Tattoo Removal In Australia
The rate of growth in tattoos is mainly due to the number of younger Australians getting a tattoo; 36% of 18-25 year olds, and 40% of 26-40 year olds, have at least one tattoo. Interestingly, the gender balance is becoming more even, with women just as likely to get a tattoo as men.
Whether done on impulse, or a carefully planned statement, a tattoo may lose its appeal for many reasons:
- Regret over getting the tattoo in the first place
- Relationship breakdown or divorce
- Changing job
- Out-dated design or poor quality
- Spelling errors
What is a tattoo?
The skin is composed of three layers:
- Epidermis – the thin top layer.
- Dermis – which contains the oil and sweat glands, the hair follicles, nerves and blood vessels.
- Subcutaneous fat layer – connects your skin to the underlying muscles and bones and controls your body temperature.
The cells in the epidermis are continually replaced as those at the skin’s surface die and fall off. If the tattoo ink was injected into the epidermis, it would eventually disappear as the cells die off to make way for new cells. To make tattoos permanent, small needles containing ink punch holes past the epidermis and into the dermis.
Punching holes into the dermis creates a local inflammation, and cells called macrophages, which are part of the body’s defence against infection, flock to the injection site. Macrophages ingest the ink, which they see as a potential ‘invader’. Most of the macrophages leave the injection site, removing the ‘invader’ pigment, but many remain behind. Some of the ink particles float free in the gel-like matrix of the dermis, and still more ink is absorbed by other cells that live in the dermis. The ink that remains in the cells of the dermis and in the dermal matrix is visible on the skin’s surface.
The difference between ‘artistic’ tattoos, performed by a tattoo artist with specialised tattoo equipment, and ‘cosmetic’ tattoos, which includes permanent makeup (for the eye, eyebrow or lip), or recreating a nipple areola after mastectomy, is that cosmetic ink is injected at the border between the epidermis and the dermis. Cosmetic tattoos fade over time, but ‘artistic’ tattoos, although will show some fading after several years, are essentially designed to be permanent.
Options for tattoo removal in Australia
There are a variety of tattoo removal providers across Australia. As we come across providers with good reputations, we will add to this list:
The science behind laser tattoo removal technology
A breakthrough in tattoo removal came with the development of medical lasers that could selectively destroy the pigment without harming the surrounding skin. Lasers work by sending high intensity, but extremely short (measured in nanoseconds, a billionth of a second) pulses of light into the skin. The light energy is absorbed by the pigment and converted to heat, which makes the pigment swell up and finally shatter into small fragments. The macrophages can then eliminate the pigment from the body.
The PicoWay laser is a new generation laser that acts in the same way as traditional lasers, but with a much shorter energy pulse (measured in picoseconds, a trillionth of a second). The PicoWay is 4.5 times more powerful in shattering the pigment, and creates smaller fragments that are easier for the body to absorb and remove. The PicoWay laser is safer and less painful than traditional Q-switch lasers. The increase in efficiency in pigment removal means that great results are achieved with fewer treatments, and the treatments can be closer together, reducing the overall time and total cost required to achieve the desired results.
Colours are not made or removed equally
Different colours of pigment absorb different levels of energy before they shatter. Black is the easiest pigment to remove, because it is the darkest and absorbs the most energy. Green and yellow are some of the most difficult. In the past, this has meant that multi-coloured tattoos required complicated (and costly) treatment regimes, using different lasers to treat different colours. One of the biggest advantages of the PicoWay laser is that the safer short pulse length, combined with two different energy levels (532nm and 1064nm), is able to treat multiple colours at the same time. The higher energy 532nm laser removes red, yellow and orange pigment, while the lower energy 1064nm laser removes black, brown, green, blue and purple.
Cosmetic tattoos and pigmented lesions can also be successfully treated with the PicoWay laser, and usually require fewer treatments than artistic tattoos.
What to expect before, during and after treatment
The first step in tattoo removal is to have a consultation with a certified and trained clinician, who will explain how the technology works and discuss the options available for removing or fading your tattoo.
The clinic will provide you with a quote, and some fact sheets about preparing for your treatment.
Whilst preparing for your treatment and to get the best results:
- Avoid sun exposure and cosmetic tanning
- Speak to your doctor about any medications you are taking that may impact your treatment (the clinic will give you a list of medications)
- Stop smoking before and during treatment
When you arrive for your treatment, the clinic will give you a consent form to sign, stating that you understand the risks and would like to go ahead with the treatment. It is important to ask any questions you have and make sure you understand before you sign the consent form.
The length of treatment depends on how big your tattoo is. Small tattoos only take 5-10 minutes per treatment, while medium sized tattoos (around the size of your hand) need 15-20 minutes per treatment and large tattoos need 20-30 mins per treatment.
As the laser does its work, the skin being treated will develop a ‘frosted’ appearance, becoming chalky and white.
A soothing cream will be applied to keep the treated area moist, followed by a protective dressing. You will need to keep the area clean for the next 24-48 hours to prevent infection. The skin may be red and swollen over the treatment area for a day or two. It is important to avoid picking, scratching or washing the area too roughly, so that the skin has time to heal, and avoid sun exposure between treatment sessions.
Your clinic will advise you on coming back for a post-treatment review to see how your skin is healing and to schedule further treatment if required. If you develop an infection, or if the treated area begins to blister or change in any way that you have not been told is normal, contact the clinic immediately for advice.
Risks and potential complications
While tattoo removal with the PicoWay laser is one of the safest and most effective tattoo removal methods available, all laser procedures carry a degree of risk and potential complications.
Side effects of laser treatment are considered to be temporary and include pain, blisters, crusting of the skin and pinpoint bleeding. These side effects are more common in darker skin types using the high energy laser, and can be avoided with appropriately trained staff.
- Complications are uncommon (about 5% of cases) but include:
- Changes in skin colour: either hypopigmentation (lighter skin at the treatment site) or hyperpigmentation (darker skin) can occur 4-6 weeks after treatment. This complication is more common in dark or tanned skin.
- Allergic reactions, particularly to red and yellow pigment, and can occur several months after tattoo removal.
- Some light colours such as yellow or white can become dark, although these colours can be removed with further laser sessions.
- Scarring can occur, particularly in dark skin because the laser reacts with melanin, or if the pigment is very deep, or if aftercare of the treatment area is badly managed.
- Incomplete elimination of all traces of tattoo ink leaving a residual image that can’t be reduced with further treatment.
- Textural changes of the skin, such as wrinkles, or depressions.
Cost of Laser Tattoo Removal Treatment
The cost of treatment is variable and depends on many factors. To estimate how many treatments you will need, a calculation is performed to give a score based on skin type, location, colour of pigment, amount of ink used, presence of scarring or tissue damage and pigment intensity. This calculation provides a fairly accurate estimate of how many treatments are needed. Other factors to be considered are how old the tattoo is and how well your immune system can clear the pigment.
The number of treatments required also depends on the laser used. The PicoWay laser is more efficient at removing tattoos, so even though the cost per treatment may be higher than a traditional laser, usually only 4-6 PicoWay treatments are needed, compared to 5-15 treatments required with a traditional laser.
A warning on pricing
If you are investigating prices at different clinics, it is important to get all the details of the treatment options in writing. Some clinics deliberately underestimate the number of treatments required to entice consumers to sign up with them.
What other options for tattoo removal are there?
- Skin grafts, where the tattoo is cut out and the skin sewn back together, or replaced with un-tattooed skin from elsewhere on the body if required. A very effective technique, but does leave a noticeable scar.
- Dermabrasion, where the skin is essentially ‘sanded’ away, taking the pigment with it. However, healing takes months and scarring, or a change in skin texture is common. Dermabrasion is only an option for small tattoos.
- Chemical extraction or acid injection (Rejuvi, Tatt2Away and Skinial) involves injecting a tattoo removal liquid (usually an acid) in a similar way to the tattoo ink. The acid releases the pigment trapped in the dermis and causes an inflammatory response, but the pigment is eradicated through the skin in the scab that forms over the injection site. The safety and efficacy of these methods haven’t been tested in clinical trials and carry more risk of complication than laser removal.
- Chemical tattoo creams that are applied to the skin daily for several months, are ineffective and contain toxic ingredients that can’t penetrate the skin deeply enough to reach the pigment.