Tattoo removal: It's possible, but not easy

Editor's note: Yesterday, we featured an article about talking to your teen about body piercings and tattoos. Today we're following up with an article about tattoo removal.

Have you ever purchased a shirt, but then decided it wasn't flattering on you so you took it back? Seems to be an easy process, right? Well, unfortunately the same cannot be said about tattoo removal. I always urge patients to think twice before getting a tattoo because having buyer's remorse about body ink could end up being a very costly and time-intensive experience.

About 35 percent of people between the ages of 18 to 34 have at least one tattoo, and according to the American Society of Aesthetic Plastic Surgery, laser tattoo removal was up 13 percent in 2016 over the previous year.

Laser tattoo removal works by breaking up the bonds of tattoo ink into small particles that are eventually cleared by the body.

The current gold standard is using a q-switched laser, which releases energy in one billionth of a second. In recent years, a variety of picosecond lasers have also become commercially available. This has been the biggest breakthrough for laser technology in 20 years as the picoseconds release their energy in one trillionth of a second, breaking tattoo ink into very fine particles and speeding up the process considerably.

Depending on the tattoo, the artwork may only take a few hours, or in some cases minutes, to complete. But the removal can take weeks or months over multiple sessions. The picosecond lasers allow for less treatment sessions than the q-switch lasers, but several treatments are still needed and they must be scheduled six to eight weeks apart.

It should be noted that some colors are more challenging to treat than others. The wavelength of the laser light is preferentially absorbed by the color it is targeting, and therefore different wavelengths are used for different colors. Tan, peach, purple, and turquoise are among the hardest ink colors to clear, while black is the easiest.

It is also no secret that getting a tattoo is not the most pleasant feeling. Removal is no different. A topical numbing agent is often applied before the removal process begins to reduce the amount of pain a patient feels.

Patients should wait at least six months after getting a tattoo before engaging in the removal process, as the skin needs time to heal from the initial inflammation of the tattoo placement.

If you are thinking about getting inked, make sure you understand the permanence of your decision before you commit. And if you are regretting a current tattoo, rejoice in knowing you have options for removal.

Nazanin Saedi, M.D., is director of Jefferson Laser Surgery and Cosmetic Dermatology Center.