used such as erbium, Co2, aragon. The principle was to mechanically destroy the tattoo with catastrophic consequences. For the tattoo to be removed successfully and without consequences the laser should have a really short impulse and Q-Switch lasers are used for that purpose. These lasers target the pigment, unlike the first lasers which would destroy the pigment and the surrounding skin leaving scars. IPL devices are not recommended for tattoo removal.
6. OTHER – There are various methods which mechanically destroy tattoos followed by catastrophic results because of big scaring. Liquid nitrogen, injection of chemicals, water under pressure, heat were used in that purpose.
Q switch lasers function on the same principles as other lasers. Chromophores, i.e. colored matter in this case tattoo pigment absorb the laser beam of a certain length. Lasers function in a specific manner because each laser wave length destroys a pigment of a certain color i.e. similar color. For each color a laser of a different wave length is needed. By absorbing the laser beam a temperature of 1200ºC is created which then destroys the pigment. The broken pigment is gradually removed by the defensive cells and 30 days after the treatment initial results can be seen and they improve with time. Q switch lasers differ from others because they have an extremely short period of laser pulse and great power. The duration of the laser impulse is measured in nano and picoseconds, while with other lasers it is measured in milliseconds which is 6-9 times longer.
The price depends on the: tattoo surface, number of colors, thickness of the tattoo, laser type, the removal method, number of laser strokes i.e. number of laser impulses. The price can be determined only after seeing the tattoo. The first treatment is the most expensive one and the price is lower for each next treatment until a certain point. If you are in a hurry to remove your tattoo, the number of laser impulses or strokes across your tattoo is bigger as is the price of your first treatment, but it takes less time to remove your tattoo and because of a fewer number of treatments you are in fact saving money. If you are not in a hurry, the price of the first treatment is lower but the removal will take more time with a higher number of treatments. So when asking for an offer mention if you would like the tattoo to be removed quickly or not.
Because tattoos have unpredictable reactions we cannot predict this, so we are giving average figures which can then vary in your case. The higher the number of laser strokes i.e. impulses the lesser number of treatments you will need. In that case light tattoos would need about 3 to 5 treatments, thicker ones 5 to 8 treatments and multicolored ones 7-10 treatments. If 1 laser stroke is done then the number of needed treatments is about 30 to 50 % higher then the stated. Certain colors (yellow and green) need more treatments. It is possible that only a part of your tattoo will disappear in a smaller number of treatments, while other parts (for example the multicolored ones) will need a higher number of treatments with a minimal price.
For light tattoos 6 to 8 treatments are needed, while for dark ones 12 to 16, for multicolored ones 15 to 20 treatments. When you sum up the numbers and calculate that the interval between treatments is 45 days then tattoo removal in other medical institutions can take up to a several years.
It is not possible to remove a tattoo 100%, but usually it is removed almost entirely and cannot be seen. Certain supplements and impurities in the pigment make a 100% removal difficult. Contours can be left after a yellow color is removed, after multicolored or repaired tattoos and this can be removed by a fractional laser later.
No special preparation is needed before the treatment. After a detailed conversation and explanation of all the details regarding the treatment we will take photographs of your tattoo. Then the treatment begins. You will keep the area under ice for 10 to 30 minutes after the treatment and then go home.
A treatment can be done every 45-60 days. Some authors state that 30 days is enough which I recommend only in extreme necessity.
Certain colors are harder to remove, especially yellow and sometimes green. Multicolored and repaired tattoos blind the laser which then has a difficulty distinguishing colors and gives weaker results.
Before we do a fractional Q switch laser treatment we make microscopic damages under your skin and in that way brake down the pigment. In that way we are maximally decreasing the possibility of complications. The initial treatment is crucial and should be done with care to avoid complications. After that we go through the tattoo with the mentioned laser. With R20 rules we go over the same area multiple times. In the end, if needed, we make microscopic damages with a fractional laser to speed up and make the ejecting of pigment easier.
There is no danger of scars, that is why the first treatment is done with lesser power while we amp up the power with every next treatment. With thicker tattoos there can be residual pigmentation. Development of allergies, loss of skin color or an infection are a rarity.
The treatment is painless and no discomfort is felt. The initial treatment can be somewhat uncomfortable if you have a thicker tattoo. Certain areas such as wrists, ankles, ribs and the tail-bone can be more sensitive. On our part, if needed, we do everything to reduce your pain and uneasiness by adjusting the laser and by cooling the skin. Tattoo removal hurts less than tattooing.
You should treat the tattoo area with an antibiotic cream for 5 to 7 days. Avoid water and sweat for several days. It is advised to use a bandage or a gauze to protect the treated area.
From Q switch lasers we use Harmony XL (Alma lasers) and QX MAX laser (Fotona). From fractional lasers we use the so called ablative and non-ablative lasers. We especially mention the Q-switch fractional non-ablative laser which is extremely efficient in tattoo removal.