Tattoo Removal

Abstract

Over 50,000 new tattoos are placed each year in the United States. Studies estimate that 24% of American college students have tattoos and 10% of male American adults have a tattoo. The rising popularity of tattoos has spurred a corresponding increase in tattoo removal. Not all tattoos are placed intentionally or for aesthetic reasons though. Traumatic tattoos due to unintentional penetration of exogenous pigments can also occur, as well as the placement of medical tattoos to mark treatment boundaries, for example in radiation therapy. Protocols for tattoo removal have evolved over history. The first evidence of tattoo removal attempts was found in Egyptian mummies, dated to have lived 4,000 years BC. Ancient Greek writings describe tattoo removal with salt abrasion or with a paste containing cloves of white garlic mixed with Alexandrian cantharidin. With the advent of Q-switched lasers in the late 1960s, the outcomes of tattoo removal changed radically. In addition to their selective absorption by the pigment, the extremely short pulse duration of Q-switched lasers has made them the gold standard for tattoo removal.

Adolescent and Young Adult Tattooing, Piercing, and Scarification

“…Not all tattoos are placed intentionally; penetration of exogenous pigments can occur from road dirt from an accident, graphite in pencils, or gunpowder, and many people may want these unintentional tattoos removed. 44 Adolescents may overestimate the effectiveness of tattoo removal when having one placed and should be instructed that tattoo placement is permanent, and it is expensive and sometimes difficult to remove them. 3 Tattoo removal techniques can be categorized as mechanical, chemical, ablative, and selective.…”

“…3 Tattoo removal techniques can be categorized as mechanical, chemical, ablative, and selective. 44 "Q-switched" lasers are the current state-of-the-art tattoo removal method. The laser wavelength is adjusted to match the absorption pattern of the different color pigments.…”

“…Longer intervals may reduce the risk of permanent pigmentary changes to the skin. 44,45 It is important to have the requisite training in the use of the Q-switched laser for tattoo removal; the literature notes case reports of significant burns within tattoos after treatment, leading to scarring and poor outcomes. 46 In one case described in a report, the patient elected to have another tattoo placed to hide the burned area.…”

“…46 In one case described in a report, the patient elected to have another tattoo placed to hide the burned area. 47 Other 44 Although laser removal may be the best way to remove a tattoo, the time, needed treatments, and cost should not be underestimated. One case report noted a 29 year old patient with 2 large, multicolored tattoos on his arms and chest who presented for removal.…”

Identifying and describing a cohort effect in the national database of reported cases of hepatitis C virus infection in Canada (1991-2010): an age-period-cohort analysis

“…A systematic review and meta-analysis of tattooing and risk of Original reported rates of HCV infection were transformed as follows: 43 Ten to 16% of youth (12−18 years old) and 3%−10% of the general population reported having permanent tattoos, 44 and an estimated 50 000 new tattoos are being done every year in the US. 45 In Canada, 10%−12% of Enhanced Street Youth Surveillance respondents reported having a tattoo (Surveillance and Epidemiology Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, unpublished data, 2012). Although it has a low probability of transmission, sexual transmission of HCV infection has been documented in people who have multiple sexual partners 46 and who are co-infected with sexually transmitted infections.…”