People with tattoos may ask that a tattoo be removed for a variety of reasons. The person should be aware that there are a number of complications that may affect the final cosmesis of the site.


Methods that have been used for tattoo removal:

(1) dermabrasion

(2) surgical excision

(3) laser

(4) chemical treatments

(5) infrared coagulation

(6) thermal cautery


Multiple laser treatments at different wavelengths is currently the treatment method of choice.


Acute complications:

(1) allergic reaction to released dyes

(2) pain

(3) inflammation and blistering

(4) crusting over the site for several weeks


Chronic complications:

(1) incomplete removal of the tattoo

(2) color change in the pigments of the tattoo (paradoxical darkening)

(3) scarring

(4) hypo or hyperpigmentation of the adjacent skin

(5) keloid scarring


Factors associated with greater difficulty in removal:

(1) professional tattoo using deep-seated pigment (traumatic tattoos are often fairly easy to remove)

(2) green, purple and yellow inks (often contain titanium dioxide)

(3) fluorescent dyes

(4) pigment containing titanium dioxide

(5) higher ink density

(6) pigment containing ferric oxide if treated with Q-switched ruby laser (becomes black)


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