Laser Tattoo removal is now one of the most popular aesthetic procedures.
Laser tattoo removal works by the following process with the goal to shatter ink particles in the skin with high intense pulses of laser energy. These fragments are then absorbed into the bloodstream and passed out of the body.
Laser tattoo removal has become one of the most sought-after aesthetic treatments. We are still seeing a year-on-year rise in the demand for tattoo removal. This is more prevalent in the 20+ age group. It is estimated that 1 in 9 people have chosen to have a tattoo removed In the UK, making the demand high and increasing for a number of reasons such as:
Lasers are considered to be the gold standard to get rid of an unwanted tattoo. Other methods that can be used to remove a tattoo are:
Laser tattoo removal works by the following process with the goal to shatter ink particles in the skin with high intense pulses of laser energy. These fragments are then absorbed into the bloodstream and passed out of the body.
Stage 1 Ink targeting: During the aesthetic procedure of laser tattoo removal a laser is used to emit a high energy, short focused beam of light directly at the tattoo
Stage 2 Breaking down of ink: The key to this is to have the correct wavelength of light. The ink colour needs to absorb the laser light. This causes the particles to rapidly heat up and fragment into smaller pieces.
Stage 3 the clean-up: Once the ink has been fragmented the smaller particles are no longer large enough to stay put. The body’s immune system kicks in and the white blood cells or macrophages eat up the smaller particles.
Stage 4 elimination: The smaller particles are seen as a foreign body by the macrophages and carry the particles through the bloodstream to be eliminated from the body.
Stage 5 fading: With each laser session more and more ink particles are broken down and subsequently removed. So the tattoo fades more and more with each treatment.
It is important to remember that multiple treatments are needed to remove a tattoo as tattoo ink is at various depths within the skin and each treatment will help remove only one layer of ink.
It is also worth noting that the body’s immune system takes time to remove the fragments so time is needed between sessions.
To get rid of a tattoo successfully there are a number of factors that need to be taken into account such as:
In order to achieve successful laser tattoo removal, the laser machine is a key factor. The laser will need to be able to deliver the correct wavelength for the ink to absorb the laser light. It will also need enough power to be able to penetrate the deeper layers of the tattoo.
Laser tattoo removal machines can be broken down into 2 main categories. Active Q switch and Passive Q switch.
Active Q switch is a more complex production with the energy generated by an articulated arm. This allows a shorter pulse width, greater pulse energy and greater peak power.
Passive Q switch is generated in the handpiece itself so is substantially cheaper but not as effective.
For example, a typical active nanosecond Q switch will have a pulse width of approx. 5 to 6 nanoseconds whereas a passive Q switch will be around 25 nanoseconds.
If you have the same energy coming out of the laser it means you have around 5 times the pulse energy with the active Q switch. So 5 times the power. This makes a great deal of difference when trying to remove tattoos.
Another factor to mention with active and passive Q switch lasers is that passive Q switch lasers do not always deliver the energy in one single shot.
For example, a 1 joule system could deliver the energy in a chain of 4 smaller pulses. The tattoo only responds to the first bit of energy which can result in a passive Q switch laser not removing the tattoo. Active Q switch lasers deliver the energy in a single shot!
Also important to consider with laser tattoo removal is the wavelength of light. We mentioned earlier that the laser energy is absorbed by the ink. So if you don’t have the wavelength within the laser that the ink will absorb you are not going to get good laser tattoo removal.
Both passive and active Q switch lasers have 1064nm (ND:YAG)and 532nm (KTP).
Active Q switch can then have additional wavelengths such as:
1064nm laser:
Effective for dark colours such as:
1064nm is considered relatively safe for tattoo removal.
532nm laser:
Effective for colour removal as the 532nm is a green light so is used for:
694nm laser:
This is also referred to as a ruby laser and is effective at removal of
755nm laser:
This is also referred to as an Alexandrite laser and is effective at removing
585nm laser:
This is a yellow light and is effective in removing
650nm laser:
This is effective in removal
It is worth noting that the 585nm and 650nm are generally achieved through dye filters in laser handpieces. They are generally only a quarter of the power of the laser at best so are not always effective.
Picosecond lasers are one of the latest trends in tattoo removal with picosecond pulses instead of nanosecond pulses. The main difference between these types of lasers is the pulse duration which is the length of time the laser interacts with the target tissue.
Picosecond: One picosecond is one trillionth of a second (10^-12 seconds). Pico lasers deliver ultra-short pulses.
Due to the shorter pulse duration, picosecond lasers create a photomechanical effect. This generates a rapid pressure wave that shatters the target pigment into very small particles without significant heat generation.
Generally associated with less pain, fewer side effects, and faster healing times due to the minimal thermal impact.
Nanosecond: One nanosecond is one billionth of a second (10^-9 seconds). Nanosecond lasers deliver pulses that are thousands of times longer than picosecond lasers.
Nanosecond lasers rely on a photothermal effect. The longer pulse duration heats the target, causing it to break down. This can lead to more surrounding tissue damage.
May cause more discomfort during treatment, have a higher risk of scarring, and require more downtime for healing.
Consultation:
The aesthetic professional or clinical should take a medical history focusing on any allergies, medications and history of skin conditions.
This will involve a close look at the tattoo and looking at factors like size location, age of tattoo and colours.
Based on the assessment the clinic should discuss a treatment plan which should offer the correct laser and wavelengths of light for the tattoo as well as an estimate on the number of sessions, expected results and risks/side effects.
The practitioner should now be able to provide an estimate of cost based on the number of sessions and size of the tattoo. The cost for treatments will vary from £50 -£500 per session as mentioned the number of sessions is determined by the:
Is it a professional tattoo or a cosmetic tattoo? Cosmetic tattoos are generally black and do not have the same layers as a professional tattoo so easy to remove. An example of this would be semi-permanent makeup.
You should provide your client with a clear indication of healing times and how to minimise any complications.
The area to be cleaned and treated and they may administer a numbing gel. Laser protection eyewear should be given also to shield from the laser.
The laser will be delivered in pulses to the tattoo. This session can vary depending on the energy used and pain tolerance. Sometimes a cooling machine can be used alongside the laser to minimise pain.
This will depend on the tattoo size and complexity. In general laser tattoo removal treatments are quick as the lasers fire at a very fast rate.
Redness, swelling and tenderness are generally expected post treatment and quite often bleeding and blistering can occur.
Laser tattoo removal is generally considered to be a safe treatment if done by a qualified professional with a respected laser machine.
Compete removal will require multiple sessions spread out every 6-8 weeks. All types of tattoos can be removed from coloured tattoos to just black ones with the correct laser machine.
Cleaning and caring for the treated area is crucial for healing and minimising risk of infection
Sun exposure can interfere with healing so direct sunlight is recommended to be avoided.
Gradual fading should occur after each session until the tattoo is completely gone.
Laser tattoo removal can be done on all skin types including darker skin tones. With the advancements in laser technology, the treatments are a lot safer and more effective. It is worth noting Nd:YAG lasers are particularly effective at treating black ink and are safe on darker skin types as the longer wavelength minimises damage to the surrounding skin.
Generally, more treatment sessions will be needed on darker skin tones as the concentration of melanin is higher than in lighter skin tones.
There is however an increased risk on darker skin tones with laser tattoo removal. The risks include:
This is not an issue to have laser treatment for tattoo removal but it is worth keeping in mind.
A gentle treatment may be needed. Which means lower energy and short pulses
Cooling may be needed to reduce inflammation and soothe the skin
Sessions may need to be spaced out further to allow more healing time between treatments.
The key to all laser tattoo removal is to ensure the treatment is done with a professional, well maintained laser machine with the right technology to remove the tattoo.
