01 Sep 2011
By J.R. Wu
As an example of tattoo removal, it is one of the simplest. In the early 1990s, American actor Johnny Depp broke up with then-girlfriend actress Winona Ryder. What once read ‘Winona Forever’ on his bicep was stripped of the ‘na’ and his tattoo now reads - Wino Forever.
But when the relationship goes bust, what happens to that impulsive idea to flaunt her name on your bicep or his name on your ankle?
Hands down, the method of choice to get a tattoo removed is laser technology. It targets the tattoo pigment. It is non invasive. It beats the don’t-try-this-at-home, do-it-yourself ways of sanding or chemically burning the skin. But even with advanced technology, getting rid of the ink isn’t easy.
“A laser in the wrong hands where you crank up the power…can burn the patient and then cause horrific scarring,” said Professor Colin Song, Senior Consultant and Head, Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital. “It’s got to be in the hands of the people who are educated to use this and trained to use these lasers.”
There is also the fact that patients can never erase the past completely.
“No matter how good your laser technology is, there will always be a silhouette of the tattoo,” Prof Song said.
Romance gone wrong aside, other reasons in multi-ethnic Singapore for getting a tattoo removed are religion, parental objection, and, sometimes, for the sake of a job.
A traditionalist girlfriend asks her beau to remove his tattoo because some faiths believe tattoos desecrate the body. Parents get upset when they discover their child sporting a tattoo done in stealth and under peer pressure to be cool. Jobseekers fret that their body art will be associated with old stigmas like gangs and prison.
Prof Song has dealt with young patients coming to him after they’ve tried cruder home remedies such as attempting to sand off their tattoo with salt or using acid to erase the ink, leaving the patient’s arm looking like an unpeeled potato. In such cases, he said, treatment is for a burn rather than removing a tattoo.
“In the old days you used to swap a tattoo for a scar. Nowadays we can lighten your tattoo without incurring a scar, provided of course you use the laser technology judiciously,” said Prof Song.
Simply put, a very short pulsed light laser is calibrated to a certain wavelength on the colour spectrum that complements the tattoo colour being targeted. The laser light is absorbed by the tattoo, the tattoo pigment fragments under the laser’s effect, and the immune system’s natural processes remove the fragments from the skin.
How completely a tattoo can be removed depends on the tattoo – its colour, age, size and location – and the number of treatments the patient undergoes. The patient’s own skin condition and health matter too. Asians tend to produce more melanin, which is responsible for skin colour, so that means the silhouette of a tattoo that has been removed could stand out more than if it was done on a lighter skinned individual.
Colourful tattoos mean a more painstaking removal process since each colour area will need a different laser calibration. Also, the laser needs to penetrate the skin only as deep as the tattoo pigmentation goes. If the laser beam is too weak, the tattoo colour won’t fragment and the ink won’t disappear. If it is too powerful, it can burn or damage surrounding, healthy tissue.
And it hurts. It can feel like needle pricks, a bad sunburn or a rubber band being snapped repeatedly against the skin.
The commercial proliferation of laser technology in tattoo removals has meant less effective, cruder methods of the past should no longer be options, such as excising the tattoo (followed by skin grafts if the area cut out is large), dermabrasion or cryosurgery where the tattoo area is frozen and then peeled off.
It also means the chance is greater of someone selling skills they don’t have. Tattoo artists don’t need a license to do their work, a laser practitioner should. Prof Song estimated 60-70 per cent of the patients who come to him to remove a tattoo don’t finish their treatment with him.
It takes multiple laser treatments that can last months to remove one tattoo. Removing a small tattoo may cost just a few hundred dollars, but larger ones covering major body areas could run into the thousands of dollars. There isn’t anything wrong with jumping doctors in the middle of treatments so long as patients stick with trained laser practitioners, Prof Song said.
“There are more people in the fray. Medical practitioners who can access a laser machine will try and use it to offer this service.
“Once you have a laser, anyone is game.”
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