Safety in Laser Tattoo Removal
Laser tattoo removal has become one of the more common cosmetic laser procedures in recent years and is the most frequently performed procedure at Tattoo MD. It is reassuring that we have performed thousands of tattoo removal treatments. However, one should not be lulled into thinking that laser tattoo removal is 100% risk-free. Our training and experience at Tattoo MD keeps us wary and careful to minimize the potential risks of laser tattoo removal procedures.
The most common risks include:
- hypo-pigmentation – loss of natural skin pigment in the treated area
- hyper-pigmentation – darkening of the skin in response to inflammation
- scarring – a raised area of scar tissue
- allergic reaction – would occur if a tattoo already had some allergic response to the pigment in it
- side effects or allergies to anesthetic creams
While this list is not exhaustive, it contains the majority of risks that we consider and discuss with patients prior to beginning treatment. Additionally, the patient and clinician must protect their eyes with safety goggles we provide to prevent laser-induced eye injury. Fortunately, eye injury has never occurred at Tattoo MD.
Hypo-pigmentation is more common in colored tattoos (i.e. red, blue, green) that require the use of shorter wavelength laser beams, including 532 and 694 nanometers. These interact more with melanin, and damage to melanin-containing cells is common when these laser wavelengths are used. This is usually reversible but is unavoidable in cases where the removal of a colored tattoo is desired.
Hyper-pigmentation is also common but almost always reversible. This occurs in darker-skinned individuals and is often confused with “scarring.” The change in color is not technically scarring. We offer skin bleaching cream from Vi Derm that can minimize this reaction and avoidance of sun exposure to the treated area helps as well. Regardless, this side-effect typically fades away over weeks to months.
Scarring is the risk that is most carefully avoided at Tattoo MD. Although patients often ask to “turn up the laser” as much as possible as early as possible, the obvious downside of that is the increased risk of scarring. Tattoos at the start of treatment contain more ink than tattoos that are more faded. They therefore absorb more light and require a lower energy setting on the laser to produce tattoo fading. Likewise, as the tattoo fades, the laser energy setting can be gradually increased without producing blistering. Severe blistering is a red flag for a higher risk of scarring, and so is avoided as much as possible. However, some individuals respond unpredictably to settings that seem gentle in other patients and blistering occurs occasionally. Fortunately, most cases of blistering resolve without scarring. Future sessions are thus adjusted accordingly to avoid blistering.
If your tattoo seems very inflamed, or weeping, then it should not be treated. The reason is that when it is treated with the laser, additional ink particles are released to which you may be allergic. This could cause much more severe allergic symptoms, such as hives, swelling, or even breathing problems. If your tattoo seems to have developed an inflammatory reaction, you should see a dermatologist for further evaluation and treatment.
If you have an allergy to any anesthetics, such as novocaine or lidocaine, please inform us during your consultation. Usually, patients may have an allergy to one kind of anesthetic but not another. We carry different varieties of anesthetics in case of such situations. We also limit the area on which anesthetic cream can be used at one time to avoid excessive absorption of anesthetic.
In summary, laser tattoo removal is generally safe, but requires careful patient selection and education. Patients should be aware of the risks prior to beginning treatment. However, most such risks are small and generally resolve well with time.
