Tattoo Removal


The Ultimate Guide to Tattoo Removal in 2021

As we grow older, we are entitled to evolve into different versions of ourselves. Maybe we choose to move to a different city or embark on a new career. As we grow and evolve, we might want to leave some old parts of ourselves in the past. For example, maybe some of us got a tattoo that doesn’t resonate with us anymore. Thanks to recent technology, patients now have the options to remove tattoos. In this guide, we’ll discuss everything you need to know about how to effectively remove a tattoo in 2021. And where you can get tattoo removal services in San Diego. If you want to skip around the article, use the table of contents links below.

Table of Contents

What Makes Tattoos Permanent
Tattoo Removal Options
Dermatologist Tattoo Removal
Is Pico Laser Effective for Tattoo Removal?
Benefits of Pico Laser for Tattoo Removal
Tattoo Removal Costs
Laser Tattoo Removal Aftercare
Tattoo Removal Dark Skin
Tattoo Removal FAQ
Best Tattoo Removal in San Diego

Pico Laser for tattoo removal

What Makes Tattoos Permanent

In order to understand how tattoo removal options work, we must first explore how the tattooing process causes the skin to retain ink. Understanding this process can help you find the method that best fits your needs. Also, you can gain an understanding of realistic expectations for the tattoo removal process.

In the medical community, the process of getting a tattoo can be classified as a trauma. Dr. Anne Laumann, a professor of dermatology at Northwestern University, shares why. In her interview about what makes tattoos permanent, she explains that ink particles used in tattoos are purposefully larger than what our body’s cells can dispose of. This prevents our body’s cell signaling systems from being able to “eat away,” at the pigment over time. Consequently, the tattoo will be permanent. Furthermore, tattoos are difficult to remove because the ink pigments are applied to multiple layers of skin, not just the most superficial layer. Therefore, tattooed skin holds ink pigments that are “trapped,” across several layers of skin.

Tattoo removal process

Over time, tattoos can become problematic. Aside from regret for aesthetic reasons, many people who have tattoos may want to remove them because they begin to see “blurriness.” This bluriness is caused by ink particles traveling too far away from the surface of the skin. Ultimately, this causes tattoos to eventually look faded, distorted, or unprofessional. In order to adequately target these pigment particles, tattoo removal methods must go beyond topical treatments to ensure that all layers of the skin are within reach. However, this is also what creates major limitations for tattoo removal methods.

In order to reach all of the target skin layers, the removal method must balance deeper penetration with enough delicacy so treated skin is healthy and unscarred. Methods that are too harsh often lead to dramatic hypopigmentation. Hypopigmentation appears as patches of skin that are lighter than your skin tone. Although nearly all ink particles are typically removed, this side effect can create an outline of where your tattoo was.

Tattoo removal options

Here we will list the methods that have been historically used to remove tattoos for each patient population. In addition, we will dive deep into comparing their benefits, shortcomings, and possible side effects.

Before we begin, we must understand the types of tattoo removal categories. In a peer-reviewed article published in the Current Problems in Dermatology, two dermatologists described the two main categories for tattoo removal. One category is dedicated to patients with medical complications, while the other is for people who wish to remove tattoos for aesthetic reasons.

Methods for tattoo removal after medical complications:

Methods for acute complications:

Acute complications are characterized by being sudden in onset and very often severe. In the tattooing process, acute complications can be noticed almost immediately during or after. In most people, acute complications can cause fainting and extreme pain or can lead to dehydration and hypoglycemia. The two single most common acute complications are allergic reactions or bacterial infections at the tattoo site. Allergic reactions can lead to an interruption during the tattooing process in which the tattoo artist is forced to stop. In some cases, finishing the tattoo is not an option in order to prevent serious complications. Bacterial infections can be localized to the tattoo site but it is possible for the infection to spread and require serious medical attention.

In these cases, removing the tattoo becomes an immediate need if antibiotics or allergy medications do not work. For acute complications, the most common tattoo removal methods are dermatome shaving and surgical incisions paired with either a local corticoid or an immunosuppressant. Dermatome shaving is an outpatient surgical procedure where the physician cuts off superficial layers of skin that contain the highest concentrations of ink pigments. Surgical incision is very similar and is performed under local anaesthetic. These methods are invasive and may require skin grafts for the skin to regrow and heal properly.

Methods for chronic complications:

Chronic and inflammatory complications often manifest as systemic diseases. The most common type of chronic complication is inflammation, which can be treated with a combination of immunosuppressant drugs, laser removal, dermatome shaving, and local corticoids. However, if the chronic complication arose from an untreated allergic reaction, laser therapy is not recommended because breaking up pigment particles may spread the inflammation. These methods can be invasive, cause significant scarring, and require extensive medical attention.

Methods for tattoo removal for aesthetic or personal reasons:

Picosecond lasers (Pico Laser)

The best method for tattoo removal uses lasers that deliver energy within trillionths of a second. These lasers are called picosecond lasers, and they are three orders of magnitude faster than Q-switched nanosecond lasers. Pico laser, the technology offered at Aesthetica Med Spa of San Diego, is a picosecond laser. It uses three wavelengths of light to treat multiple tattoo colors.

Pico laser delivers shorter pulses that are safer for normal tissue and more effective for tattoo removal. A comparative study of picosecond and Q-switched nanosecond lasers for tattoo removal published in JAMA Dermatology reported that 75% of tattoos treated with picosecond laser technology had more color removal than nanosecond lasers. Although pico laser treatments can cause temporary discomfort, it is generally well-tolerated among patients.

Laser therapy

Lasers are light amplification by stimulated emission of radiation. There are several lasers applicable to the removal of tattoos and skin pigmentation, but whether each one is right for your will depend on the type, size, and color of tattoo you want to treat. To decide which laser therapy is right for you, keep reading or please call Med Spa Aesthetica of San Diego today to make an appointment.

Intense Pulsed Light (IPL)

Similar to carbon dioxide lasers, IPL’s are not the most optimal lasers for tattoo removal. IPL’s are devices that emit pulses at the rate of milliseconds and have been shown to only partially remove tattoo ink. Since IPL is not truly a laser light, this treatment is not powerful enough to fully disintegrate ink particles, but still creates significant damage and scarring to the skin. Generally, lasers that use heat have historically led to significant skin damage and side effects such as blistering and hypopigmentation.

Q-switched nanosecond laser

The Q-switched nanosecond laser delivers very short pulses of energy on the order of nanoseconds. According to the Mayo Clinic, this laser may be safe to use on darker skin tones without changing the natural pigment. Additionally, fast laser delivery to small areas of skin ensures that surrounding tissue is typically spared. This method is non-invasive, non-surgical, and has (until recently), been the most advanced method for laser tattoo removal.

Chemical peel tattoo removal

Chemical peeling combines harsh and natural methods to speed up the overturn of new skin cells. Chemical agents are applied to the tattoo area, which slowly activates cell death and causes the outermost layers of skin to shed. This activates the body’s ability to heal and produce new skin cells. Chemicals used for tattoo removal are trichloroacetic acid (TCA) and phenol, each of which has unique advantages and uses with varying degrees of penetration. Although phenol is more powerful in reaching middle layers of skin that trap ink pigmentation, chemical peeling has been shown to fade tattoos without completely removing them.

Carbon dioxide laser

Carbon dioxide lasers are ablative and non-discriminative to tissue around pigmented areas. The only advantage that this method has to offer is that it is able to target all tattoo colors. A review article about carbon dioxide lasers in Seminars in Plastic Surgery reports that these lasers are far too aggressive and nonselective because they ablate all skin and always create further scarring. Generally, lasers that employ thermal methods for tattoo removal are declining in popularity because newer laser methods have proven to be more efficient with significantly less to no scarring.

Dermabrasion tattoo removal

Dermabrasion utilizes a medical grinding tool that removes the outermost layers of skin that house tattoo ink pigmentation. Over time, the goal of dermabrasion is to remove layer by layer of skin to slowly and carefully remove the tattoo. However, dermabrasion is still one of the more aggressive methods for tattoo removal because it leaves the patient with an open wound that must be carefully treated to prevent infections or sunburn. Dermabrasion may be right for certain individuals, but this method requires healing time on the order of 10 or more days after each session, which is often incompatible with most people’s lifestyles.

Surgical excision tattoo removal

Surgical excision tattoo removal requires surgical excision to remove the tattooed skin and then bringing together surrounding skin to close the excision. Therefore, this method is only recommended for very small tattoos if the patient does not mind having a surgical scar afterward.

Cosmetic tattoo removal

Tattoo removal is considered a cosmetic service, which is unfortunately not covered by medical insurance. However, it is important to seek out experts in tattoo removal, such as the practitioners at Aesthetica Med Spa of San Diego who can address your medical concerns and needs safely. Practitioners will appropriately adjust laser wavelength to better match your skin tone, can help you deal with post-treatment side effects, and will give you the best results possible.

Is pico laser effective for tattoo removal?

Yes! Pico laser is effective and safe for tattoo removal. In fact, pico laser therapy is the most advanced laser technology for tattoo removal to date. A literature review published in Dermatology Surgery reports that picosecond laser technology (used by Aesthetica Med Spa of San Diego) is effective for tattoo removal, treatment of skin disorders, removing acne scarring, and even for correcting photoaging (sun spots, freckles, and fine lines). A comparative study between nanosecond and picosecond laser technology published in Archives of Dermatology Research reports that lasers with picosecond delivery are much more efficient than nanolasers, highlighting that pico laser technology is the most advanced laser method to this date.

One of the main concerns for individuals looking for tattoo removal is whether or not their treatment will successfully target multicolored tattoos. Because, pico laser is safe and efficient for black and colored inks, such as red, orange, yellow, green, and blue pigments. A study published in PLOS One showed that by adjusting picosecond wavelengths, each colored tattoo can be optimally targeted.

pico laser tattoo removal

Benefits of pico laser for tattoo removal

Pico laser offers several benefits for tattoo removal, and even far beyond simply removing tattoos! The benefits of pico laser include:

  • The use of energy instead of heat protects skin from damage
  • Pico laser increases the production of collagen and elastin, both of which are crucial for the appearance of youthful, hydrated skin
  • Pico laser breaks up tattoo ink so that your body’s immune system can dispose of it naturally
  • As your immune system removes ink from the skin’s surface, tattoos begin to disappear while keeping the skin’s healing process undisturbed
  • Pico laser can target all tattoo ink colors safely and efficiently
  • Because pico laser uses energy rather than heat, there is no need to worry about excessive skin irritation, inflammation, or post-treatment side effects

Tattoo removal San Diego costs

Tattoo removal costs vary depending on tattoo size, location, and coloring. Cost may also fluctuate depending on which method you choose. As the most advanced technology for tattoo removal, pico laser offers the highest return for value. For a cost estimate of pico laser tattoo removal in San Diego, please call or visit Aesthetica Med Spa of San Diego. A professional opinion can be given to you with a free consultation.

Laser tattoo removal aftercare

Aftercare for laser tattoo removal is quite simple and manageable. Each treatment session will be separated by a couple to a few weeks, giving your skin time to heal before your next session. Other than discussing your skincare routine with your dermatologist or clinician, there is no need for you to change your lifestyle too much after laser therapy. Pico laser is the most gentle and efficient option for laser tattoo removal and does not use thermal energy to remove tattoos. As such, aftercare is very minimal and does not require you to take time off work or school to recover.

Some common post-treatment instructions may include

  • Cool compress and Tylenol for swelling or pain
  • Being mindful of the treated area and handling it with care to avoid trauma
  • Regular cleaning of the treated area
  • Ointment application and covering of the treatment area may be recommended by some clinicians depending on the size and reaction to laser therapy
  • No swimming in water with chlorine, salt, or high-temperature pools and tubs in order to prevent infection or slowing down the healing process for 24 hours post treatment
  • If the tattoo and treated area is large, it may be recommended to halt physical activity that causes heavy perspiration for 24 hours post treatment
  • Although pico laser is gentle and safe for the skin, it is always recommended to be mindful of sun exposure and minimize it whenever possible
  • No picking scabs, rubbing, scratching, scrubbing, shaving, or peeling treated skin
  • Avoid sun exposure post treatment or apply SPF 50+ frequently
laser tattoo removal
After your treatment, you may experience swelling, redness, and pain that are likely to subside within hours or 1-2 days. Typically, pico laser therapy will not create open wounds or blisters that will prevent you from resuming your everyday activities. If you have any concerns or specific questions about laser tattoo removal aftercare, please discuss them when you make a consultation.

Tattoo removal for dark skin

The evolution of tattoo removal methods has tried to address issues commonly seen in patients with darker skin tones, such as hypo- or hyperpigmentation and the need for repeated or combined treatments. In a study published by the Journal of Clinical and Aesthetic Dermatology, researchers found that darker skin holds color pigments that closely resemble common tattoo ink, indicating that darker-skinned individuals require more treatment sessions at reduced power levels for safe tattoo removal.

The development of advanced laser technologies–such as pico laser–offer the ability to remove unwanted tattoos with less skin damage, scarring, and skin lightening. Still, it is important to remember that not all laser treatments are built the same. Pico laser utilizes the most advanced technology to remove ink particles while inducing your body’s natural ability to regenerate its own skin cells, giving you a seamless tattoo removal experience.

dark skin tattoo removal

Common side effects of tattoo removal for dark skin may include:

  • Hyperpigmentation: The disintegration of natural melanin in tattooed skin may cause the skin to appear darker in certain areas.
  • Hypopigmentation: Sometimes disintegration of natural melanin may also cause its removal from the surface of the skin, leading to lighter skin patches at the tattoo site
  • Keloid scars: Although rare, keloid scars may appear up to six months after laser tattoo removal. Keloid scars are caused by extra fibrous tissue growth that appears as a raised patch of skin that is uneven with the surrounding area.

If you would like to discuss your concerns about which laser wavelengths are used, please call Aesthetica Med Spa of San Diego for a tattoo removal consultation.

Tattoo Removal FAQ

How do lasers remove tattoos?
Lasers can either deliver heat or optical energy to dermal layers that extend beyond the surface. However, lasers that use thermal energy (heat) can cause serious damage, discoloration, burning, or swelling. Therefore, the newest laser technology has introduced lasers that utilize optical energy that is concentrated over very small areas of the skin. Because tattooed skin is holding ink particles that are too big for the body to naturally decompose, the lasers are used to break up the ink droplets. By breaking them up, the lasers have jump-started your body’s immune system and its natural ability to decompose them. In addition, lasers that utilize energy delivery on the scale of picoseconds have been shown to induce the production of elastin and collagen to give your skin a youthful appearance. This also allows your skin to heal faster without any adverse effects such as discoloration, burning, indentations, or uneven pigmentation.
How long will it take to remove my tattoo?
The time requirement for tattoo removal can vary among individuals. The pico laser treatment itself will typically last less than 30 minutes each (depending on the size of your tattoo). The number of sessions required will also vary.

Tattoo removal is one of the most extensive and involved laser removal processes. It’s important to understand that tattoo ink is meant to be permanent and that multiple layers of skin have been punctured to hold ink particles. As such, pico laser therapy and all other laser removal therapies require time, patience, and dedication to achieve optimal results.

Can you completely remove a tattoo?
Pico laser technology is the most advanced laser method for tattoo removal. With energy being delivered in trillionths of a second, pico laser’s technology optimizes the way particles of ink pigmentation are broken up. By breaking up the ink across several layers of tattooed skin, the ink becomes transportable for your immune system to slowly remove it from the skin’s surface. Pico laser is able to completely remove tattoos, but every tattoo is unique. Aesthetica Med Spa of San Diego cares about its patients and will work closely with you to achieve your desired results every step of the way. Appointments for tattoo removal in San Diego can be booked through us.
How many treatments will I need?
The number of treatments for tattoo removal will vary on tattoo size, tattoo method, and tattoo ink color. Bigger tattoos will generally require more sessions, while smaller and amateur tattoos (such as line tattoos) will only require a few to several treatments. The color of the tattoo can also impact the duration and number of treatments because darker and lighter colors will respond to specific wavelength frequencies. As such, colored tattoos (such as red, blue, green, yellow) might require repeated sessions with multiple lasers.
Does tattoo removal hurt?
Pico laser uses numbing cream on the surface of your skin to minimize discomfort during the procedure. Compared to getting a tattoo, laser removal is not painful. Patients have described laser tattoo removal to feel like a rubber band snapping on the skin, causing temporary pain or swelling. However, pico laser technology is extremely efficient and faster than all other lasers, so patient discomfort is minimized as much as possible.
What is the aftercare for laser tattoo removal?
Laser tattoo removal, although gentle and advanced in its technology, can still require precautions and aftercare to ensure that you have a pleasant healing experience. Without needing to change your lifestyle, the aftercare from pico laser is easy to manage. The most important task after treatment is to be mindful of your laser-treated area, to clean it regularly, and to avoid irritation from unprotected sun exposure. For more detailed aftercare instructions, please visit this blog’s section “Laser tattoo removal aftercare.” Your clinician will also be happy to discuss aftercare instruction thoroughly with you.

Best laser tattoo removal in San Diego?

As a state-of-the-art practice that focuses on research-based and quality technology, we strive to provide you with the safest and most powerful laser tattoo removal in San Diego. Pico laser utilizes the most advanced methods for laser tattoo removal as of 2021. Our team at Aesthetica Med Spa of San Diego is thoroughly trained to understand every step of the procedure so that we can provide you with peace of mind and quality care during your visits.

For a free consultation, please contact us at Aesthetica Med Spa of San Diego.