Laser tattoo removal

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Laser tattoo removal requires a variable number of sessions. This depends on factors such as the amount of ink in the tattoo, the depth at which the pigment is deposited, the age of the tattoo, the colours used, and the presence of fibrotic tissue at the time of treatment.

In practical terms, laser tattoo removal produces a controlled thermal effect that disrupts the pigment without damaging the surrounding skin. An interval of approximately eight to twelve weeks between sessions is required to allow adequate skin healing and pigment clearance. As a result, the overall process of laser tattoo removal may extend over several months or even years.

In general, the more professional and artistically complex a tattoo is, the more difficult it can be to remove. With regard to colour, solid black and dark blue pigments usually respond better to laser treatment than red, green or yellow tones.

In addition, many inks used in multicoloured tattoos contain titanium dioxide, a white pigment widely used in the paper, paint, lacquer and plastics industries. This compound is frequently present in green inks and is often used to create shading and brightness effects.

Several scientific studies have associated titanium dioxide with a poorer response to laser tattoo removal. This may result in darkening of the tattoo, a shift towards intense green pigmentation, or the appearance of small punctate lesions around the treated area.

Before each session

Depending on the laser settings used, discomfort during treatment may vary in intensity, as this technology acts on the pigment through heat. To minimise discomfort, the Laser Unit recommends the application of specific topical anaesthesia or, in selected cases, local anaesthetic injections approximately thirty minutes before each session.

After each session

Immediately after laser treatment, the skin in the treated area may appear inflamed and can be accompanied by a burning or stinging sensation of variable intensity. The specialist may apply an antibiotic or protective topical cream to reduce the risk of infection and cover the area to minimise discomfort caused by friction with clothing.

In the days following treatment, small crusts may appear and usually fall off naturally over a period of approximately two weeks. During this time, appropriate wound care is essential to prevent infection and promote optimal skin healing.

Patients should avoid rubbing, scratching or removing the crusts, and may need to protect the area with sterile dressings if necessary. During the first few days, the application of a topical antibiotic (when indicated) and a repairing ointment is recommended to support skin recovery. In addition, exposure to ultraviolet radiation should be avoided for at least one month after the laser session in order to reduce the risk of hyperpigmentation in the treated area.

Although laser technology for tattoo removal is currently highly effective and generally associated with few side effects, it is important to understand that the skin does not always return to exactly the same appearance it had before the tattoo was applied. For this reason, clear and accurate patient information is essential so that expectations are realistic and decisions are made with an understanding of potential risks.

The most common unwanted effects include:

Hypopigmentation

In some cases, lightening of the treated area may be observed. This effect is usually temporary and tends to resolve over time, often without a significant aesthetic impact.

Hyperpigmentation

Conversely, in some cases — more frequently in darker skin phototypes — temporary hyperpigmentation may occur as a result of skin inflammation. In these situations, the dermatologist may consider the use of topical depigmenting agents to help accelerate resolution.

Scarring

The risk of scarring is significantly reduced when patients follow the post-treatment skin care recommendations provided by the dermatologist. Nevertheless, this possibility should be taken into account, particularly in darker phototypes, which are more prone to the development of keloids.

Changes in skin texture

In some cases, the treated area may become thicker or feel rough after laser tattoo removal. In most patients, these changes resolve naturally within a few weeks, although additional treatments may occasionally be required to improve skin texture.

The content of this page has been prepared by the Communication Department and the Medical Team of Grupo Pedro Jaén, in line with our editorial commitment to ensuring the accuracy and up-to-date nature of the information provided.

References on laser tattoo removal:

1. Hernandez L, Mohsin N, Frech FS, Dreyfuss I, Vander Does A, Nouri K. Laser tattoo removal: laser principles and an updated guide for clinicians. Lasers Med Sci. 2022 Aug;37(6):2581-2587. doi: 10.1007/s10103-022-03576-2. Epub 2022 May 23. PMID: 35604505.

2. Kurniadi I, Tabri F, Madjid A, Anwar AI, Widita W. Laser tattoo removal: Fundamental principles and practical approach. Dermatol Ther. 2021 Jan;34(1):e14418. doi: 10.1111/dth.14418. Epub 2020 Oct 26. PMID: 33068020.

3. Henley JK, Zurfley F, Ramsey ML. Laser Tattoo Removal. 2022 Jul 19. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 28723036.

4. Hsu VM, Aldahan AS, Mlacker S, Shah VV, Nouri K. The picosecond laser for tattoo removal. Lasers Med Sci. 2016 Nov;31(8):1733-1737. doi: 10.1007/s10103-016-1924-9. Epub 2016 Apr 7. PMID: 27056705.

5. Bäumler W, Weiß KT. Laser assisted tattoo removal – state of the art and new developments. Photochem Photobiol Sci. 2019 Feb 13;18(2):349-358. doi: 10.1039/c8pp00416a. PMID: 30452057.

6. Gurnani P, Williams N, Al-Hetheli G, Chukwuma O, Roth R, Fajardo F, Nouri K. Comparing the efficacy and safety of laser treatments in tattoo removal: A systematic review. J Am Acad Dermatol. 2022 Jul;87(1):103-109. doi: 10.1016/j.jaad.2020.07.117. Epub 2020 Aug 4. PMID: 32763326.

7. Dash G, Patil A, Kassir M, Goldman MP, Gold MH, Adatto M, Große-Büning S, Grabbe S, Goldust M. Non-laser treatment for tattoo removal. J Cosmet Dermatol. 2023 Jan;22(1):74-78. doi: 10.1111/jocd.14819. Epub 2022 Feb 9. PMID: 35122391.

8. Bäumler W. Laser Treatment of Tattoos: Basic Principles. Curr Probl Dermatol. 2017;52:94-104. doi: 10.1159/000450809. Epub 2017 Mar 10. PMID: 28288450.