One of Many Ineffective Products

We’ve been involved in the tattoo removal business for over a decade and during all those years we’ve seen some crazy stuff. We’ve seen clients buy screwball products off the internet including a range of do-it-yourself tattoo removal schemes. I think it is worthwhile to cover tattoo removal creams including the claims that have been made and why these products end up wasting your money.

The Skin: a Remarkable Organ

The first thing one must understand in order to view creams with skepticism is how the skin is so remarkable at repelling materials that are placed upon it. If our skin were just a sponge to everything we touched, we would indeed be in big trouble. It would be impossible to maintain our own body’s chemistry and fluid balance without the nearly impervious barrier of our skin. The way our skin is able to have this remarkable property is through differences in lipid and water content. The outer surface of our skin, the epithelium, is actually composed of multiple sub-layers which possess a high lipid (oil) content. Consequently, the outer layer of our skin is highly resistant to water and water-soluble materials. Thus drugs and materials that are soluble in water have a very difficult time getting past this outer layer. The deeper layer of our skin, the dermis, is composed of many layers of collagen (long strings of proteins bundled together) along with elastin (the material that makes our skin springy and elastic) and many specialized types of cells. The dermis contains a great deal of water and as you are probably well aware, it is very difficult to mix oil and water together. Therefore, the outer surface of the skin resists water-based materials and the inner layer of the skin resists oil-based materials. If you combine the two layers together, very few molecules can penetrate both layers of the skin. Furthermore, there is a very tight connection between the cells at the bottom-most layer of the epithelium that divides the epithelium from the dermis. These tight junctions further insure that it will be difficult if not impossible for molecules to penetrate into the dermis. Only very small molecules such as alcohols are able to pass through the surface of the skin and become absorbed into the body (don’t put rubbing alcohol on a baby!).

Where in the Skin Does a Tattoo Reside?

Tattoos are located within the dermis, the deeper layer of the skin. Therefore, in order to reach a tattoo, the epithelium and the tight junction between the epidermis and the dermis must be breached, and the product must traverse the dermis to reach the tattoo. There is no drug, cream, or magic fairy dust that is capable of doing this. In fact, drug companies spend billions of dollars attempting to find a way to breach the skin and deliver drugs topically (and we are still waiting for a break-through). So in order to treat a tattoo with a topical cream, there is quite a barrier to breach.

Why Do Tattoos Appear to Fade Spontaneously?

Ask a tattoo artist or the lay public and you’ll get various answers to this question. Proposed mechanisms include chemical instability of the tattoo ink causing it to chemically break down under ultraviolet rays from the sun or migrations of the tattoo ink in the skin over time. But there is another mechanism that causes tattoos to fade that nearly no one knows about and is seldom mentioned: skin textural changes.

When I was practicing emergency medicine as a physician in Dallas, TX, I had the misfortune of having to care for a great many patients who suffered serious burns. In one unfortunate case, some lunatic ran around Dallas throwing gasoline on random pedestrians and setting them on fire. One such victim suffered severe burns covering much of his back. Interestingly, the patient had a large back-piece tattoo of a jaguar. The skin overlying the left half of the tattoo was not burned and the tattoo looked like a old tattoo; the blacks looked like a washed-out greenish grey color, the lines were blurry and indistinct, and the most of the colors appeared faded and without luster. However, the right half of the tattoo had the entire epithelium burned away and the surface of the skin was hanging from the patient’s back like an apron, exposing the raw dermis underneath. Amazingly, the tattoo without the overlying epithelium was beautiful and the blacks were as black as coal, the lines were sharp and distinct, and the colors were vibrant. It looked like a brand new tattoo. I saw similar patterns in patients who were thrown off their motorcycles who weren’t wearing leather who lost their epithelial layers overlying their tattoos.

It turns out the fading of tattoos isn’t usually a problem with the ink breaking down or migrating but rather subtle textural changes in the skin surface. When our tattoos are young (or our skin is young) light passes through the upper layer without much scattering. This light then reflects off the tattoo in the dermis uniformly and consequently the tattoo looks as intended. When our skin ages, the surface becomes more irregular and light scatters. This scattering effect of the skin surface causes not only the tattoo to appear blurry (as if the ink was migrating) but actually can cause the illusion of color changes through a process known as the Tyndall Effect. So thickening or textural changes of the skin surface may be a greater factor in the appearance of tattoo fading that the ink itself. For more information about how tattoos appear to change color through skin changes, read this interesting article: Why Do Cosmetic Tattoos Change Color?/

What’s in Topical Tattoo Removal creams

Tattoo removal creams used to contain all kinds of terrible things like topical acids that could eat away the surface of the skin. There were some terrible problems associated with the use of these types of materials and the FDA sent warning letters to companies involved with products that burned the skin with acids. Consequently, most tattoo removal creams contain a cocktail of plant materials. If you read the ingredient list of one of the most widely pushed tattoo removal creams on the market, you will find that it contains about 20 different plant ingredients. It is impossible for any of these tattoo removal creams or their materials to penetrate through all the layers of the skin and actually remove a tattoo but that doesn’t stop lots of people from buying these products in a misguided attempt to remove their tattoos.

Sample Ingredients from a Common Tattoo Removal Cream:

Aloe Barbadensis Leaf Juice, Anthemis Nobilis Flower Extract, Butyrospermum Parkii(Shea Butter), Ceteareth-20, Cetearyl Alcohol, Citrus Medica Limonum(Lemon) Peel Oil, Dihydroxyacetone, Dimethicone, DMDM Hydantoin, Epilobium Angustifolium Extract, Eugenica Caryophyllus(Clove) Flower Oil, Glycerin, Glyceryl Stearate SE, Glycine Soja(Soybean) Oil, Iron Oxides, Isopropyl Myristate, Juglans Regia(Walnut) Shell Powder, Lavandula Angustifolia(Lavender) Oil, Melaleuca Alternifolia(Tea Tree) Leaf Oil, Methylparaben, Mineral Oil, Petrolatum, Phyllanthus Emblica Fruit (Indian Gooseberry) Extract, Polysorbate20, Propylene Glycol, Propylparaben Rosemarinus Officinalis(Rosemary) Leaf Oil, Salicylic Acid, SD Alcohol 40-B, Silica, Talc, Theobroma Cacao (Cocoa) Seed Butter, Titanium Dioxide, Tocopheryl Acetate, Water

So what’s with all these plant ingredients? It’s a interesting trick; with so many plant allergens in the mix (as well as formaldehyde-releasing preservatives) there is a high likelihood that a user of the product will develop a contact dermatitis reaction (a form of allergy to topical materials, similar to the reaction to poison ivy). This inflammatory reaction predictably causes textural changes of the skin which creates the illusion that the tattoo is fading. However, these products still do nothing in the way of actually removing the tattoo and we have yet to see a case of someone with a tattoo removal success in using these products.

Laser Tattoo Removal

Now that you understand skin anatomy and its remarkable resistance to topical products, you can understand why laser makes sense. Intense laser light can pass through the layers of the skin and reach the tattoo ink in the dermis where it can smash up the tattoo ink and stimulate its removal by the immune system. This process takes time and patience but the long term results can be excellent. Please don’t become the next sucker to buy an ineffective tattoo removal cream. Schedule a free consult and learn more about how we can remove your tattoo!