The application of tattoos is a widespread practice with a long cross-cultural history. Because of their widespread application, there is a rising trend for the removal of unwanted tattoos. Tattoo removal is the complete removal of the multicolor ink that is deposited under the skin.
Before the advent of the medical laser, common techniques included cryosurgery, dermabrasion or excision. Darker colored or black inks are most responsive to treatment, although devices which include a variety of wavelengths can successfully address the fuller spectrum of colors seen in the modern tattoo. Treatment of tattoos can be performed anywhere on the body.
Removal of tattoos depends on the principle of selective photothermolysis; the proper wavelength is applied and the ink absorbs the energy preferentially, causing it to break down. The body’s natural maintenance processes remove broken down pigment over time. Surrounding tissue is largely unaffected but not entirely spared, so tattoo removal is typically uncomfortable for patients. Numerous sessions are required to maximize results.
The Q-switched laser is the most commonly used for tattoo removal. Adequate skin cooling maximizes patient comfort and allows practitioners to deliver more energy safely; modulation of treatment parameters allows users to customize treatment based on the condition and skin type of the individual patient, to maximize results as well as manage patient comfort and the potential for side effects. Treatment of darker skin with laser- or light-based modalities can be problematic due to the increased potential for burning or post-inflammatory hyperpigmentation (PIH).