Article medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)
Templestowe Lower and Berwick Clinics
Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
Laser tattoo removal or modification quick facts
- Laser tattoo removal or fading with q-switched nanosecond lasers and picosecond 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 nanosecond lasers and picosecond lasers emit extremely high energy, short-lived pulses of laser that shatter tattoo ink particles to allow them to be removed by the body’s immune system.
- Different laser wavelengths are required to remove different tattoo colours.
- Laser can 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 eyelids, eyebrows, or lips can also be removed.
- Anaesthetic creams/injections are used to numb the skin prior to laser treatment.
- At Victorian Cosmetic Institute, we have three lasers, the PiQo4 (picosecond) laser, the Medlite laser and the Sinon Ruby laser that are used for tattoo removal, and between them have wavelengths that are able to remove any colour tattoo.
- Our preferred laser is the PiQo4 laser which is the most powerful laser tattoo machine currently on the market, with both nanosecond and picosecond pulses and 4 wavelengths to remove any colour.
How have lasers revolutionised laser tattoo removal?
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.
From the 1990s, tattoo removal has been performed by q-switched lasers. Q-switched lasers emit very short pulses of laser energy, lasting only millionths of a second. These short-lived, high energy pulses break-up the tattoo ink into smaller particles that the immune system can digest and remove. Short-lived pulses also transfer minimal heat into the surrounding skin, minimising skin damage. It’s like quickly touching an iron so doesn’t burn you.
In the past few years, further advances have allowed the production of picosecond lasers that are able to fire pulses that last only billionths of a second. These lasers further reduce the number of sessions required and the risk of scarring with laser tattoo removal. The PiQo4 laser is an example of a laser that can produce both nanosecond and picosecond pulses.
The lasers used emit certain wavelengths that are highly attracted to specific tattoo ink colours. The high affinity towards tattoo inks colours and relatively low affinity to normal skin further allow the lasers to target tattoo ink with minimal effect on the surrounding skin.
Multiple laser treatments are required to successfully remove or fade a tattoo. Each session of laser breaks down ink particles to allow the immune system to remove them. Lasers allow for complete removal of the tattoo, or just to fade it so the tattoo can be modified.
At Victorian Cosmetic Institute, we have multiple lasers for tattoo removal, however, our PiQo4 laser is the preferred laser due to its higher effectiveness.
How do q-switched lasers remove tattoos? What about different pigment colours?
Lasers such as the PiQo4, 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 these lasers to literally shatter and disrupt the tattoo pigment allowing the immune system to eliminate them from the body. Ordinarily, tattoo 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.
Different laser wavelengths are specifically attracted to certain ink colours. Therefore, to removal all colours, a number of wavelengths are required. The PiQo4 laser has 4 wavelengths and is capable of removing all tattoo ink colours. 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. The Medlite laser cannot remove green tattoos effectively with either wavelength. The Sinon Ruby laser is attracted in particular to green, black and dark blue pigments.
Figure: This diagram illustrates the relative absorption each colour to of various laser wavelengths
What type of tattoos can be removed with lasers?
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.
Cosmetic tattoos, such as those used on the lips, eyelids and eyebrows can also be removed with laser, and generally take fewer sessions than other 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, there is greater attraction of the laser to the melanin or pigment in the skin. This makes tattoos more difficult to remove on darker skin. Risk of hypopigmentation (loss of skin pigment) is more likely on darker skin types. When appropriate to the colour of the tattoo being removed, using longer laser wavelengths such as 1064nm, which are less attracted to melanin than shorter wavelengths, can help reduce this risk of hypopigmentation.
How many tattoo removal 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?
With the advent of newer, more powerful and combined nanosecond and picosecond lasers such as the PiQo4 laser, it is possible to remove tattoos in fewer sessions than the previous generation of lasers. The exact number of sessions cannot be determined in advance. On average, 3 to 10 sessions are required. We recommend 2 months or more between sessions to allow for the immune system to remove the ink that has been broken down by the laser. This also allows enough time for the skin to fully heal prior to retreating.
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 tattoo removal 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.
How does VCI reduce the risk of scarring?
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 occurrence post laser tattoo removal (ie the area of skin appears whiter than the rest). In many cases the skin pigmentation returns to normal after 1 year, but in some cases may be permanent.
One feature of the PiQo4 laser is its power. This allows the usage of larger spot sizes for a greater number of sessions before having to reduce and spot size to obtain the necessary power output to break down the remaining tattoo ink. Larger spot sizes are more efficient at removing tattoo ink as they penetrate deeper, given the same energy density (fluence). Therefore, using larger spot sizes when possible reduces the risk of scarring.
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.
Laser tattoo removal patient diary
Tattoo Removal Pricing
|Tattoo Size/Location||Cost Per Session|
|Size greater than 900cm2 (eg. larger than 30cm x 30cm)||Price On Consultation|
|Size from 625cm2 to 900cm2 (eg. between 25cm x 25cm - 30cm x 30cm)||$1500|
|Size from 400cm2 to 625cm2 (eg. between 20cm x 20cm - 25cm x 25cm)||$900|
|Size from 225cm2 to 400cm2 (eg. between 15cm x 15cm - 20cm x 20cm)||$600|
|Size from 100cm2 to 225cm2 (eg. between 10cm x 10cm - 15cm x 15cm)||$500|
|Size less than 100cm2 (eg. up to 10cm x 10cm)||$350|
|Eyeliner (lower OR upper)||$750|
|Eyeliner (upper And lower)||$950|
|Lip / Lip Liner||$950|
|Lip Test Patch||$75|
Why should I choose Victorian Cosmetic Institute as my provider of laser tattoo removal?
At Victorian Cosmetic Institute, we use the latest laser technology to perform your treatment. The PiQo4 laser is the class leader for tattoo removal, being able to remove tattoos of any colour with its 4 wavelengths, and also by being the most powerful laser available. Our practitioners 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 1300 863 824.