With the resurgence of the tattoo these past two decades there
has naturally been a growing interest in having tattoos faded
or removed. Of an estimated 48 million Americans with tattoos
today, roughly 17 percent are said to want them removed, according
to a Harris Interactive poll.
The reasons behind removing tattoos are varied, but often times
have to do with the tattoo’s location. If it’s
visible, it can be a distraction to people we work with and
possibly hold us back from getting promotions. The art itself
may no longer reflect who we are. Gang- or hate-related tattoos
can be life threatening, not to mention a hindrance to a good
career. And a former lover or spouse’s name may not be
popular with a new lover or spouse. Many of us simply want
to fade a tattoo prior to getting a cover up.
Whatever our reasons, we have a variety of options to consider
today, none of which are perfect or pain free
Laser Tattoo Removal
Almost everywhere we look today, we are told laser tattoo removal
is the way to go. True enough, but a problem for most of
us is the price. Laser tattoo removal is not covered by most
health insurance plans, costs upwards of $400 per treatment,
and removal usually requires eight to 10 treatments. If you
are one of the lucky few who can afford laser, there are
still a few things you need to know.
Different lasers are needed to remove different colors in a
given tattoo. The laser that works great on black ink can’t
make a dent in red or yellow ink. Depending on the colors of
your tattoo, your laser surgeon will need at least three different
types of lasers. Ask your doctor if he or she has all of the
lasers needed to remove your particular tattoo.
Many doctors advertising laser tattoo removal let a nurse or
laser technician perform the actual procedure. It is possible—albeit
not common—to find doctors that specialize in laser tattoo
removal and do the work themselves. Avoid, however, the doctors
who only have one laser to work with and don’t actually
do the procedure themselves. Even expensive scars can be unsightly.
Pain: Severe without anesthesia
Effectiveness: 95 percent
Dermabrasion involves sanding the top layers of skin with an
abrasive tool, while excision involves surgically removing—cutting
out—the tattoo from the body. These are two of the
least desirable ways to remove a tattoo because of the possibility
of extreme scarring; nonetheless, excision may still have
a place in tattoo removal today. Consider that few tattoos
are ever 100 percent removed. In most cases there is some
residual ink left where the artist went in a little too deep.
Excision may be an excellent way to remove even the small
lines or dots that may remain after your primary tattoo-removal
effort. Most cosmetic surgeons are skilled enough to remove
the remaining ink and close the incision with little to no
visible scaring. Like laser removal, this won’t be
cheap, but it may be worthwhile.
Pain: Minimal with local anesthesia
Effectiveness: 95 percent
Variot Tattoo Removal
Variot tattoo removal has been around for more than a century
and uses a tattoo machine and an acid to remove tattoos.
In 1888, French physician Variot G. Nouveau tattooed a solution
of tannic acid, glycerin, and distilled water into the skin
of a patient over a tattoo. The result was a thick scab.
When the scab healed and parted from the skin, it took a
lot of the tattoo with it. There was scaring and certainly
room for improvement, but Dr. Nouveau proved that over-tattooing
with an acid to remove a tattoo does work.
Dr. Nouveau’s technique was later improved upon and introduced
to America in 1928 in an article called “A Study of Tattooing
and Methods of Removal,” by M.D. Shie, in the Journal:
American Medical Association. Variot was then considered the
best way to remove tattoos. Decades later, tannic acid was
found to be a carcinogen, and lasers appeared on the scene
shortly thereafter. Variot tattoo removal was all but forgotten
by the medical community.
In 2004, after a long hiatus, Variot was reintroduced by W.
Cheng in the British Journal of Dermatology as a Chemical Extraction
Technique. In that research, a San Francisco doctor reported
only a 6 percent chance of scarring while removing body tattoos,
and a 2 percent chance of scarring while removing permanent
makeup tattoos. Instead of using the original tannic acid solution,
the doctor created his own solution and used a state-of-the-art
medical grade tattoo machine.
Today many tattoo artists have heard stories about or experimented
with tattooing saline or hydrogen peroxide into the skin, or
simply dry-tattooing the skin (derma-pricking) in efforts to
fade or remove a tattoo. Several companies sell their own preparations
to be tattooed into the skin in efforts to fade or remove a
Your best hope today of finding someone who offers some variation
of Variot tattoo removal might be within the permanent makeup
artist community, but a few traditional tattoo artists do offer
the service. It’s usually cheaper than laser and can
be more gentle to the skin when done properly.
Pain: Mild with topical numbing creams
Effectiveness: 90 percent
Trichloroacetic Acid (TCA)
The thought of applying an acid to our skin to remove anything
seems extreme or even insane to most of us. However, that
is exactly what thousands of men and women do every day in
order to remove fine lines, wrinkles, and acne scars from
their faces. This is commonly referred to as a facial peel,
and it can be done on the body as well. In that regard, acids
have been used to remove fine stretch marks, brown spots,
warts, and calluses on the hands or feet. Acids have many
more uses and are sometimes referred to as the poor man’s
TCA is a popular nonprescription acid commonly used by doctors,
health spas, and private individuals to treat the skin conditions
mentioned above. It usually comes as a clear, water-like liquid
and is applied to the skin with a cotton swab. TCA has been
twice medically tested and proven to fade and/or remove tattoos.
Results were initially published in the British Journal of
Plastic Surgery in 1988 and the South African Medical Journal
in 1990. In both studies, TCA was found to be a simple and
effective tattoo removal agent with an 85 percent success rate.
The process behind TCA tattoo removal is actually very simple.
A mild or controlled burn is generated on the surface of the
skin, much the same as we do with a laser. This burn triggers
our body to repair the damaged skin by growing new skin. In
the process of doing this, the ink breaks apart naturally and
migrates to the surface with the new skin growth. Your body
actually does most of the work. The acid or the laser is simply
the trigger mechanism.
Pain: Mild for most, moderate for some
Effectiveness: 85 percent
Tattoo Removal Creams
Many tattoo removal creams contain hydroquinone, which is usually
the active ingredient in skin bleaching creams. Over the
counter sales of skin bleaching creams containing hydroquinone
are banned in the UK, France, Australia, Japan, and several
other countries because it is known to cause cancer and a
debilitating skin disease called exogenous ochronosis.
In August 2006, the FDA proposed a similar ban on over-the-counter
sales of hydroquinone in U.S. markets. If or when the FDA’s
proposed ban is made law, tattoo removal creams containing
hydroquinone will be taken off the market.
While the idea of a smooth, pain-free cream removing a tattoo
may be appealing, there is no published medical evidence that
it can do so. Barring new evidence, consumers should use caution
if considering one of these creams, particularly when hydroquinone
Pain: Excluding Cancer and Ochronosis, none.
Effectiveness: No published studies to support claims available.
Tattoo Removal Reality Check
There is no such thing as perfect pain-free tattoo removal.
Most tattoos are never 100 percent removed and there is usually
some skin discoloration. If you try to take out every last
bit of a tattoo, there will likely be scarring.
Trying to remove a tattoo too quickly will also lead to scarring.
Patience and persistence are usually the most important ingredients
in any tattoo removal strategy. The latter said, it is possible
to get most of the tattoo out so that it is no longer recognizable
as a tattoo and may be easily covered with a little foundation
or a new tattoo.
The information provided above is to be used as general information
only and is not intended to replace medical advice, to be interpreted
or used as a medical treatment program, or to be used to diagnose
or cure any disease or medical condition.