March 14, 2022
You need to understand what a tattoo is and how it works before understanding exactly how laser tattoo removal works.
You need to understand what a tattoo is and how it works before understanding exactly how laser tattoo removal works.
Tattooing is an ancient practice that has become a pretty lucrative business over time. A tattoo these days can cost anything between (estimate) $50 to thousands depending on its design and the work involved. Archaeological records showed that tattooing has been around since Neolithic times, across the globe as well evidenced by ink found on mummified preserved skin.
The oldest evidence of tattoo practice is the clay figurines recovered from tombs in Japan, dating back to some 5000 BCE or older. These figurines had their faces painted or engraved, which represented tattoo marks. The oldest tattoo documented on a human being was a discovery back in 1991.
The individual was christened "Ötzi The Iceman." His mummified body was discovered in the Alps, on the border between Austria and Italy and was believed to have died around 3300 BC. It was recorded that he had around 57 tattoos.
Tattoos give an insight, a window into ancient practises and cultures. Being inquisitive creatures, we are automatically drawn to these findings because they represent a tangible connection to our past - as unique as we are.
From Egypt to Japan and New Zealand, such discoveries keep us charmed. Each country, nation and region has its distinctive design and purpose even.
The archaeological discoveries of pottery and ceramic artefacts in the Tōhoku region of northern Honshu in Japan presented interesting findings. The dogū (pictured) was a typical representation of the design that prevailed during the Jōmon period. One can make out a crown sitting on top of the figure's head while deeply incised lines and markings adorn the body. The Jōmon period lasted some 14,000 years, and during this period, an increase in the production of phallic images and female figurines was prevalent.
One of the most instantly recognised tattoos is arguably the Tā moko of the Māori nation.
The Mataora, face tattoo found on men is regarded as a symbol of nobility. The Moko kauae, located on the lips and chin of women, is a symbol of status and leadership. The Māori people were recognised as the pioneers in using smaller, narrower Uhi (broad toothed combs of varying widths ) without teeth that carved grooves in the skin.
The most important item in tattooing is the ink. The earliest of such were made from, among other things, ash, charcoal, plants and soot, which was found on everyone's dear old(est) friend, "Ötzi The Iceman". Over time, people started experimenting and cooking up recipes for ink. It was discovered that one Roman physician Aetius had a recipe that included vitriol, corroded bronze mixed with vinegar, pine bark and insect eggs - perplexing but true.
In 1985 out on a construction site in Tennessee, a seemingly interesting but negligible discovery was accidentally made by workers. It was assumed to be a toolkit of sharpened turkey bones, stone tools and pigment-filled half-shells. The items were placed in storage and forgotten - almost. Years later, an archaeologist and an expert in ancient tattoos who himself initially thought the toolkit was perhaps a medicine bundle realised, with the help of a zooarchaeologist, that it was actually a tattoo kit that dated back between 5,520 and 3,620 years!
The discovery of evidential proofs in the form of tattooed mummies, including tattoo kits, is exciting because it also leads to the discovery of tattooing methods and techniques of ancient times.
An individual may have regrets about their ink because of many reasons and so may want to seek removal treatments. To understand how it works, particularly laser tattoo removal, one must first understand how a tattoo is rendered.
Today's tattooing technique revolves around using a tattoo gun as it has become a commercial enterprise. The tattoo needle punctures skin around 100 times per second. The ink is deposited 1.5 to 2 millimetres below the skin surface. This enables the ink to bypass the outer layer of the skin or the epidermis.
The tattoo needle works like a fountain pen. It is dipped into ink and then delivered into the skin, penetrating its epidermis into the dermis layer where it settles. This process is actually a physical one where something happens to cause the skin to absorb the ink.
Thousands of epidermal cells are shed from skin each day and replaced with new ones. The ink injected into this layer would simply come off in a matter of weeks. So for the ink to remain somewhat permanent, it has to be delivered into the dermis layer. This is where the nerves and blood vessels are located, which explains why skin tends to bleed while getting a tattoo done. The bleeding is part of the skin's natural defence against injury.
During this act of defence, a sort of incursion of immune cells results in the injury site. Specialised immune cells known as macrophages engulf foreign particles and clears them from skin tissue. However, this is only partly effective or successful when it comes to tattoo ink.
Some of these macrophages laden with ink particles remain in the dermis layer. Others are taken up by fibroblasts, the main dermal residents and pigment particles have also been found between the dermis' collagen fibres. Interestingly, the body's immune function keeps the ink in place permanently. This happens when the area is flooded by white blood cells that defend the site from the needle's penetration.
Recent research showed that the body continues to respond due to being tattooed. Not only does it produce the white cells in numbers, it also continues to protect itself by sending immune cells, which is why the ink stays in place.
Fresh ink will experience some pigment loss, but most ink will stay. According to a study (on mice), 68 percent of ink was still present at the injection site 42 days after the tattoo was done.
Although the tattooing and aftercare procedure is the same regardless of skin tone, people with darker skin may have a slightly higher risk of scarring. The common side effect is keloids.
Keloids are formed due to the body's response to an injury, in this case, a tattoo. They have a smooth and shiny appearance and are larger in size than the original injury. People with dark skin tones or those with a family history tend to develop them. Keloids can also develop due to the skin being too deeply and overworked on.
The critical part of getting a tattoo is the experience of the tattooist. They must understand that different skin tones may result in a slight difference in how the colour of a tattoo or even a design would turn out. Additionally, it might be safe for someone to get a small (test) piece done first to see how it heals.
While most of the ink stays in place, some pigments can traverse the body to the lymph nodes and other parts as well.
In a 2015 report published in the Obstetrics and Gynecology journal, doctors described how at first, they found a woman's cervical cancer had spread in particular to her lymph nodes. On successfully removing the nodes, they discovered that what they thought were malignant cells were, in actual fact, tattoo ink particles.
A chemical analysis was done for the first time by a team of German and French scientists on the lymph nodes of four cadavers - two had tattoos, and two did not. The findings showed the presence of pigments in the former and enlarged lymph nodes. This concurs with the findings of pathologists, who have for years noticed unusual colouring in lymph node biopsies taken from patients with tattoos.
The team employed different tests to analyse the forms of tattoo ink collected in the lymph nodes and any subsequent damage that may have been caused. They discovered that nanoparticles, measuring less than 100 nanometers across, were most likely to have relocated to the lymph nodes. A common ingredient in tattoo inks, carbon black, appears to break down quickly into nanoparticles ending in the lymph nodes. Some larger particles of another common ingredient used in white pigments, Titanium Dioxide (TiO2), were also found in the lymph nodes of the tattooed cadavers.
Other matters found include nickel, cobalt and chromium, which are sometimes added to tattoo pigment as preservatives.
Inevitably, tattoos fade over time. This process starts almost immediately after a tattoo session as your skin heals. As the days, weeks and years pass, the colours will look less vibrant. In some cases, it may not even resemble the original design because the pigments break down, causing a muddled appearance.
Other factors that affect a tattoo's appearance also include:
The most common cause is sun exposure. The sun's UV rays, as we know, can cause a myriad of skin issues as they can penetrate deep into the skin. Although the dermis layer is generally safe from its burning effect, the ink will start to break down over time and noticeably. This process is at its peak when the tattoo is healing as the skin is most sensitive and vulnerable. The use of sun protection cream and lotion is essential that a tattoo maintains its colours and vibrancy for the long term.
#2 POOR AFTERCARE ROUTINE
Aftercare is important after getting inked. In fact, proper care is necessary for almost everything we acquire - to maximise its quality lifespan. A beautifully inked piece of work needs care and attention as it is part of your skin, after all. Failing or being ignorant in heeding advice on the matter is, at times, the difference between money well-spent and a lifetime's regret.
#3 BAD QUALITY INK
Quality begets quality, so don't be a scrooge and opt for ink just because it's cheap - chances are the quality of the ink used is suspect. Cheap ink, including DIY ones can compromise the skin, causing issues that may not be reversible and detrimental to health.
#4 INK COLOUR
Colour choice also plays an important role in the lifespan of an ink. Blackwork tattoos and grayscale colours generally last longer compared to coloured ones. With that said, however, it also depends on the experience of the tattooist. Watercolour tattoos look absolutely stunning, but the chances of it fading away fast is also high, which is a reminder that just because something looks great on paper, it doesn't mean it will continue looking as such on skin. This is best discussed with your tattoo artist.
#5 TATTOO PLACEMENT
Not many realise this, but a tattoo's placement can contribute to or restrict its lifespan. Areas exposed to light (and sunlight) run the risk of fading fast. So do areas where friction and wear are regularly applied. This is because skin cells are lost more easily in those areas causing ink to fade. If you're worried about distortion, then best to avoid areas susceptible to weight gain.
The more intricate and detailed a tattoo is, the higher the risk of fading. Small inks with equally tiny lettering and lines tend to fade quicker than ones with bolder lines. These types of tattoos are challenging to the tattooist and the skin as well.
Generally, taking care of skin involves several factors, including leading a healthy lifestyle. Ensure that your body gets the proper rest and enough hydration it needs, protection from harmful elements like the sun's UV rays, including bad habits like smoking, moderation when it comes to indulgences like alcohol and others. All these pave the way for better skin and would indirectly help preserve the lifespan of your tattoo.
#8 THE ARTIST
Arguably the most crucial factor when getting a tattoo is the tattoo artist. The artist's experience, proficiency level, ability to envision how the ink would actually turn out are just some things to consider. Never opt for someone just because they're cheap, and don't just rely on word of mouth. Do proper research because this concerns your skin and, to an extent, your wellbeing. Also, remember that tattoos come in an assortment of techniques and designs, so an artist who excels in blackwork may not be as proficient in multicoloured ones.
Tattoos do fade as we age. So the best that we can do is try to ensure that we get one that can at least hold its shape and semblance of its design. Sagging and wrinkling of skin with ageing is expected, so perhaps it's best to plan a tattoo where such effects will not be so pronounced.
Skin, with proper care that includes a healthy lifestyle, can do wonders when it comes to minimising the effect of ageing. Tattoos that are well taken care of (beyond the "honeymoon" period) can result in a longer lifespan in their vibrancy and appearance. A tattoo is a lifetime commitment, so having the discipline to maintain it is a prerequisite.
We all have regrets, no matter how few, minuscule or otherwise. Thankfully when it comes to tattoos and aside from cover-up recourse, there's also complete tattoo removal via laser treatment. Laser tattoo removal involves using a laser specially designed to remove ink on the skin without affecting surrounding areas.
This precision technology is undoubtedly a welcomed method compared to the days of old when tattoo removals are a painful affair that involves baking powder, hot iron and other items and tools that leaves little to the imagination - of horror. As with getting a tattoo, the treatment (via laser) also requires commitment.
The number of sessions involved in a laser tattoo removal treatment ranges from 8 to 12, or more. One reason is that the lymphatic system can't flush away all of the broken-down pigments at once. Another reason is that the skin is very sensitive, so it needs to recover from trauma. Factors that contribute to the number of sessions required also include colour, density and size of the tattoo. Improvements can be seen after the first session but do our bit in taking care of the area between sessions.
At Amaris B. Clinic, Dr Ivan Puah has seen his fair share of tattoo removal request and the following are common questions asked in regards to tattoo laser removal:
Generally, most of the colours can be treated. The difference is in the number of sessions that may be needed. Different colour tattoos absorbs laser light differently and will require lasers of different spectrums to treat effectively.
A better gauge of the number of sessions needed would be made known during consultation. On average, between 8 to 12, or more, is required depending on the tattoos themselves - colour, density, age and other factors.
A patient can expect some minor discomfort. Generally, if they can withstand the discomfort when getting tattooed, they can bear discomfort during the removal process.
Sensitive areas such as the armpits will affect the level of discomfort involved. The hands and feet have more touch receptors and nerve endings, that is why they are sensitive areas. Leaner areas where ink is closer to the bone can present a slightly more discomforting experience because there is lesser fat.
Like getting a tattoo, the first experience is usually the most discomforting for an individual. With more sessions, your pain threshold increases and by the third or fourth session, the discomfort is significantly lesser than the first.
Cost is dependent on the attributes of the tattoo, its location and others. This will be discussed during consultation.
As older tattoos are most likely already experiencing the effects of fading, they are usually easier to remove and require fewer sessions.
These would be yellow, purple, turquoise and fluorescent dyes, while dark and green are the easiest to remove. This is because different dyes respond to different light wavelengths.
Although it is uncommon, it is still possible. Hence, a doctor's experience is critical to avoid complications and unwanted side effects.
It is highly not recommended to do DIY tattoo removal and should be carried out by medical doctors who are trained in performing laser tattoo removal treatments.
There is nothing much to do regarding preparation. Perhaps, ensuring that skin is adequately hydrated, knowing that patience is necessary as it will require several sessions and adopting a healthier lifestyle in the run-up to the treatment day itself may facilitate better recovery.
Also, do let the doctor know of any skin conditions, allergies or even any concerns that you may have.
Keep the Treated Area Dry and Clean
Aftercare is essential in minimising the possibilities of issues. Ensure that the skin is treated dry and clean. Use a soft towel to pat the area after cleaning. Antibiotic ointment should be applied as directed, and keep the area bandage during the first 72 hours following treatment. Follow your doctor's advice and raise any concerns you may have regarding recovery.
Don’t Soak in the Tub
A relaxing soak in a bathtub might be tempting but avoid it at least for the first three days post-removal. The critical thing to remember is to keep the treated area dry so avoid water sports-related activities like swimming or water polo. In the shower, try not to use highly pressurised water to prevent it from hitting the treated area. Instead, opt for a tepid shower.
Minimise Sun Exposure
Minimising sun exposure on skin is also a must. Try not to head outdoors too much, and if you must, protect your skin, especially the treated area. Avoid other sources of UV rays like tanning beds as well.
Go for a Walk
Go for walks as this simple activity helps to, among other things, boost your immune system. An improved blood circulation definitely helps in the wellbeing of the body in general, and the increased blood flow to the treated area can facilitate better recovery.
Getting a tattoo is exciting but don't be too disheartened should later you realise that it wasn't actually a good idea. Laser tattoo removal treatment is widely available today, and with it, a tattoo that has overstayed its welcome doesn't have to be a permanent regret of a lifetime anymore.