Tattoos

What Is A Tattoo?

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.

What Is In Tattoo Ink?

In the past decade, there has been an increase in the variety of tattoo ink compositions. The list below details some of the known substances used. However, with no regulation of ink components, the exact nature of the inks used in an individual tattoo is unknown.

Red – mercury sulfide (cinnabar), ferric hydrate (sienna), cadmium
Black – carbon, iron oxide, logwood
Brown – ferric oxide
Blue – cobalt aluminate
Green – chromic oxide, lead chromate, aluminium
Yellow – cadmium sulfide, lead
Purple – manganese, aluminium
White – titanium oxide, zinc oxide, lead

How Are Tattoos Classified?

Tattoos are classified as “professional” or “amateur”.

Amateur tattoos usually consist of black carbon and lie in the more superficial layers of the skin. These tattoos are usually simple outlines and require fewer treatments to fade because they contain less pigment. Traditional tattoos such as Pacific Islander tattoos and Asian ‘Sak Yang’ tattoos are examples of amateur tattoos.
Professional tattoos range in size, design and most importantly colour. These tattoos are more densely coloured and layered, making them more difficult to remove.

How Are Tattoos Removed?

Q Switched lasers

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.

Picosecond Lasers / PicoSure

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.

Other factors influencing response to treatment include:

Amateur versus professional tattoos – professional tattoos require more treatments as the ink is placed more deeply and at a greater density than amateur tattoos.
Location – tattoos located on the extremities will require more treatments than those on the head and neck area.
Ink colour – black is the easiest colour to remove, followed by red while green can be very difficult to remove. Multiple colours will require more treatments.
Layering – an overlay of tattoos will require increased treatments.
Scar history – those with a history of scarring will usually require more treatments as laser fluences (power) tend to be lower.
Tattoo size – larger tattoos may require more treatment sessions if the entire tattoo is too large to treat in a single session.
Smokers do not respond as well to treatment as non-smokers.

What Are The Side Effects Of Laser Treatment?

Side effects are rare if the operators have adequate training and experience.

Potential complications include:

Scarring (most commonly seen on the chest, shoulders)
Blistering, infection and bleeding
Colour changes within the tattoo especially in flesh-tinted and white tattoos that contain iron-based pigments. Lasers may discolour a white tattoo so that it becomes black or brown because the iron in the pigment changes to ferrous oxide in the process.
Unwanted skin colour changes, including permanent lightening or darkening of the skin
Changes in the composition of tattoo inks – this may result in an allergic reaction
Interestingly, people who have been treated in the past with gold salts for rheumatoid arthritis may develop darkening of the skin in treated areas.

Patients are strongly advised to seek treatment from appropriately trained and equipped medical practices and experienced doctors.

FILORGA® NCTF® BOOST 135 HA

Filorga is a nutrient-rich concentrate containing 54 active ingredients. This French-made cocktail of HA, vitamins, amino acids, coenzymes, nucleic acids, and antioxidants stimulates the production of collagen, elastin and HA by fibroblasts. You may choose between 3 different injection methods: Needleless, Microneedling or Booster injection. There is minimal downtime and effects last for 6 months to a year.

Am I Suitable For This Treatment?

If you want to learn more about how to remove undesirable tattoos without the hassle associated with invasive cosmetic surgery, contact us here and schedule an appointment with our doctors today.

Feel free to send us some photos instead if you are unable to find the time for a consultation.