Laser Tattoo Removal

Quick Facts

• Laser tattoo removal with q-switched lasers are currently the most effective means of removing or fading tattoos with the lowest chance of scarring in comparison to other methods.
• Q-switched lasers emit extremely high energy, short pulses of light that shatter tattoo ink particles to allow them to be removed by the body's immune system
• Laser can be used to completely remove a tattoo or fade it for future modification or correction.
• Usually 10 to 20  sessions are required to completely remove a professional tattoo. Fewer sessions are required for amateur tattoos or to just fade a tattoo rather than remove it. There are various factors that determine how many sessions a tattoo will take to remove.
• Cosmetic tattooing of the eyeline, eyebrows, or lips can also be removed.
  
• Anaesthetic creams/injections are used to numb the skin prior to laser treatment
• Different laser wavelengths are required to remove different tattoo colours.
• At The Victorian Cosmetic Institute, we have two lasers,  the Medlite laser and the Sinon Ruby laser that are used for tattoo removal. Green pigment is best removed with the Sinon Ruby laser.
• Between these two lasers, any colour tattoo can be treated
• All treatments are performed by doctors
• The price per session begins at $350 inc GST

How can tattoos be removed?

Tattoos are a popular method of body art, and there are an estimated 20-30 million tattooed individuals in the world. Approximately 50% of those who get tattoos regret all or part of their tattoos and want to have them removed completely, or faded enough to allow for re-tattooing of a new design over the old tattoo. 

In the last decade, tattoo removal has been revolutionised by q-switched lasers. Q-switched lasers emit wavelengths of light that are much more highly attracted to the tattoo ink in skin than the surrounding (normal) skin. This high affinity towards tattoo inks means that they are able to remove or fade tattoos with minimal effect on the surrounding skin.

Q-switched lasers work by emitting very short-lived, high energy wavelengths of light that break up the tattoo ink into smaller particles that the body can digest and remove. Their extremely short-lived pulses (around a few billionths of a second) mean that there is minimal heat energy transferred  to the skin and this minimises damage to the skin. Although q-switched laser treatments require several sessions to successfully remove or fade a tattoo, they have the greatest chance of returning your skin to its previous state in comparison to the other methods of tattoo removal. Q-swtiched lasers allow for complete removal of the tattoo, or just to fade it so the area can be tattooed over

At The Victorian Cosmetic Institute, we have two different q-switched lasers, the Medlite laser and the Sinon Ruby laser, producing a total of three different wavelengths. Each different wavelength is preferentially attracted to different tattoo colours. With three wavelengths to choose from, this maximises the chance of removal for all tattoo colours on all skin types.

Video: A demonstration of laser tattoo removal by Dr. Gavin Chan

What is a q-switched laser?

Q-switched lasers such as the Medlite Nd:YAG laser and the Sinon Ruby laser are suited to tattoo removal due to their extremely short pulse duration and high power. This property allows q-switch lasers to literally shatter and disrupt the tattoo pigment allowing the immune system to eliminate them from the body. Ordinarily, the pigment particles within the tattoo are too large for the body's immune system to remove. By shattering them into smaller particles with laser, the body is able to remove them.

The Medlite Laser produces two different wavelengths that allows it to successfully treat different tattoo pigments on different skin types. Each wavelength is attracted to a different range of colours. For example, the 532nm wavelength is attracted to red, yellow and orange, whilst the 1064nm is attracted to all other colours except for green.

The Sinon Ruby laser is attracted in particular to green, black and dark blue pigments. The ruby laser is really the only laser that can properly treat green pigment.

White tattoos and skin coloured tattoos are hard to remove as they tend to reflect the laser light. Furthermore, these tattoos tend to oxidise and turn black initially, and then lighten with subsequent treatments.

Figure: This diagram illustrates the relative absorption of the various laser wavelengths used

The Medlite laser's 532nm wavelength is attracted to red, orange and purple in particular.

The Medlite's 1064nm is used for black and can also treat most colours except green/red.

The Sinon Ruby laser's 694nm is attracted to green, black and blue pigment in particular.

What type of tattoos can be treated?

Traumatic tattoos, or those caused by dirt or debris being embedded in the skin, e.g after motorbike accidents, can also be removed in the same manner as conventional tattoos.

What about cosmetic eyebrow, eyeliner, and lip tattoos?

Cosmetic tattoos or 'permanent make-up' can be removed with laser treatment. Tattooed eyebrows, eyeliner, and lip liner can be removed or faded.

When working around the eye area, particular care is taken by our doctors to ensure that there is no eye damage, and you may be required to wear eye shields that sit on the cornea for the removal of permanent eyeliner tattoos. The laser used to remove these pigments can also remove hair (but only temporarily) and this can be a problem when removing eyeliner, and eyebrow tattoos.

Furthermore, with cosmetic tattoos, it is possible for a shift in colour to occur e.g a pink lip liner tattoo may become dark green or black. Although, this darker colour can still be treated with laser, it may not appear aesthetically pleasing during the period of removal. Therefore, test patching on a small area may usually be required first on some tattoos. An alternative form of tattoo removal using the Erbium laser can be performed as a first line treatment if a colour shift is suspected. The Erbium laser works on the principle of vapourising a fine layer of skin with the tattoo in it.

Can tattoo removal be performed on any skin type?

Tattoos can be removed from all skin types, but the darker the skin, the less contrast there is between the colour of the skin and the tattoo, which makes it more difficult to remove without affecting the normal skin.

How many treatments will I need?

Generally several treatments are required for tattoo removal. Multi-coloured and professional tattoos are generally harder to remove than single coloured or amateur tattoos and require more treatments. For complete removal professional tattoos usually require more than 10 treatments (usually 10 to 20), and amateur tattoos more than 4 as a rule. To fade a tattoo (e.g for tattooing over with a new design), fewer sessions are required.

Factors that determine how many sessions will be required include;

• The skin type - the darker the skin type, the more sessions will be required. Because the skin's melanin and the tattoo ink are competing targets for the laser, the darker the skin, the more the laser will be attracted to the normal skin. Therefore, to prevent complications, usually lower setting will need to be used on the laser and more sessions will be required the darker the skin.
• Location of the tattoo - as tattoo ink is broken down by laser and taken away by the body's lymphatic and immune systems. Blood supply and lymphatic drainage vary with various body areas, with the greatest supply being the head/neck and trunk, and the least to the extremities. Therefore tattoos that are situated in areas of high blood supply and lymphatic drainage require fewer treatments to remove. 
• Colour - the colour of the tattoo is determined by the type of ink used and the constituents of the ink. Black tends to be the most readily removed, with yellow, green, and multiple coloured tattoos being the hardest tattoos to remove.
• Amount of ink - the amount of ink present in a tattoo will also determine how many sessions. Tattoos with minimal ink or outlines only tend to be easier to remove and require fewer sessions than heavily inked and solid tattoos.
• Scarring - tattooing the skin can often lead to complications such as scarring and other changes in the tissue that make the tattoo more difficult to remove by laser. For tattoos that have caused these problems, more sessions may be required to remove the tattoos.
• Layered tattoos - Tattoos that have been tattooed over with another tattoo tend to be more difficult to remove due to the added ink of the subsequent tattoo.

The above information was proposed in the Kirby-Desai scale, named after two dermatologist who retrospectively studied 100 patients to see if they could estimate the number of sessions required depending on various factors.

Overall, it is difficult to predict exactly the number of sessions required to remove or fade your tattoo.  

Treatments are generally performed at a minimum of 6 to 8 weeks apart. This allows the body time to remove the tattoo pigment particles that have been broken down by the laser. The interval can be extended to allow the body more time to remove the tattoo pigment particles, but not reduced as this can increase the chance of scarring. The practitioner and patient need to be aware of the fact that a compromise must be struck between using excessively high laser energy levels, reducing the number of sessions, and increasing the risk of complications, and using lower laser energy levels and subsequently increasing the number of sessions required.

Will the tattoo be completely gone?

100% removal of the tattoo pigment is not always possible, but in most cases is achievable. Amateur tattoos require fewer treatments for resolution than professional tattoos. With professional tattoos, even after 10 treatments, approximately 50% of professional tattoos will only have faded by 50%.

Patience is required, as sometimes significant fading does not occur until several sessions have been undertaken.

What is involved in laser tattoo removal? Will it hurt?

Firstly, a consultation is required with one of our doctors. They will discuss with you the pros and cons of laser tattoo removal. Should you decide to go ahead, you will be given some topical anaesthetic cream. Most of the time this can be applied by yourself at home. Glad wrap is used to cover the area to be treated after application of the anaesthetic cream. In most cases, anaesthetic injections are given over the area to be treated. Because these are given after the anaesthetic cream, the injections are not painful. When topical anaesthesia (cream) and local anaesthetic injections are used, the procedure is virtually painless.  We also have nitrous oxide or 'laughing gas' as an option for those who want further analgesia for the procedure.

Laser tattoo removal without the above anaesthesia is extremely painful.

Once the area to be treated has been anaesthetised properly, the laser can then be fired over the tattoo without discomfort.

What will my skin look like after treatment?

The tattoo may appear slightly raised and frosted (white) in appearance immediately after the laser treatment.  There may be surrounding skin redness, and there may be some pinpoint bleeding. An antibiotic cream will be applied along with a non-stick dressing after the treatment. This should be worn for 24 hours and the area kept dry. You should not pick at any scabs formed by the treatment, and keep the treated area out of direct sunlight and apply sunscreen if exposed to sunlight.

It usually takes 1 to 3 weeks to heal (on average, but sometimes more) after laser tattoo removal, and the treated skin may appear like a wound/scab during this time. We advise that you keep the dressing applied post tattoo removal on for 1 to 2 days, and then apply Bepanthen ointment on the tattoo regularly until the scabs fall off.

Will I scar?

As with any laser treatment, scarring is a very small possibility. The laser is attracted primarily to the tattoo pigment, and hence damage and scarring to the normal skin is limited. At times, a flattened scar may be more socially acceptable than a tattoo as there is usually an excuse for it - e.g an accident.

Occasionally, there are some textural changes to the skin. You may find that there is a slight difference in colour (lighter) of the treated areas to adjacent skin. The likelihood of this occurring increases with an increased number of treatments. Loss of pigmentation is a common occurence post laser tattoo removal (ie the area of skin appears whiter than the rest). In many cases the skin pigmenation returns to normal after 1 year, but in some cases may be permanent.

Can I tattoo a new design over the same area once the tattoo has been removed?

Yes, it is possible to have the same area re-tattooed if you wish once the original tattoo has been removed. The area will need to heal completely before this can be done. Laser tattoo removal can be used to fade or remove a tattoo prior to having it tattooed over.

Can I remove a tattoo that has just been applied?

Yes, it is possible to remove tattoos that have just been applied. This is relevant for tattoos that have been wrongly applied, or for those who are immediately dissatisfied with their tattoo.

Is it possible to remove cosmetic eyebrow, eyeliner, and lip tattoos?

How much will it cost?

Tattoo removal begins at  $350 including GST per treatment session for a tattoo with a surface area of less than 100cm2 (slightly larger than a matchbox).

An indication (only) of the approximate prices are listed below. Prices are per session, and the number of sessions required cannot be predicted in advance.

For cosmetic tattoo removal, prices are as follows;

** Lip tattooing can sometimes go dark when lasered.  A test patch is recommended.

The number sessions required depends on a number of factors. Click here for more information about this.

For tattoos larger than this, price is on application.

Sedation may be required for the treatment of larger tattoos (+$450 including GST for sedation).
There is a 10% surcharge if more than one laser in one session is used.

Why should I choose The Victorian Cosmetic Institute as my provider of laser tattoo removal?

At The Victorian Cosmetic Institute, we use the latest laser technology to perform your treatment. The Medlite laser  and the Sinon Ruby laser are extremely effective means of removing unwanted tattoos. By having two lasers with three different wavelengths, we are able to maximise your chance of removing your tattoo safely.

Our doctors are also highly experienced in laser treatments, and will be able to give you the best advice for your treatment.

The first step is simply contacting us for your initial laser skin rejuvenation consultation, where we will discuss with you what is a realistic and achievable outcome, and what to expect from your laser treatment.

Making that first phone call about any cosmetic procedure can be a confronting task - many of our patients have preferred filling out our online enquiry form. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate.

It's as easy as clicking either of the buttons below and completing the provided form.

Otherwise, you can phone us directly on (03) 8850 0655 (Templestowe) or (03) 9707 0888 (Berwick).