The duration of the tattoo removal process is a concern for virtually all patients. Some patients may wish to remove a visible tattoo before an event – such as their wedding or enlisting in the military. It’s important to establish upfront that tattoo removal is a process that relies on the body’s ability to eliminate ink from the skin. It’s not unusual for the body to take over a year to completely eliminate ink. Setting expectations clearly upfront allows patients to be satisfied throughout the experience – rather than feeling as if they were misled. To allow the skin enough time to heal between treatments and the body’s immune system to flush away ink, we recommend a minimum of six weeks between laser sessions – and eight weeks for darker complexions. Stacking the treatments too close together can cause damage and permanent side effects to the skin and doesn’t allow the body enough time to remove the ink that was shattered at the most recent session. For ideal results, we recommend waiting three months between treatments. Ultimately, as a tattoo removal practitioner, you cannot know precisely how many treatments a tattoo will need to be fully removed. However, you should assess the patient’s tattoo for how easily it should remove. We generally suggest speaking in terms of treatment ranges with patients. Tattoo removal treatments fit along a bell curve – most patients will need between fine and eight treatments, some will see complete removal in three or four, and others may need 10 or more treatments if there is significant scarring or layered tattoos. We suggest telling patients where they are likely to fit along the bell curve based on the unique factors of their tattoo.

The Kirby-Desai scale is a popular and well-regarded tool for analyzing the number of treatments a tattoo will need for removal. The scale accounts for the following factors that affect the rate of removal: Fitzpatrick skin type Tattoo layering (if the tattoo is a cover-up) Location on the body Ink colors Amount of ink (vividness of tattoo, if it was professionally applied) Pre-existing scarring The Kirby-Desai scale was published in 2009, and technology has improved since then to remove tattoos, but it continues to be an excellent tool for assessing where a patient stands on the bell curve. There are also other factors, such as patient health, that affect the speed of removal. If a patient is young, physically fit, and has a strong immune system, they will tend to see results faster than an older, obese patient with health problems. Encouraging patients to exercise, drink ample water, and massage thetreated area (once healed) are good aftercare tips to share with patients looking to get the best results. Technology plays an important factor in the rate of removal. The Astanza Trinity is the most powerful multi wavelength laser system on the market – no other system can match its high peak power across three wavelengths. Interested in learning about laser wavelengths for achieving results?

Laser tattoo removal typically does involve some level of pain. That said, many say that it hurts less than they expected. It’s a common belief that tattoo removal is excruciating, yet most laser tattoo removal patients say that the sensation of removal is comparable to having a tattoo applied. Common descriptions include the sensation of a rubber band snapping against the skin or bacon grease – basically it’s uncomfortable but bearable. It hurts, but it’s bearable. When discussing pain with patients, it’s important to share that while they may experience some level of discomfort, the pain is relatively manageable and tolerable. It may take some tough love to encourage patients concerned about sensitivity. The vast majority of tattoo removal providers offer some form of soothing to the skin during the treatment. Offering skin numbing during the procedure allows your practice to stay competitive, provide better patient care, and have higher patient satisfaction. Offer skin numbing to keep laser tattoo removal patients feeling happy. The most popular numbing method is a Zimmer Cryo 6, which is a powerful chilling machine that blows cold air on the skin before, during, and after treatments. It’s highly effective and an asset to busy practices that need a solution that is fast and easy-to-use. Other options for numbing include good old-fashioned ice packs, lidocaine injections, or topical numbing creams. Each numbing method has its pros and cons.

Many patients are concerned about scarring from laser tattoo removal – they understandably want their skin to look as natural as possible after they’ve completed the tattoo removal process. If the tattoo already features scarring, expect that to remain. What many people don’t know is that any scarring that remains after a tattoo removal procedure is often left over from when the tattoo was originally applied by the tattoo artist. When the proper laser protocols and patient aftercare are utilized, it’s very uncommon for a laser tattoo removal patient to scar from a Q-switched laser treatment. However, it is very common for a tattoo to feature pre-existing scarring from when it was applied. When a Q-switched laser treats the skin, it targets and breaks down the tattoo pigment in the skin. If pre-existing scarring is present, it will break down this pigment within the scar tissue. Once the tattoo removal process is complete, the ink will have been eliminated from the location but any of the scarring from the original tattoo will likely still remain. During the initial consultation while you are assessing the tattoo, touch it and see if pre-existing scarring is present. If so, mark it as such in the patient’s records and inform the patient that the laser will not eliminate scar tissue, just their ink. A Q-switched laser is not the best device to use for scar revision and will not provide significant improvement to remaining scarring. Some skin specialists use fractional lasers (such as fractional CO2 or an Erbium:Yag laser, like the Asclepion DermaBlate®, backed by Astanza). to resurface scarred skin after the tattoo removal process. Improper aftercare or incorrect protocols pose a risk. While it is uncommon to cause scarring from the laser tattoo removal sessions themselves, it is still possible. For example, if you use excessive fluence when treating a tattoo and cause unwanted side effects (such as immediate pinpoint bleeding), scarring may occur. Another risk for scarring, even if the treatment is performed properly, happens when patients fail to follow aftercare instructions. Blisters and scabs are common side effects that are important in the tattoo removal healing process. However, picking scabs or not caring properly for blisters can allow scarring to happen. When discussing aftercare with your patients, make sure to emphasize their role in the outcome of their tattoo removal. There are also some patients that may have a history of keloids and may be predisposed to scarring, which is why it’s important to take a detailed medical history of each patient. Scarring from tattoo removal is highly unusual. Reassure your laser tattoo removal patients that you use proper protocols and a professional-grade system that is safe for their skin. Ultimately, as a practitioner, you’ll still want the patient to sign a consent form addressing the risks of the procedure and promote a strong emphasis on personal aftercare outside your practice.