Frequently Asked Questions (FAQ)

Popular questions and expert answers all about tattoo removal

How does laser tattoo removal work?

The Q-switched Nd:YAG laser used for light therapy treatment fires the trapped pigments in the skin extremely short and energetic, focused light pulses. These light pulses are set to specific wavelengths in order to remove the tattoo ink, so that the pigment is absorbed by the light and therefore scattered. The now crushed pigments in the skin layer can no longer hold their place and hence are taken up by macrophages, endogenous phagocytes and transported via the lymphatic system. The surrounding healthy skin tissue is least affected by this gentle type of treatment.

What is a Q-switched Nd:YAG laser?

The dermatological Q-switched (also known as Giant Pulse Formation), Nd (neodymium-doped) YAG (Yttrium Aluminum Garnet) crystal laser generates extremely short, high-energy, artificial light beams (usually infrared: wavelength of 1064nm and 532nm in frequency doubling) and is able to selectively treat undesirable color pigments in various layers of the skin. In this case, only the colored particles that the laser precisely shoots absorbs the laser light. Surrounding skin tissue remains unharmed in this quick and gentle process when applied correctly.

What kinds of tattoos can be removed?

In general, the darker the color, the better the tattoo absorbs the laser beam that crushes the color pigments into nanoparticles. For different colors, different laser systems are used at different wavelengths. The most widely used systems are the ruby (694nm: black, blue, dark green), alexandrite (755nm: black, blue, green) and the Nd:YAG laser (1064nm / 532nm: black, blue, red, orange, yellow and brown). Light colors such as white, yellow and sometimes light green and turquoise can usually only be partially removed with extensive laser treatments. Concerning very eye-catching colors, many professional laser tattoo therapists advise against treatment because of the risk of some pigments remaining is too large. Colors such as black, blue, dark blue and red are often best for laser treatment.

Important! Despite recent regulations and clinical studies, it is still not yet clear about which substances remain after laser therapy are carcinogenic amines. Therefore, if there is any doubt by your dermatologist, get a sample tested and get detailed advice on the risks and side effects. For more information, see this also in our blog post.


What should be done after the laser treatment?

In general, the less the skin site is manipulated the more successful the result! Unfortunately itching is part of the healing process. The treatment site should be carefully cleaned and swabbed for 3 days, and creams for supporting the healing process are allowed. Resulting scabbing and bubbles should never be scraped or punctured. Most importantly, the skin has highly increased sensitivity to light up to 12 weeks after laser treatment and should therefore always be protected from harmful UV rays via the use of sunblock. 

Will the skin be harmed during the treatment?

In general, for a professional laser treatment using the latest technology, harm to the skin is very minimal! Choosing the right laser beam affects the treatment of the color particles, the depth of insertion and the size of the surrounding tissue or skin area. The high-energy laser beam scatters the ink drops. This results in the particles exiting the epidermis to the blood vessels, depending on how deep and how many times the tattoo was layered. So, in some cases it may arise in the slight leakage of blood, lymphatic fluids or collagen. The skin that receives laser treatment results in redness and slight swelling, much like that of a sunburn.


How old must the tattoo be in order to be successfully removed?

In general, the earlier the better! The minimum age of a tattoo should be around 30 days. Depending on the physical condition and maintenance of the freshly tattooed area, the skin requires its own recovery time. During consultation, it is decided by the laser therapist if and when you can start the treatment. Experience shows that depending on whether the tattoo was performed by laymen or professionals, penetration depth in tissue and containment of the applied tattoo are circumstances that must be considered in treatment.


How many treatments are necessary until the tattoo is removed?

In general, the success of laser treatment depends on many different factors, making an exact prediction impossible.

Experience shows that amateur tattoos often require fewer sessions than professional work. Factors such as color composition, age of the tattoo, depth, size and type of pigmentation, the physical constitution, care in the treatment as well as the use of proper laser technology are crucial in determining the duration of therapy. The skin and the body need time for recovery. In general, one should expect 6 -12 sessions every 4 - 6 weeks. The more patience the patient, the better the results.


What should be considered during the laser treatment?

During the laser treatment, you should make sure that the treated area is exposed to as little UV radiation as possible for a period of several weeks. Vacation plans can be discussed with your respective laser therapists.

Exact follow-up and individual post-procedure sessions will be given by your dermatologist.

How painful is laser treatment?

In general, the amount of pain is very different for everyone! As with tattoos, depending on the part of the body, laser treatment ranges from pain-free to painful. Treatment with a nanosecond Q-switched Nd:YAG or picosecond Alexandrit - Laser is basically the most painless method - similar to the snap of a rubber band on the skin. Optionally, an EMLA® pain-relief cream can be applied 30-45 minutes before treatment. After treatment, the skin area feels inflamed, just like a sunburn and should be cooled. Some doctors are also now working with a nitrous oxide / oxygen anesthesia. Their customers are excited because it makes the laser tattoo removal completely painless. We will soon report more comprehensively on the blog.


How much time should be between treatments?

Generally speaking, a laser is not an eraser! The more patient you are with the laser treatment, the more successful the outcome! The period of the regeneration phase for the skin should be 4 - 6 weeks to achieve the best treatment results. The body needs its own time to break down the tattoo ink. But it is very specific for every particular tattoo as well as your own physical condition. The tattoo will brighten up even weeks after treatment. The more patience you have, the more successful is the removal of tattoos.


How high is the risk of scarring with laser treatment?

In general, as with any medical procedure, particularly in dermatology, laser therapy may lead to scarring.

Especially with green, yellow, blue, deeply engraved Professional tattoos and cover-ups may result in 3 percent scarring of the patient’s skin. The professional treatment with a Q-switched Nd:YAG laser is usually scar-free! It depends above all on detailed information given in a consultation and compliance of patient care. You will receive personal care instructions from your therapist that you should strictly adhere to in order to achieve the optimal outcome. It cannot be stressed enough that you can be treated only by a certified laser specialists!


What are the side effects of a tattoo removal with a Q-switched Nd:YAG Laser?

Swelling, irritation and redness.

After the laser treatment, the skin will be especially sensitive, irritated and reddened. A slight swelling may be contained and suppressed by cooling the area during and after treatment, at which point, the tattoo can also become somewhat reddened. Strong but very rare skin reactions may occur, such as discoloration, blisters or infections. Sun bathing, saunas and tanning beds must be avoided in order to avoid staining the skin. Patching the skin and clothing are the best for UV-protection. The intake of blood thinning agents such as Aspirin should be avoided one week before starting treatment to rule out bruising.

Formation of crusts, scabs and wound bubbles

A scab is formed after the treatment on the treated skin area where defective tissue cells are removed. Such scabbing must not be removed as new skin cells develop underneath and interrupting the regeneration process is not helpful.

The skin area should be kept dry and clean, so swimming and full baths should be avoided during the scabbing stage, as it can usually lead to infections.

Unfortunately, a reaction of the skin and pigment cells in the post-treatment is not predictable, because every human body reacts differently. The risk of hyper or hypopigmentation exists in any scarring. The regeneration phase of the skin is completed after 6 - 8 weeks at the most.

How much do tattoo removal therapy procedures cost? (in Germany)

In general, “buy cheap, buy twice.” A professional tattoo removal by laser light therapy by a specialist has its price!

The cost of tattoo removal in Germany depends on factors including the age, size, and type of tattoo and the resulting duration of treatment. In order to give an indication to the price, you should schedule a personal consultation with your dermatologist. After a detailed discussion, a sample treatment should be performed in order to determine a possible treatment period. Let your dermatologist propose an individual offer. Important to note is that there are individual health services (IGeL-Services) that may be accepted by your doctor. However, health insurance does not cover the cost of laser tattoo removal, so it must be financed privately,since it is not a medically necessary procedure. But when dealing with your skin, one should not sacrifice quality for cost.


Why should the laser treatment be carried out by trained medical professionals and experienced laser therapists?

The entire treatment process for the removal of tattoos and permanent make-up is highly complex and is unfortunately trivialized in many cases by amateur therapists and the media. Reasons why a laser treatment should be carried out by and be under the supervision of a physician is because they are subject to medical, insurance law, forensic and technical requirements. The first priority is the prevention and control of possible associated reactions and risks of side effects and allergic reactions. We noticed in our research that many amateur alser therapists have not even completed a first aid course. So the question arises, what happens if the client / patient suffers an anaphylactic shock during the laser treatment? This is not unusual and many tattoo professionals can attest to that as well. A successfully completed medical degree, a multi-year residency training and extensive experience with various laser systems are important arguments for you to opt for laser treatment by a doctor. He/She will also be the one who advises in specific cases of ethical, aesthetic and medical reasons for removing a tattoo by laser treatment, or not, and will offer you alternative treatments. The most important point is you still know far too little about the possible consequences of laser therapy for tattoo removal especially with regard to the splitting of the color pigments into aromatic Armine to AZO pigments and azo dyes, etc. Please ask your doctor any questions and get expert advice!

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