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Everything You Need To Know Before Getting A Tattoo Removed

Beauty
Illustration by Grace Hoffman

The good, the bad, and the ugly

Today is National Tattoo Day. While many of you may already have an appointment booked this afternoon to get a celebratory piece, or are feeling inspired to get one soon, I’m here to tell you a quick tale of getting one removed.

I have a lot of tattoos—21, to be exact. And many of them—most of them, even—happened on a whim and are pretty random. Whether I’m invited to a party with a flash situation taking place or I suddenly wake up on a Sunday morning with the urge, I make a pretty last-minute decision, even though it involves permanently inking my body.

While I’d like to say I live my life with no regrets, I’m not a huge fan of every single piece I have. I got my very first tattoo about 10 years ago (the second I turned 18, because mom and dad couldn’t stop me!), and, well, let’s just say I’ve changed a lot in these past 10 years. While, thankfully, it’s not a floral tramp stamp, I don't really love the three giant outlines of stars going up the side of my back like I once did.

When I was given the opportunity to try out tattoo removal a few years back, I blindly jumped into it hoping to get my stars removed for good—without having done any research beforehand. To save you all of the gruesome details, I left the dermatology office in tears and horrified because (a) my back was now one giant painful blister (b) I would need to do this at least six more times and (c) I would have to wait weeks in between each session, prolonging my not-so-cute blister situation.

And so, I never went back—and now I have three giant half faded/blotchy stars on my back. While I think I’ll finish the job someday (technology has improved since my experience), I wanted to reach out to the experts so that they could share all of the details they think patients need to know before booking a removal appointment. And maybe this will even prevent some of us from getting a tattoo we might come to regret.

This way, you, too, won’t end up in the Union Square Duane Reade crying to your mother on the phone while buying gauze for your back, as it drips with pus. (Sorry.)

Below, the low-down on tattoo removal.

Know your options
So, you’re looking to permanently remove something you were once sure you'd love forever? First things first, what are your options?

Laser technology, which has improved greatly over the past few years, is the most common and successful means of removing unwanted body ink. “It’s possible to remove a tattoo with a laser and not have any undesired skin color changes or scarring,” explains Dr. Jerome Garden M.D., director of the Physicians Laser and Dermatology Institute in Chicago. “Which lasers are used depend on the colors within the tattoo, the patient’s underlying skin tone, and the lasers your doctor has available. It’s helpful to find a doctor that has many different lasers available for tattoo removal, which allows for more flexibility when treating a tattoo.”

If you have a small tattoo, Garden says, surgical removal is also an option, though this will most definitely lead to a small scar.

While Claudio Sorrentino, founder and owner of Body Details, stands by laser removal as being the best and safest option, he points out a few other means of removal to me. Other procedure options include sanding, which involves scraping tattooed skin down until the tattoo begins to rub off, leaving scar tissue in place, and salabrasion, which uses various salt scrubs to rub the top layer of skin off, while the salt pulls the ink to the surface. Dermabrasion, chemical peels, and cryosurgery are other options.

One thing to be wary of? Any at-home removal creams and acids. Talor Coughlin of J. J. Wendel Plastic Surgery warns to stay far away from them, in fact. “There are creams, acids, and injections that are advertised for ‘fading’ or ‘removing’ tattoos, but they are NOT recommended. They contain unknown chemicals and abrasive acids that are not regulated, which can cause more harm to the body than good.”

It’s going to take time, and it’s going to cost you
As laser removal is pretty much the best way to go these days, we’ll focus on this. When going into it, you must keep in mind that it won’t be a quick process. Fully removing or fading a tattoo will take multiple sessions, which can take up to a full year or more.

“Most people assume the laser will magically be waved over the tattoo and the tattoo will immediately disappear,” says Garden. “Tattoo removal can take anywhere from four to 10 treatments, or more, depending on the color and quality of the tattoo.” Sessions will require four to eight weeks of waiting time in between to ensure that the spot is fully healed before going back over it, which can really drag out the process.

Keeping this in mind, also know that the average session can cost anywhere from $150 to $500 each. If you’re looking into laser removal, Sorrentino says that the rule of thumb is that the cost to remove a tattoo will be roughly 10 times the cost of what the patient paid to get it in the first place. “If you paid $100 to get the tattoo, you can expect to pay at least $1,000 to have it removed.” Woof.

Yes, it hurts!
While lasers seem to be the best option—unless you decide sanding your skin sounds like a good idea—they certainly are not painless... something to which I can personally attest. While I don’t personally find getting tattoos to be all that painful, my first and only laser removal session—which took place at a pretty prestigious dermatology center that certainly was using the latest in technology—was way more painful than any tattoo I’ve ever gotten. Coughlin describes it best: “It feels like getting popped with bacon grease.” (Yes, it does.)

However, many providers will offer something to numb or ease the pain. I was injected with a numbing agent around the entire outline of my tattoo—which actually hurt significantly more than the laser itself! For Coughlin, she uses a cooling machine called the Zimmer Cryo on her patients during treatments.

Still, newer technology is less painful. Sorrentino explains that older laser technology used a photothermal mechanism of action, which means it used light-based rays to heat and break up ink. Newer lasers, such as PicoWay technology that Sorrentino and many other places use, use photoacoustic technology instead. These lasers pulse every one trillionth of a second, which creates very little heat and a “shock wave” to destroy ink particles, and end up being much more comfortable and require less healing.

Some tattoos are easier to remove than others
In terms of removal, not all tattoos are created equal. Ink color plays a big role in laser effectiveness. Garden explains: “Generally, black tattoos are the easiest to remove, with blues, green, and red also being responsive to the right lasers. Yellow and orange are the most difficult to remove. White pigment can also be problematic, even if it is mixed in with other colors, such as with cosmetic tattoos, since the laser light can cause the white tattoo pigment to darken.”

Garden also explains that amateur tattoos are easier to remove than professional ones, as they contain less pigment and the pigment tends to be shallower in the skin. So, if you’re looking to remove that shitty stick and poke your friend gave you while you were drunk, you’re in luck—it’s likely way easier to remove than the one you got at a shop by a legitimate tattoo artist. Phew!

If your tattoo is older, it also has a better chance of removing successfully. As Sorrentino explains, “Our bodies recognize tattoo ink as a foreign element and are therefore constantly working to remove the tattoo from the moment you get it. Ink particles are thick and placed deep within the skin, making it hard to remove them naturally, but your body does make progress little by little—which is why tattoos fade over time. In general, older tattoos are easier to remove than new ones, as the longer someone has had a tattoo the less ink there will be to remove.

Placement plays a role, too. According to Coughlin, tattoos located closer to the heart will require fewer treatments and provide quicker results, as there is better circulation to the skin. Tattoos located on placed like the wrist, fingers, ankles, and feet will likely require additional treatments. 

There’s a risk of permanent skin damage
Know that there are risks of temporary and permanent skin damage involved with laser removal, especially if not administered by a board-certified dermatologist. According to Coughlin, the most common side effect is skin hyperpigmentation or hypopigmentation, which involves either the darkening or lightening of the skin around the affected area. “This can correct itself in six to 12 months after treatment if properly protected from direct sunlight,” she says.

Additionally, there are other more permanent risks (though more uncommon) to be aware of: scarring, infection, burns, and textural changes of the skin. “It’s important to follow post-care instructions from your provider to avoid any of these potential risks,” she says.

The best way to avoid these risks, according to Garden, is to ensure the provider is qualified to perform the treatment. He suggests finding a board-certified dermatologist or plastic surgeon that has significant experience with lasers.

Success rates can vary
Lasers are known to be the safest and most successful way to remove a tattoo today. However, as stated previously, the success rate of a tattoo removal really varies from person to person.

A surprising fact? A person’s overall health plays a major role in the success rate of removing ink. “A person’s immune system and healthy lifestyle play a huge part in successfully breaking down the ink,” says Coughlin. So, you might want to make sure you’re taking care of yourself before booking an appointment.

Still, overall, it really depends on who you choose to go to. “There are many locations now that perform laser tattoo removal not under the direct supervision of a qualified trained physician—this increases the risk of poor outcomes and possible permanent scarring,” says Garden. So, as stated above, be sure to do your research and find a board-certified derm or plastic surgeon with significant experience before you book your first consultation.

At the end of the day, just take a few more moments to think before you jump to get new ink on an impulse, because options for removal are much more intense than you may think. Still, as long as you do your research and make sure you’re prepared, you should be able to be tattoo-free—even if it takes a year or two. Happy National Tattoo Day!

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