Permanent Cosmetics and Laser Tattoo Removal

Laser Tattoo and Permanent Make Up Removal

Published in #1 Permanent Make Up '2010

by Elena Oganina and Irina Maximova

The number of people having tattoos is growing day in day out. Statistics show that every sixth citizen of the Earth has a tattoo. However, the number of people willing to get rid of an unwanted ink or permanent makeup is increasing too.

One of the reasons why people started thinking about removing skin art from their body or face is poor quality of the performed work, which often mutilates body and, what is more unpleasant, face. Up to the present time, an ugly tattoo or permanent makeup was rather difficult to remove.

Before we review more or less well known ways of removing an unwanted artistic or cosmetic tattoo, it is necessary to understand what a tattoo actually is.

A tattoo on the body or permanent makeup on the face is, in fact, a drawing, which consists of particles of tattoo pigment pushed into the skin with a needle. Moving up and down, the needle of a tattoo machine or a special permanent makeup machine punctures the skin where the pigment (or tattoo ink) is introduced. As soon as the dye has reached the skin, human body starts protecting itself from the inserted foreign matter. The pigment particles get encapsulated by protective skin cells. This is how our immune system works. These protein covers don’t let anything foreign get inside the body. Without the immune system protection, everything emplaced under the skin would have been carried all over the body by the blood flow. In the result, a tattoo would have disappeared after some time. So, while protecting itself, our immune system forms protein covers (capsules) around the dye particles, thus keeping the tattoo in the place where it was originally applied for long years.

On the other hand, the ink encapsulated under the skin is particularly resistant to any internal or external impact. A tattoo or ugly permanent makeup is so difficult to remove precisely because of this protective cover around the pigment particles. Protective capsules form from skin cells in 4-7 days. This is why, from the structural point of view, it makes absolutely no difference how much time has passed since a tattoo was done - a week or twenty years. A tattoo or permanent makeup is easier to be done than to be removed.

Let’s have a look at some ways of tattoo or permanent makeup removal.

One of the most primitive and simple ways to hide the previous artist’s poor work is the so-called camouflaging. A new design is applied upon the original tattoo or permanent makeup to cover it. This method is quite appropriate for body skin treatment. Generally, a camouflage or cover up is bigger in size - to hide the old work.

However, when it comes to facial tattooing, it can be difficult to cover the original permanent makeup if it has been applied in thick lines, densely or askew, especially when a new pigment attempts to emulate the natural skin color. In a while, the cover up pigment will change its initial color and will look like dirt or fester on the skin. Later, such a cosmetic defect will get worse and almost impossible to correct.

Tattoo Removal Using Infrared Coagulation

This method basically uses electric current, plasma or laser beam (surgical lasers) to burn the layer of skin that contains the tattoo ink. The treated area scabs over and the scab falls off in two-three weeks.

The Mechanical Means of Tattoo Removal

The mechanical means of tattoo removal include taking off a tattooed skin layer by a fraise or a dermatome, as well as microdermabrasion of skin layers by salt crystals under pressure

The skin healing process depends on how big a tattoo is, how deep the pigment resides within the skin and how thick the skin in the treated area is, while the client’s age and overall health are important factors as well. The thickness of skin varies with gender: women and children have thinner skin than men do.

Side Effects

  • ❖ When removing a tattoo by the abovementioned methods, somewhat bigger area of skin is subject to treatment because if we stick to the tattoo layout, the scar will be exactly of the same form. 
  • ❖ These removal techniques leave scars on the body and face. There may be white pitted or hypertrophic scars and reddish keloids. ❖ The removal procedure is rather painful and typically requires a local anaesthetic. ❖ Removing a tattoo is a serious problem!

Let’s have a deeper look into the types of lasers used for tattoo removal. Tattoo laser removal technology is quite new to the world. Now, after almost half a century of practice and research in this field, there have been determined the most relevant laser beam parameters.

There are lasers of several types. All of them have their own features when it comes to removing tattoos and permanent makeup.

Erbium laser is used for removing tattoos residing in the upper skin layer. The majority of modern professional tattoos are applied in this layer. The treatment has a good cosmetic effect with no risk of scarring. Amateur tattoos are done deeper. In such cases, vapor exfoliation done with an erbium laser might be inappropriate as it may leave unpleasant scars on the treated area.

Erbium laser (Er:YAG laser) with a wavelength of 2.94 μm is used for microdermabrasion, which involves removal of the outermost layer of dead skin cells from the epidermis. Compared to other laser systems, such as CO2 lasers, it produces the least amount of undesirable effects, no scarring or healing abnormalities (if the client is treated by a professional). The laser is operated in pulsed mode. The penetration depth of the laser light into biological tissue is 0.05 mm, i.e. its absorption is 5-10 times higher than that of a CO2 laser and its effect is solely cosmetic.

Such features are not suited for coagulation of tissues. Lasers of this type are effective for removing skin texture imperfections (keratosis, surgical scars or acne scarring), pigmented lesions of various origin on the face, neck and upper chest, as well as cosmetic professional tattoos done with contemporary pigments. Depending on the treated skin area, the healing process takes from two to four weeks.

CO2 laser (carbon dioxide laser) is the first surgical laser, which has been actively used in medicine since the 60’s up to now. The penetration depth is 0.1 mm, which makes CO2 laser an effective tool for a wide variety of surgical applications. The laser beam passes through biological tissue without leaving deep burns. Its disadvantage is the continuous wave operation.

Holmium laser is used for subcutaneous operations. The lasing medium is yttrium-aluminum garnet crystal (YAG crystal) doped with holmium ions. The generated wavelength of about 2.1 μm is highly absorbed by biological tissue.

Diode lasers use a broad spectrum of wavelengths, from 0.6 to 3 μm, over a wide range of beam parameters. The lasers are applied in ophthalmology. They are mainly operated in continuous mode, which hinders their application in laser surgery.

Neodymium:YAG laser is the most commonly used type of solid-state lasers applied for both medical and cosmetic purposes. This high-power laser uses neodymium-doped yttrium-aluminum garnet crystal (Nd:YAG) as gain medium, emits in the near infrared region at a wavelength of 1.05 μm in any operation mode and is characterized by high efficiency and possible fiber output beam.

Nonlinear potassium titanyl phosphate (KTP) crystal used in neodymium lasers allows for doubling the frequency of the wave.

The Nd:YAG Q-switched system allows to break down the ink in both professional and amateur tattoos. The laser emits energy within the given absorption spectrum of the pigment to fragment dye particles into smaller pieces. Special Q-switching technique is used to produce light pulses with extremely high peak power by means of shorter pulse duration. Each laser pulse destructs certain tattoo pigments. Tattoo pigment is quickly heated to fragmentation temperature together with fibrous tissue encapsulating it. Thus, all pigment particles get fragmented layer-by-layer.

The smaller ink pieces are then removed by normal body processes. Cellular renewal process depends on individual metabolic rate and takes approximately 1-1.5 month.

Compared to other removal techniques, this method is more preferable because it is selective. During the pulse of laser energy, which is very short (3-6 nanoseconds), the color of the laser light is absorbed only by the tattoo pigment before its heat can dissipate to the surrounding skin. This laser type allows to remove tattoos with no risk of hypertrophic or keloidal scarring.

Effective tattoo or permanent makeup removal requires one (in rare cases) to numerous treatment sessions. There are multiple factors that predetermine the number and success of laser tattoo removal procedures. Let’s review them in more detail.

  • ❖ Type of pigment

Certain oxide-based pigments are especially difficult to remove. But the majority of contemporary tattoo pigments are well suited for treatment. The dye used for applying permanent makeup is easily removed as well.

There are some fast dyes, which remain visible, though considerably faded, even after a number of laser removal treatment sessions,.

  • ❖ Pigment color

The darker is the color, the easier it is to remove. Flesh tones have proved more difficult to remove.

  • ❖ Skin color

Darker skin absorbs some of the laser light, making the process of removal less effective.

  • ❖ Pigment depth

The laser beam affects the top, visible part of pigment in the outermost skin layer. Once the top pigment layer is destroyed, it reaches the following one. Thus, the deeper and more densely pigment resides within the skin, the more removal treatment sessions are required.

Side Effects

  • ❖ Inflammatory reaction 

Inflammatory reaction is possible after the removal procedure. It happens due to cellular debris formed during the destruction of pigment particles burned by laser beam. The elements produced in the result of the thermal chemical reaction may cause minimal edema and erythema of the treated area. All these changes are transient.

  • ❖ Pain

The pain associated with laser tattoo removal is typically similar to that experienced when getting one and may be even more tolerable. It is important to follow post care directions. One should understand that the specialist removing tattoos and permanent makeup is not a magician. No one knows for sure if this or that tattoo pigment will be completely removed. However, using neodymium:YAG laser almost guarantees no scarring and maximum possible effect.

It should be also taken into account that removing a tattoo or bad permanent makeup is very delicate work requiring a high degree of precision and knowledge about skin and its physiology.

In artistic and cosmetic tattooing, a tattoo machine or a permanent makeup machine is just a tool. No matter how good a machine is, it may create ugly permanent makeup, just like a laser used by an unskilled and inexperienced specialist may injure skin and produce scars.

This is why it so important to be very careful when choosing a cosmetic tattoo specialist and a tattoo artist, as well as a laser tattoo removal specialist!