Removals increase as tattoo popularity rises 

Lasers produce the best results

Tattoos are no longer associated only with gang members and musicians or actors. While tattoos have less of a stigma than in the past, experts interviewed by Same-Day Surgery say that they continue to see an increase in their tattoo removal business.

"While the number of requests for tattoo removal don’t correspond to the increasing number of people with tattoos, we do see a steady, slow increase in the numbers of people asking for removals," notes Brian Zelickson, MD, medical director of the Abbott Northwestern Laser Center in Edina, MN.

There is no typical tattoo removal patient, he adds. "Age and gender are all across the board. I’m removing new and old tattoos on people in their early 20s and in their 60s," Zelickson says.

Roy G. Geronemus, MD, director of the Laser & Skin Surgery Center of New York and a clinical professor of dermatology at New York University Medical Center, both in New York City, says, "I see more young people in their early 20s for tattoo removal because young professionals believe that their college tattoo doesn’t fit in with their new career, and young mothers don’t want their children to see their tattoos and think that they’re acceptable."

The three most common methods for tattoo removal are laser surgery, dermabrasion, and surgical excision, with laser surgery as the process recommended by most dermatologic surgeons, he says.

"If the surgeon uses the appropriate laser for the tattoo, lasers are efficient, effective ways to remove the tattoo," Geronemus adds. In fact, the use of lasers for tattoo removal increased by 27% between 2001 and 2003, according to the American Society for Dermatologic Surgery in Rolling Meadows, IL.

Lasers most often used for tattoo removal are the Q-switched ruby laser, which works well on green but not red inks, and the Q-switched neodymium YAG and the Q-switched alexandrite lasers, which remove green but not red inks, says Geronemus.

Tattoo removal with lasers does require several treatments and is painful, Zelickson points out. "Laser treatments also may not be able to remove all of the pigment," he adds. The easiest tattoos to remove are amateur tattoos that are black ink line drawings and are close to the heart, he adds. "The better the blood circulation in the area, the better the results," he says.

The advantage of laser removal over other methods is that scarring is minimal, Zelickson says. "Surgical excision and dermabrasion do leave scars, but surgical excision does get all of the pigment," he explains.

Complications from laser tattoo removal are not common but can include a discoloration in which the pigment turns black and cannot be removed, Zelickson adds. Occasionally, the laser treatment triggers an allergic reaction to the pigment in the patient, he says.

Tattoo removal is an elective procedure, so patients are paying out of their own pockets, says Geronemus. Costs for tattoo removal vary widely according to the number of pigments used in the tattoo and the number of treatments required for removal, he adds. The typical cost for one laser treatment for tattoo removal is $400 to $600, he says.

Abbott Northwestern Hospital participates in a tattoo removal program for gang members and does not charge for the removal, Zelickson points out. "It is part of an overall rehabilitation program in which several hospitals participate. As the gang member removes himself or herself from the gang culture, the physical sign of gang involvement, the tattoo, is removed," he explains.

Zelickson says that because tattoo removal is a growing service, same-day surgery managers need to be sure that patients are well-educated prior to the procedure.

"Make sure patients understand the disadvantages and advantages of each option for tattoo removal and make sure the patient’s expectations are realistic," he notes. "Treatments can be painful and may not remove 100% of the tattoo, and patients need to understand this before they begin treatment."


For more about tattoo removal, contact:

  • Roy G. Geronemus, MD, Director, Laser & Skin Surgery Center of New York, 317 E. 34th St., New York, NY 10016. Phone: (212) 686-7306. Web:
  • Brian Zelickson, MD, Medical Director, Abbott Northwestern Hospital Laser Center, 4100 W. 50th St., Edina, MN 55424. Phone: (952) 929-8888.