HOW TATTOO REMOVAL WORKS:
 

At Central Coast Laser Clinic we use the most advanced Q switched lasers for targeting even the most difficult colours, easily removing multi-coloured professional tattoos as well as single colour amateur tattoos safely and with an extremely low risk of scarring.

Tattoos consist of thousands of particles of tattoo pigment suspended in the skin. While normal human growth and healing processes will remove small foreign particles from the skin, tattoo pigment particles are permanent because they are too big to be removed. Laser treatment causes tattoo pigment particles to heat up and fragment into smaller pieces. These smaller pieces are then removed by normal body processes.

Laser tattoo removal is a successful application of the theory of selective photo thermolysis. However, unlike treatments for blood vessels or hair the mechanism required to shatter tattoo particles uses a photo mechanical effect. In this situation the energy is absorbed by the ink particles in a very short time, typically nanoseconds. The surface temperature of the ink particles can rise to thousands of degrees but this energy profile rapidly collapses into a shock wave. This shock wave then propagates throughout the local tissue (the dermis) causing brittle structures to fragment. Hence tissues are largely unaffected since they simply vibrate as the shock wave passes. For laser tattoo removal the selective destruction of tattoo pigments depends on four factors:
 

• The colour of the light must penetrate sufficiently deep into the skin to reach the tattoo pigment.

• The colour of the laser light must be more highly absorbed by the tattoo pigment than the surrounding skin. Different tattoo pigments therefore require different laser colours. 

• The time duration (pulse duration) of the laser energy must be very short, so that the tattoo pigment is heated to fragmentation temperature before its heat can dissipate to the surrounding skin. Otherwise, heating of the surrounding tissue can cause burns or scars. For laser tattoo removal, this duration should be in the order of nanoseconds.

• Sufficient energy must be delivered during each laser pulse to heat the pigment to fragmentation. If the energy is too low, pigment will not fragment and no removal will take place.

Our Q-Switched laser will emit specific wavelengths of light matching the most popular ink colours found in most tattoos. Passing through the layers of skin, the beam is absorbed by the tattoo ink only, breaking it apart. The body, through its natural filtering system, removes the residue – you will literally see your tattoo fading away! The laser treatment may create a superficial burn wound. There is immediate whitening of the treated area, which lasts for several minutes. Many patients than develop blisters, crusts or scabs within 24-72 hours, which may last for 1-2 weeks. Some patients may experience bruising or swelling. Do not pick at the scab or allow the skin to become abraded, as this may result in infection and scarring. The treated area may be pink or pale after the scab separates. Loss of skin pigment in the treated area (usually temporary) is common. Complete healing is usually seen by 6-8 weeks. 

Several colours of laser light (measured as wavelengths of laser energy) are used for tattoo removal, from visible light to near-infrared radiation. Different lasers are better for different tattoo colours. Consequently, multi-colour tattoo removal almost always requires the use of two or more laser wavelengths. Tattoo removal lasers are usually identified by the lasing medium used to create the wavelength (measured in nanometers (nm):
 

• Q-switched Frequency-doubled Nd:Yag: 532 nm. This laser creates a green light which is highly absorbed by red and orange targets. Useful primarily for red and orange tattoo pigments, this wavelength is also highly absorbed by melanin (the chemical which gives skin color or tan) which makes the laser wavelength effective for age spot or sun spot removal.

 

• Q-switched Nd:YAG: 1064 nm. This laser creates a near-infrared light (invisible to humans) which is poorly absorbed by melanin, making this the only laser suitable for darker skin. This laser wavelength is also absorbed by all dark tattoo pigments and is the safest wavelength to use on the tissue due to the low melanin absorption and low haemoglobin absorption. This is the wavelength of choice for tattoo removal in darker skin types and for black, blue, grey ink.

 

Risks

Although laser treatment is well known and often used to remove tattoos, unwanted side effects of laser tattoo removal include the possibility of discoloration of the skin such as hypopigmentation (white spots, more common in darker skin) and hyperpigmentation (dark spots) as well as textural changes - these changes are usually not permanent when the Nd:YAG is used. Very rarely, burns may result in scarring but this usually only occurs when patients don't care for the treated area properly. Occasionally, "paradoxical darkening" of a tattoo may occur, when a treated tattoo becomes darker instead of lighter. This occur most often with white ink, flesh tones, pink, and cosmetic make-up tattoos.

Some tattoo pigments contain metals that could theoretically break down into toxic chemicals in the body when exposed to light. This has not yet been reported in vivo but has been shown in laboratory tests. Laser removal of traumatic tattoos may similarly be complicated depending on the substance of the pigmenting material. In one reported instance, the use of a laser resulted in the ignition of embedded particles of firework debris

Can All Tattoos Be Treated?
Yes, the great majority of tattoos, whether professional, amateur or cosmetic tattoos, respond to our laser treatments. While we do employ the most advanced lasers and can remove the majority of colours, some inks will not respond to any laser treatments.

Does the treatment hurt?
A little. The laser can cause a stinging sensation – a bit like having an elastic band flicked against your skin. For more sensitive areas, a topical anaesthetic can be applied to minimize discomfort.

How many treatments will I need?
Complete laser tattoo removal requires numerous treatment sessions, typically spaced at least 6 to 8 weeks apart. Treating more frequently than seven weeks increases the risk of adverse effects and does not necessarily increase the rate of ink absorption. Anecdotal reports of treatments sessions at four weeks leads to more scarring and dyschromia and can be a source of liability for clinicians. At each session, some but not all of the tattoo pigment particles are effectively fragmented, and the body removes the smallest fragments over the course of several weeks. The result is that the tattoo is lightened over time. Remaining large particles of tattoo pigment are then targeted at subsequent treatment sessions, causing further lightening. The number of sessions and spacing between treatments depends on various parameters, including the area of the body treated and skin colour. Tattoos located on the extremities, such as the ankle, generally take longest. As tattoos fade clinicians may recommend that patients wait a few months between treatments to facilitate ink resolution and minimize unwanted side effects

Are there any precautions to take whilst being treated?
While you are having a tattoo removed, you must not expose that area to the sun before, during and for some weeks following the treatment. At Central Coast Laser Clinic, a full assessment is made during your free consultation and recommendations will be made. Sometimes you will need to consult a Doctor to get a medical clearance before the treatment can proceed. Side effects are usually temporary and can be mild, rarely can they be severe, and they are:

Bacterial Infections:
Keep the area uncovered and dry to allow the area to dry out and after 24 hours start applying Bepanthen First Aid cream several times a day to assist with the healing process. Always observe good hygiene practices. Any infection or picking and scratching of a wound can result in possible scarring. At Central Coast Laser Clinic we work on a moist healing therapy and have found this method to be very successful.

Loss of colour in the skin:
The  skin can become lighter and can take up to 6 months to go back to its original colour.

If your skin becomes darker:
It can occur because of inflammation of the area and a brown mark will appear and will take many months to fade using fading cream

Possible Scarring:
It is very rare. However it can happen with lighter skins , particularly with some sun exposure, that is why you must follow the advice given for before & after care of your wound. We find that with anyone that follows our instructions on after care, they have no problems with the healing of the skin. Areas with thin skin will be more likely to scar than thicker-skinned areas. 

Post-treatment considerations 

Immediately after laser treatment, a slightly elevated, white discoloration with or without the presence of punctuate bleeding is often observed. This white colour change is thought to be the result of rapid, heat-formed steam or gas, causing dermal and epidermal vacuolization. Pinpoint bleeding represents vascular injury from photoacoustic waves created by the laser's interaction with tattoo pigment. Minimal oedema and erythema of adjacent normal skin usually resolve within 24 hours. Subsequently, a crust appears over the entire tattoo, which sloughs off at approximately 14 days post-treatment. As noted above, some tattoo pigment may be found within this crust. Postoperative wound care consists of simple wound care and a non-occlusive dressing. Since the application of laser light is sterile there is no need for topical antibiotics. Moreover, topical antibiotic ointments can cause allergic reactions and should be avoided. Fading of the tattoo will be noted over the next eight weeks and retreatment energy levels can be tailored depending on the clinical response observed

Concerns:
If you have any concerns with your aftercare please contact us immediately. If the area looks infected (honey coloured crusting, oozing or a spreading redness) or if you experience an unusual discomfort or excessive bleeding, or if any other complications develop please contact your local Doctor.

Textual and/or colour changes in the skin can occur and can be permanent. Many of the cosmetic tattoos and body tattoos are made with iron oxide pigments. Iron oxide can turn red-brown or black. Titanium oxide and other pigments may also turn black. This black or dark colour may be un-removable. Because of the immediate whitening of the exposed treated area by the laser, there can be a temporary obscuring of ink, which can make it difficult or impossible to notice a specific colour change from the tattoo removal process. 
 
Infection: Although infection following treatment is unusual, bacterial, fungal and viral infections can occur. Herpes simplex virus infections around the mouth can occur following a treatment. This applies to both individuals with a past history of herpes simplex virus infections and individuals with no known history of herpes simplex virus infections in the mouth area. Should any type of skin infection occur, additional treatments or medical antibiotics may be necessary. 
 
Bleeding: Pinpoint bleeding is rare but can occur following treatment procedures. 
​