Waiting For a New Type of Tattoo Removal
My friend has wanted to have 2 tattoos removed for as long as I've known her. One tattoo on her foot was (badly) done by her friend in high school - and shows every time she wears sandals. Another friend regrets the "tramp stamp" she got with a girlfriend after her high school graduation. She is very embarrassed by it - especially when her kids see it. Neither one has had their tattoos removed. The first friend put tattoo removal off because of the price. The second has heard that laser tattoo removal is painful, so she won't go. My friends are waiting for a new type of tattoo removal - one that's better.
Right now, Q-switched lasers are considered the gold standard in tattoo removal. (Picosecond lasers may overtake them.) But that doesn't mean there isn't room for improvement.
Q-switched lasers break tattoo ink up into small particles that are removed by your immune system. Picosecond lasers, like the PicoSure and the PicoWay, came onto the market more recently. This newer technology breaks up tattoo ink into smaller particles than Q-switched lasers, allowing tattoos to be removed in about half the time, but also for about double the price.
So what are the down sides to laser tattoo removal?
- Laser tattoo removal is slow. Lasers can take 10 sessions or more (depending upon the tattoo) spaced in 4 - 8 week intervals. The location, depth and age of the tattoo can influence the outcome.
- Not all lasers can remove all colors. Pastel colors, like white and yellow, are particularly difficult. Sometimes light colors can become dark after laser treatment. When this happens, it is called paradoxical darkening. The darkened colors are removed later with other laser sessions.
- Laser tattoo removal is expensive.
- Laser tattoo removal can be very painful.
- People with light skin tend to get the best results. Dark skin is more likely to develop post inflammatory hypopigmentation or hyperpigmentation, after treatment.
- There can be changes in the skin texture after laser tattoo removal. Sometimes skin develops a wrinkled appearance.
- There's an increased risk of raised hypertrophic or keloid scars. People with the following conditions are more likely to scar:
- Laser tattoo removal on dark skin
- ink pigments placed too deeply into the dermis
- skin isn't cared for correctly after the laser treatment.
- In some cases, removal of the tattoo ink is incomplete, or even impossible with lasers. The broken ink particles can be transported into the deep layers of the dermis - and sometimes into the subcutaneous tissue (fat layer) - and beyond the laser’s reach. If this happens, the particles stay visible as a shadow (a phantom tattoo) and can only be removed through surgery.
- Most alarming of all, is that tattoo pigments are broken into small particles that are removed by your immune system.The inks are not regulated by the FDA and can contain a mixture of a ingredients. Typical ingredients in inks are additives, bonding agents and ethanol. However, tattoo artists sometimes add their own ingredients to ink. A 2003 report from the European Commission found "most chemicals used in tattoos are industrial pigments originally produced for other purposes, such as automobile paints or writing inks, and have little or no safety data to support their use in this way." Another article from 2008 in the journal, Contact Dermatitis, found that, "Modern tattoo colourants frequently consist of azo pigments that not only contain multiple impurities but also are originally produced for car paint and the dyeing of consumer goods."
There are obvious risks with releasing these potentially carcinogenic inks into the liver and lymphatic / immune system.
A Washington Post article by Harry Misiko from 2014 titled, "Questions Raised About Tattoo Inks, Cancer," said the following:
"German dermatologists published an article in March about their effort to determine if a tattoo had caused skin cancer in a 48-year-old man. About four months after a tattooist had pumped red and black pigments into the skin on the man’s left leg, he was diagnosed with skin cancer at a spot where red ink had been used, and he was sent to the specialists for treatment.
In the article — it appeared in PRS Global Open, a medical journal of the American Society of Plastic Surgeons — the dermatologists reported finding no direct connection between the tattoo ink and the cancer, but they urged doctors to look for signs of squamous-cell carcinoma in patients who have a reaction to tattoos.
They also pointed out that there are no international standards for tattoo ink mixtures and that inks in some countries may contain carcinogenic substances, giving tattoo-seekers a lot more to think about than whether the needle is sterile and the artist is talented."
Enter Trans Epidermal Pigment Release, also known as TEPR.
TEPR Is a Type of Chemical Ink Extraction.
In 1888, the dermatologist Prof. Dr. G. Variot published a technique to remove tattoos. He used a needle soaked in tannic acid to penetrate the skin, then followed it with a silver nitrate pencil to enhance healing.
How does this new type of tattoo removal work?
Now new chemical ink extraction methods have evolved based on Dr. Variot's method. All the methods (Eliminink, Skinial, Tatt2Away, Magic Pen) use similar tools to tattoo machines. But instead of injecting ink into your skin, the tattoo is micro-needled to create channels into your skin. Then a tattoo removal liquid is applied to the channels to allow the liquid to reach the tattoo ink and dissolve it.
Most of the methods use an adhesive stencil applied to the tattooed area. The stencil helps the person performing the tattoo removal to target small areas of the tattoo. Using the stencil ensures partial treatment of the tattoo. Skin heals faster than it would if the whole tattoo was treated in one session.
The tattoo removal liquid releases the ink from your cells so it can be pushed out through the skin's surface. There is inflammation and a crust / scab forms over treated areas. When the scab falls off, the tattoo ink comes with it. After the treated areas have healed, the process is repeated on untreated areas until the entire tattoo has been removed.
Watch the video below to see tattoo removal using Tatt2Away on ABC4 News in Utah.
How is this new type of tattoo removal / TEPR better than lasers?
- TEPR is quicker than laser tattoo removal. A tattoo about 3" x 4" can usually be removed in 3 - 5 treatments. Larger tattoos take more treatments. The tattoo is treated in segments to allow healing and limit the risk of scarring. Time between treatments is usually about 8 weeks.
- This new type of tattoo removal works on ink of all colors.
- TEPR is less expensive than laser tattoo removal. Because there are fewer sessions, the process is shorter and costs less.
- People who have had this new type of tattoo removal say it hurts less than laser tattoo removal. Some patients request a topical numbing cream. Most people say it feels similar to getting a tattoo.
- The depth of the tattoo doesn't matter. Tattoo artists usually inject ink between 0.6 and 1.2 mm in the skin. Amateurs deposit ink at varying depths. In most cases, the depth of the tattoo removal solution injection can be adjusted to the depth of the tattoo ink in your tattoo.
- TEPR dissolves the tattoo ink and removes it without releasing it back into the your liver and immune system. Pigment is released directly from the skin. It is NOT released back into the body, so there is no risk of absorbing any potentially carcinogenic ink.
- TEPR, the new type of tattoo removal, works on most skin types and colors. People who have a history of scarring, and pregnant or nursing women are not good candidates for this type of tattoo removal. You can minimize your risk of scarring and skin color changes by:
- giving an accurate physical history
- carefully following after-care instructions
- having a test spot treated
What is in the TEPR ink removal solutions?
Each company has its own proprietary secret formula. Most are made of lactic acid, a kind of alpha-hydroxy acid (AHA). This acid is found in our bodies and is the main organic compound in sweat. It comes from the breakdown of glucose (sugar). AHAs occur naturally in dairy products, wine, and some fruits and vegetables. They are often used in facial chemical peels.
Does this new type of tattoo removal have any side effects?
Red patches can occur at the injection point. Some people get small burns or allergic reactions on the tattoo area. Like lasers, there is always the risk of infection or scarring. TEPR is not recommended to remove tattoo eyeliner because of the possibility of a chemical burn to the eyes.
Update 12/29/2017: I've been getting feedback via Instagram that some people are getting scarring from TEPR. It's depressing! I wish there was a really good answer for tattoo removal. Sadly, right now - just my opinion - there's not.
How do I take care of my tattoo after TEPR?
The most important thing is to protect the wound. A bandage will be applied to the treated area right after the treatment. It should be changed once or twice a day. Apply a triple antibiotic ointment to the wound until a scab forms. Vaseline or a scar gel may be applied until the scab falls off.
There are no perfect solutions for tattoo removal.
It's hard to get ink out of skin. Improved tattoo techniques, and the wide variety of colors used, make tattoo removal more and more difficult.
- Surgical removal is expensive and leaves a scar.
- Lasers are expensive, painful, and release inks into the immune system. And they may leave a scar.
- TEPR, the new type of tattoo removal, may give lasers a run for their money. It is less expensive, works on all ink colors, and inks come out through the skin - not your body's immune system - minimizing health risks. But it too, may leave a scar.
I guess the question you need to ask yourself is, "Just how bad do I want to get rid of this tattoo?"
There's a patch that doctors are using with laser tattoo removal. Read more about it in our post, A Tattoo Removal Patch That Works in 6 AMAZING Ways.
If you are in the process of having a tattoo removal done, but don't want it to show, you can cover it with airbrush makeup. Learn more in our post, How Airbrush Makeup Covers Tattoos, Acne, Vitiligo, Etc.
Did you know not all states regulate tattoo parlors? And they don't all license tattoo artists either. If you're considering another tattoo you should read this: Tattoo Safety - 13 Ways to Stay Healthy When You Get a Tattoo.
Amy Takken, RN
Amy Takken is a registered nurse with 20+ years of experience helping people improve their health. Her in-depth skincare articles have been featured on Nazarian Plastic Surgery and The Palm Beach Center for Facial Plastic & Laser Surgery.
Masterpiece Skin Restoration is your online resource for all things medical aesthetics, skincare, beauty, and wellness. We keep you up to date on leading edge technology and the services available to help you restore your natural beauty.
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If you liked this post, you'll LOVE these:
DermApproved.com, Q-Switched Lasers, a Dermatologist’s Gold Standard for Tattoo Removal
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1150908/ Tattooists Use Pigments Designed as Car Paint
https://www.ncbi.nlm.nih.gov/pubmed/18353031 Modern Tattoos Cause High Concentrations of Hazardous Pigments in Skin.
The Information provided on our website is not medical advice and should not be viewed as such. By law, only a medical doctor can diagnose or give medical advice. As a registered nurse, my goal is to educate, so I provide information on skin care, skin care products, and skin care treatments. If you have any condition that concerns you, please see a medical doctor. While most skin conditions are benign, some - like melanoma - can be deadly. If there is any doubt, please, please consult your physician. Thank you!