Microneedling Tattoo Removal

An Old Technology Made New

We’ve been hearing about a new trend in tattoo removal called microneedling. The treatment involves using clusters of small needles to drill holes through the skin into the dermis and inject caustic materials that cause the surrounding tissue to die, thus destroying the tattoo. This is essentially a form of deep chemical dermabrasion. Chemical dermabrasion for tattoo removal fell out of style about 30 years with invention of tattoo removal lasers which could do the job of removing a tattoo without seriously damaging the skin. Scarring is much less common with lasers than with chemical or mechanical dermabrasion for tattoo removal and so hardly anyone takes that approach any longer. However, recently, several companies have resurrected the technique but rather than creating one big deep wound in the skin of the tattoo, they break the treatment up into multiple smaller areas leaving the skin in between the treated areas intact. Multiple sessions are required to then treat all the areas of the skin. The argument is that this causes less morbidity than treating the entire tattooed skin surface all at once.

Gruesome and Destructive

I first saw microneedling being performed at a tattoo convention by tattoo artists and I was absolutely horrified. They had created deep necrosis of the skin of their subject. Each microneedled area contained an eschar (a deep area of dead tissue and scab which looks like a piece of beef jerky). The recommended wound management practice was to keep the areas uncovered and allow them to dry and harden and eventually fall off later. This is terrible advice. Innumerable scientific studies demonstrate that deep open wounds heal the most quickly and with the best cosmetic results when they are treated with moist wound dressings and covered until the epidermal layer is restored. So not only is the applied product highly injurious to the skin but the wound management practices belong in the 19th century. The healing time of this treatment is on the order of many months and most of the cases I have seen result in significant textural and pigment changes to the skin if not frank scarring. The practitioners either didn’t know or wouldn’t reveal what had been injected into the skin to induce these injuries, but I suspect it was likely either glycolic or lactic acids (commonly used for *topical* chemical dermabrasion).

Results Compared with Lasers

The entire point of lasers is to *selectively* target the tattoo ink within the dermis. Cosmetic lasers operate under the principle of “selective photothermolysis” which is to say that light is used to select, heat, and destroy specific targets in the skin while minimizing collateral damage of the healthy skin. Microneedling and dermabrasion in general take the opposite approach which is to “destroy everything including tattoo ink” resulting in significant collateral damage resulting in prolonged recovery times and increased complication risk.

Microneedling is a terrible idea for tattoo removal. It will not be faster than lasers and in fact there is so much trauma that you will very likely have permanent scarring. The idea with laser procedures is that the light passes through the surface layers of skin and concentrates the heat below at the point where it interacts with the tattoo ink. Microneedling is the opposite, it makes mincemeat out of the surface of the skin, which is what causes the scarring. ~ Harold J. Kaplan, MD, Los Angeles Facial Plastic Surgeon

Laser Tattoo Removal is not a simple task. Many treatments are required and it is true that some colors are more difficult to remove than others. The aggregate cost of all the treatments can be an intimidating barrier to entry for many prospective clients. Unfortunately, this drives clients with tattoos towards alternative strategies for removal such as ineffective creams and destructive techniques such as injecting chemicals into the skin. Fade Away Laser always endeavors to be honest and straight-forward with our pricing and commitment to service. We tailor our treatments to your specific tattoo and attempt to give you the best results possible.