A tattoo is created by injecting tiny pigment granules into the skin, each smaller than a human cell. Normally, our immune system’s white blood cells help remove foreign substances and cellular debris from our body. However, tattoo granules are too large to be eliminated so they remain in the skin permanently. Only specialised lasers can break down the pigment and gradually fade the tattoo.
These were introduced in the early 90s and were commonly used for scarless tattoo removal. These lasers deliver short-duration pulses of light energy in a nanosecond and shatter ink particles into fine dust via photo-acoustic principles. The white blood cells can then effectively ingest and remove the finer material via the lymphatic system. Wavelengths of laser light are selected according to the colour of the tattoo ink.
While Q-Switched lasers are able to achieve scarless removal of tattoos, multiple treatment sessions are required. Lightly inked tattoos such as self-applied lettering with India ink may disappear with less than 5 treatments. However, densely inked professional tattoos take much longer to clear. A recent study demonstrated that even after 15 Q-Switched laser treatments, only 75% of tattoos had fully cleared.
While green and blue inks have traditionally been much slower to clear, the development of lasers able to produce pulses in the picosecond has sped up the process of removal. Multiple treatment sessions are needed with a 2- to 4-month interval. Heavily-inked professional tattoos can take more than 15 treatments to clear.
Side effects are rare if the operators have adequate training and experience.
Potential complications include: