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Want to get rid of that old tattoo?

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It seems that tattoos are everywhere these days, but along with the increase in people getting inked, the number of people undergoing procedures to have a tattoo removed is also on the rise, experts say.

The US Food and Drug Administration, which regulates both tattoo inks and the laser devices used to remove the body art, cautioned that deciding to have a tattoo removed is a lot easier than the removal process itself. The experts advised that tattoo removal is a painstaking process and the result may not be perfect.

A January 2012 poll by Harris Interactive showed that of the 21% of American adults who have a tattoo, 14% regret their decision to get one. This research may come as no surprise to the American Society for Dermatologic Surgery, which reports that its doctors performed nearly 100 000 tattoo removal procedures last year, an increase of 14 000 from 2010.

Removing ink not that easy

Although more Americans are taking steps to remove their tattoos, the FDA noted that removing tattoo ink is easier said than done. The agency explained that when a tattoo is created, an electrically powered machine injects ink past the outer layer of skin into the dermis, or the second layer of skin. Dermis cells are more stable so the ink placed there will be permanent.

Safe tattoo removal requires laser surgery performed by a dermatologist who specializes in tattoo removal, said the FDA's Mehmet Kosoglu, who reviews applications for marketing clearances of laser-devices. The lasers emit concentrated light energy in short bursts, which is absorbed into the pigment. The lasers then break the pigment apart into smaller particles, which are metabolised, stored or excreted by the body.

Several types of lasers have been FDA-approved as light-based, prescription devices to lighten or remove tattoos, including a laser workstation marketed by a Massachusetts-based company to remove both tattoos and benign skin lesions.

Complete removal not always possible

The procedure, which uses pulsed lasers that emit concentrated light energy in short bursts, complies with FDA requirements for safety and effectiveness and has been used in tattoo removal for the past two decades. The entire process takes time and the results may not be perfect.

FDA experts pointed out various colors of ink absorb different wavelengths of light, so tattoos with more than one color may need more than one type of laser. They noted that lighter colors, such as green, red and yellow, are harder to remove than dark colours, such as blue or black.

From start to finish, tattoo removal typically requires six to 10 treatments, depending on its size and colors. A few weeks of healing time is required between treatments, the FDA added.

"Complete removal, with no scarring, is sometimes not possible," Kosoglu said in an FDA news release.

The pain involved in the process of laser tattoo removal varies from person to person. The sensation involved has been compared to being spattered with drops of hot bacon grease or being snapped with a rubber band. The treatment can also be adjusted depending on a patient's comfort level.

How the skin will react after procedure

The FDA said laser devices are cleared for use by, or under the supervision of, a health care professional who understands which laser to use, how skin will react and how to treat the skin after the procedure.

"If you have any concerns about having a tattoo removed, it's a good idea to consult your dermatologist, who is knowledgeable about laser treatments," FDA dermatologist Dr Markham Luke said in the news release.

Dermabrasion, or "sanding" away the top layer of skin, cutting away the tattoo and sewing the skin back together, is another FDA-approved method of tattoo removal. The safety and effectiveness of tattoo-removal ointments and creams that you can buy online, however, has not been confirmed.

"The FDA has not approved them, and is not aware of any clinical evidence that they work," Luke said. He noted that these products may actually cause skin reactions, such as rashes, burning, scarring or changes in skin pigmentation.

The FDA report was published online on the agency's Consumer Updates page.

More information

The US Centers for Disease Control and Prevention provides more information on the risks associated with tattoos.

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