Tattoos consist of thousands of particles of tattoo pigment suspended in the skin. While normal human growth and healing processes will remove small foreign particles from the skin, tattoo pigment particles are permanent because they are too big to be removed. Laser treatment causes tattoo pigment particles to heat up and fragment into smaller pieces. These smaller pieces are then removed by normal body processes.Several colors of laser light (measured as wavelengths of laser energy) are used for tattoo removal, from visible light to near-infrared radiation. Different lasers are better for different tattoo colors. Consequently, multi-color tattoo removal almost always requires the use of two or more laser wavelengths. Tattoo removal lasers are usually identified by the lasing medium used to create the wavelength (measured in nanometers (nm)):

• Q-switched Frequency-doubled Nd:YAG: 532 nm. This laser creates a green light which is highly absorbed by red and orange targets. Useful primarily for red and orange tattoo pigments, this wavelength is also highly absorbed by melanin (the chemical which gives skin color or tan) which makes the laser wavelength effective for age spot or sun spot removal.
• Q-switched Nd:YAG: 1064 nm. This laser creates a near-infrared light (invisible to humans) which is poorly absorbed by melanin, making this the only laser suitable for darker skin. This laser wavelength is also absorbed by all dark tattoo pigments and is the safest wavelength to use on the tissue due to the low melanin absorption and low hemoglobin absorption. This is the wavelength of choice for tattoo removal in darker skin types.

Laser tattoo removal requires numerous treatment sessions, typically spaced at least 21 days apart.

Although many tattoos can be completely removed, there are over 100 types of tattoo inks used today.
Professional tattoos, on average, require 8 – 15 or more treatments, while amateur tattoos require 5 or more sessions due to the different composition of inks. Fading should be visible within 3 weeks. Complete removal can never be guaranteed.

At each session, some of the tattoo pigment particles are effectively fragmented, and the body removes the smallest fragments over the course of several weeks. The result is that the tattoo is lightened over time. Remaining large particles of tattoo pigment are then targeted at subsequent treatment sessions, causing further lightening.
The number of sessions and spacing between treatments depends on various parameters, including the area of the body treated and skin color. Tattoos located on the extremities, such as the ankle, generally take longest. As your tattoo fades, your Therapist may recommend that you wait up to a few months between treatments to facilitate ink resolution and minimize unwanted side effects.

The amount of time required for the removal of a tattoo and the success of the removal varies with each individual.

At Laser Lipo House, we use the predictive “Kirby-Desai Scale”, to assess the potential success and number of treatments necessary for laser tattoo removal.

The following parameters are taken into consideration:

• Skin type and colour,
• Location of tattoo,
• Colours used,
• Amount of ink used,
• Scarring or tissue change,
• Number of layersing, and
• The unmeasurable factor of the Client’s own immune system.

Parameter scores are then added to yield a combined score that will show the estimated number of treatments needed for successful tattoo removal.

Laser tattoo removal can be uncomfortable but is tolerable, and in most cases not as painful as getting the tattoo was. The pain can be described to be similar to that a “slap” from an elastic band. Depending on the Client’s pain threshold, some clients may require some form of local anesthesia, which must be applied to the area at least 60 minutes before the time.

You Tube video clip: http://www.youtube.com/watch?v=sSN449L4fp8

Before treatment:

Please book a free initial consultation. Your general health and treatment details will be discussed.

• Do not expose skin to direct sunlight, sunbed or self-tan lotion for at least 4 weeks before and/or after treatments.
• Do not use bleaching creams for 5 days before treatment.
• Do not apply perfume, deodorants, sunblock, essential oils or any other skin lotions to the treatment area on the day of treatment.
• Avoid swimming in chlorinated water on the day of treatment.
• Avoid microdermabrasion, exfoliating or peels on treatment area for 1 week before treatment.

During treatment:

• Hair may be shaved off any hairy areas that are to be treated.
• Eye protection is provided.
• The laser is applied to the affected area. Quick flashes of bright light may be seen during treatment.
• There can be a slight stinging sensation during treatment but this quickly fades once the treatment has finished.
• A dressing and Aloe Vera gel will be applied to the tattoo after treatment.
• Each treatment session is 30 minutes long.

After treatment:

Immediately after laser treatment, a slightly elevated, white discoloration with or without the presence of punctuate bleeding is often observed. This white color change is as a result of rapid, heat-formed steam or gas, causing dermal and epidermal vacuolization.

Pinpoint bleeding represents vascular injury from photoacoustic waves created by the laser’s interaction with tattoo pigment. Minimal edema (swelling) and erythema (redness) of adjacent normal skin usually resolve within 24 hours.

Within the first 12-24 hours a freckle-like scab will form over the entire tattoo, which sloughs off at approximately 14 days post-treatment. Some tattoo pigment may be found within this crust.

The treated area should not be exposed to:

• Intense heat eg. Waxing, Direct sunlight, Sunbed, etc;
• Chemicals eg. Self tan lotion, Household chemicals, Hair removal cream, etc.;
• Alcohol eg. Hand sanitiser, Perfume, Deodorant, etc.

Although laser treatment is well known and often used to remove tattoos, unwanted side effects of laser tattoo removal include:

• If a blister or crust forms following treatment, it is imperative that the patient does not manipulate this secondary skin change. Early removal of a blister of crust increases the chances of developing a scar. Clients with a history of hypertrophic or keloidal scarring need to be warned of their increased risk of scarring.
• Very rarely, burns may result in scarring but this usually only occurs when Clients don’t care for the treated area properly.
• “Paradoxical darkening” of a tattoo may occur, when a treated tattoo becomes darker instead of lighter. This seems to occur more often with flesh tones, pink, and cosmetic make-up tattoos.
• “Paradoxical darkening” of a tattoo may occur, when a treated tattoo becomes darker instead of lighter. This seems to occur more often with flesh tones, pink, and cosmetic make-up tattoos.
• Please inform the Therapist if you have any allergies.
• An allergic reaction to tattoo pigments after Q-switched laser treatment is possible. Rarely, when yellow cadmium sulfide is used to “brighten” the red or yellow portion of a tattoo, a photoallergic reaction may occur. The reaction is also common with red ink, which may contain cinnabar (mercuric sulphide). Erythema, pruritus, and even inflamed nodules, verrucose papules, or granulomas may present. The reaction will be confined to the site of the red/yellow ink. Treatment consists of strict sunlight avoidance, sunscreen, interlesional steroid injections, or in some cases, surgical removal. Unlike the destructive modalities described, Q-switched lasers mobilize the ink and may generate a systemic allergic response. Oral antihistamines and anti-inflammatory steroids have been used to treat allergic reactions to tattoo ink.
• Studies of various tattoo pigments have shown that a number of pigments (most containing iron oxide or titanium dioxide) change color when irradiated with Q-switched laser energy. Some tattoo colors including flesh tones, light red, white, peach and light brown containing pigments as well as some green and blue tattoo pigments, changed to black when irradiated with Q-switched laser pulses. The resulting gray-black color may require more treatments to remove. If tattoo darkening does occur, after 8 weeks the newly darkened tattoo can be treated as if it were black pigment.
• Tanned skin whether obtained by the sun or the use of sun beds should be avoided. The tattoo cannot be removed if the skin is tanned.
• Do not apply fake tan. If fake tan has been applied recently , wait until it has disappeared before you have your tattoo removed, or scrub it off the tattoo and the area around the tattoo before the tattoo removal treatment.
• Pregnant women cannot be treated! Therefore please inform your Therapist if you are pregnant or are planning a pregnancy.
• Treatment cannot be done if you have had any gold medications/injections, suffer from lupus disease (incurable immune system illness), or have used St Johns Wort or Roaccutane over the past 6 months.
• Treatment is not done if the area is experiencing problems like dermatitis, psoriasis, abrasions, pimples etc.
• Since the application of laser light is sterile there is no need for topical antibiotics. Moreover, topical antibiotic ointments can cause allergic reactions and should be avoided.

Taking care of your wound

Be gentle with the treated area until it has settled down so as to minimise the risk of scars.

There may be swelling of treated skin for a few days. Skin around the eyes is particularly prone to swelling which may lead to partial closure of the eye for a few days after treatment.

• To help reduce swelling, apply an ice pack for two to three minutes every quarter of an hour on the day of treatment and use extra pillows under your head when sleeping to help reduce swelling from areas treated on the face.
• Wash twice a day with mild soap and water. Anti-bacterial soap can cause irritation and inflammation.
• Avoid shaving in and around the lesion until any bruising has faded.
• Pat with a paper towel to dry, don’t rub. Rubbing can cause the scabs to come off too early, causing your body to form a new scab. The healing process just became longer.
• Apply the Aloe Vera gel twice a day. This will increase the speed of healing and reduce scarring.
• Avoid using any makeup on the lesion for five days after the treatment, as applying or removing it may damage the skin, which is very fragile during this time.

Pain Management

Before treatment:

• Standard painkillers such as paracetamol can be taken 30 minutes before treatment.
• The area can be covered with EMLA anaesthetic cream which you can buy from the chemist, an hour prior to laser treatment. Apply over the tattoo and cover with gladwrap.
• To mitigate pain the preferred method is simply to cool the area during treatment with an icepack which numbs the topical layer of the skin.

After treatment:

• Standard painkillers such as paracetamol can be used. Avoid taking any medicines containing aspirin for pain relief for five days after the laser treatment, as it increases the risk of bruising and may break down any clots that are necessary to ensure a good result. If however you are prescribed aspirin by your doctor, please continue with this as normal.

Tips to reduce scarring before your tattoo removal treatment

Q: How often can I have treatments?
A: The amount of time required for the removal of a tattoo and the success of the removal varies with each individual. The body removes the small fragments over the course of several weeks. Treatment intervals must however be at least 21 days.

Q: How much does it cost?
A: Treatments are charged at R500 per 30 minute session. The size of the area treatable in 30 minutes is 10cm².

Q: How many treatments would I need?
A: Professional tattoos, on average, require 8 – 15 or more treatments, while amateur tattoos require 5 or more sessions due to the different composition of inks. The following factors influence the number of treatments required: Skin type, Location of the tattoo, Colour, Amount of ink used, Scarring or tissue change, the number of Layers as well as the Client’s own immune system. Tattoo lightening may continue for several months after the last treatment session.