DP Removing Tattoos

In the top layer of the Dermis are the pigments of tattoo or a permanent make up, tattooes usually go deep into the Dermis and remain visible for longer (stratum basale).

Due to the location of the ink, fading occurs at 2 moments

  • After placement, the PMU is quite dark. Because part of the injected pigment has ended up in the epidermis. During healing, this pigment disappears through normal skin renewal (after 2 to 3 weeks), causing the PMU to fade
  • Furthermore, progressive fading occurs under the influence of various factors: natural renewal of the skin, UV rays (sun, sun bed), peeling creams (especially those containing Retinol), certain medication against acne (eg Ro-accutane), … This fading occurs over the years (3 – 5 years) but can go much faster as one is more exposed or uses the fading factors.

Risks or possible complications after placement PMU

  • Sometimes slight bleeding
  • Limited inflammatory response (swelling, redness)
  • Scarring (Granuloma): due to lack of experience / knowledge of executive person
  • Allergic reaction: rather rare when using ‘right’ pigments
  • Migration of pigment when using Indian or Chinese ink.

Remove Permanent Make-Up

  • A natural blur occurs with time as mentioned
  • This process can be accelerated by using peeling creams containing retinol: this Vit. A precursor promotes natural skin renewal, resulting in faster fading. Often this cream should be used for at least 3 months.
  • Laser therapy: uses laser light that is specifically sensitive to the pigment causing the fading to be accelerated (and kind of forced natural blurring) Laser therapy

Laser therapy

  • Ideally, use is made of a Q-Switched Nd: YAG laser with a broad spectrum: this type of laser is capable of removing almost all colors, specifically addressing the tattoo pigment, with the intention of natural fibers not or as little as possible to damage.
  • The pigment molecule that is in the skin is not degraded per se, but the pigment from this molecule is ‘bleached’ by the laser. This is due to the absorption of the light energy that the laser emits.
  • The fraction of the energy that is not absorbed by the pigment is converted into heat which is the cause of limited damage in the environment. This gives rise to a limited local injury, type of burn (grade 1 to 2) leading to local redness, swelling and sometimes blistering.
  • Therefore, treatment should be initiated immediately after laser therapy for this surrounding reaction to promote smooth healing and avoid scar tissue. For that reason, it is also unjustifiable that a subsequent laser session or any new PMU treatment takes place earlier than 4 weeks after the last laser session.
  • Laser therapy also includes the possibility of complications, although they are rare:
    • Depigmentation of the skin: there is a risk that the natural pigment of the skin also disappears due to the laser therapy: this is often a temporary phenomenon that disappears after a maximum of 1 to 2 years.
    • Destroying hair follicles: laser therapy can burn hair or sometimes damage hair follicles. This is rare because the follicles are sensitive to a different width than that of tattoo pigments. Usually these hair come back within a period of a few months after stopping the laser therapy.
    • Scar formation: rare
    • Oxidation of pigment: in a number of cases certain pigments, present in the tattoo ink, are oxidized during the first laser session. This effect is very difficult to predict given the correct composition of the tattoo ink with which the PMIU was placed is usually not known. The annoying thing about this complication is that the pigment is ‘activated’ by the impact of the laser and therefore immediately gets a darker color than the starting point. The opposite than the intended effect, but unavoidable. It is true that the subsequent laser sessions (albeit in number more than with pigment that is not subject to this) will always cause a complete blurring of progressive bleaching.

Iwan Van Breuseghem, MD, PhD


For more information tattoolaser@yahoo.com


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