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Why You Don’t Need Blisters and Scabs to Remove a Tattoo

Why You Don’t Need Blisters and Scabs to Remove a Tattoo

Why You Don’t Need Blisters and Scabs to Remove a Tattoo

or Why We Love the Epidermis

by Thomas Barrows, M.D.

this is not our case: unnecessary blisters after laser tattoo removal

This is not our case: photo shows a common adverse reaction to laser tattoo removal: blisters.

The purpose of this article is to help you to understand how Fade Away Laser approaches tattoo removal and importantly, how we attempt to give you the best possible outcome not just in terms of removing your tattoo, but preserving the look and feel of your skin.

Our skin is a complex organ. The epidermis is a water-resistant layer which acts as our first defense against infections and preventing insensible water loss. Preserving the integrity of the epidermis is an important step in preventing infections and scarring as well as preventing unnecessary pain and prolonged down-time (recovery time). For more information about the skin as an organ, please read our article Why Tattoo Removal Creams Don’t Work.

Before the invention of ultra-short pulse tattoo removal lasers, tattoo removal was a destructive process. Over-treatment caused by using a longer pulse duration resulted in significant heat production around the tattoo and this excess heat caused significant wounds in the skin. Large blisters, bleeding, scab formation, and prolonged healing were the norm. Although the goal was to destroy only the tattoo ink, the surrounding skin was often collateral damage. A decade or more ago is was common to see scarring as the result of tattoo removal.

What is “Selective Photothermolysis?”
Selective Photothermolysis is the basic principle whereby tattoo removal works. We use specific narrow wavelengths of laser light to target the tattoo ink in the skin while avoiding other skin organelles such as your epidermis, dermis, blood vessels, and melanocytes, to name just a few. The laser delivers a pulse of energy that lasts just billionths or even trillionths of a second. Extremely short pulses prevent the transfer of heat from the target tattoo ink and allows for thermal relaxation (cooling) of the surrounding tissues to minimize collateral damage. Since we are only targeting the tattoo ink and not the surrounding skin, we “selectively” treat only the tattoo ink with an extremely short burst of laser light (“photo”) producing heat (“thermo”) and destruction (“lysis”) of the tattoo ink. The selectivity of the wavelength and the use of the very short pulse duration minimizes risk to the skin. Blisters still sometimes occur, particularly when there is very dense tattoo ink.

When we first began Fade Away Laser nearly a decade ago, it was common to see tattoo removal practitioners shred the skin like mincemeat. Even after the invention of ultra-short pulse lasers, laser technicians couldn’t let go of the idea that one should destroy the epidermis and cause wounds in the skin such as blisters or scabs in order to remove a tattoo. Unfortunately, many people even today who seek out laser tattoo removal treatments incorrectly believe that you need to see blisters, bleeding, and scabbing on the skin in order to have received an effective treatment. More troubling is that there are still laser technicians who are poorly trained or simply don’t understand the fundamental tenants of selective photothermolysis and use skin destruction as an incorrect endpoint to determine that they have adequately treated the tattoo. We worked very hard to educate our clients why we prefer to *not* damage their skin so that we have the best chance of returning the skin back to its pre-tattoo health and quality without leaving behind residual scars, textural changes, hypopigmentation (lightening of the skin), or hyperpigmentation (darkening of the skin) when we have completed the removal of their tattoo.

We simply need to deliver adequate energy into the tattoo to cause fracturing and release of tattoo ink particles. Tattoo ink doesn’t disappear immediately after a laser treatment; it takes time for your own immune system to remove it. In fact, our goal is for your skin to return to normal within a few days after your laser treatment. You will then experience a gradual lessening of tattoo ink over the next 6-10 weeks after treatment. This process is in no way improved by destroying the skin surface. Although we can’t prevent epithelial injury in all clients, it is our goal to minimize it as much as possible. The long term results and complications rates are better with this approach. Be wary of a laser technician who tells you otherwise. We love the epidermis! For more information about tattoo removal, see our article How Does Tattoo Removal Work?

If you have questions about tattoo removal or want to schedule an appointment for a free consultation to remove your tattoo, please just go to the web-page of the location nearest you and conveniently set up an appointment online.

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