Tat Removal

I’m not too many years shy of 40, and the anchor tattoo on my ankle has been with me since I was 21. The guy and that ship sailed many years ago, and I’ve reached a point in my life where I’m no longer interested in an ankle-based conversation piece.

Michael Speaker, clinic manager at Tattoo Laser Removal Clinic overlooking Mission Bay (858-272-2021; trlaser.com), told me that people have tattoos removed for all sorts of reasons. “Hand tattoos are popular candidates for removal; people call them ‘job stoppers.’ Every time you put your hand out, you’ve got whatever it might be showing on top of your hand, and it could cost you a job. Sleeve tattoos, which run all the way from the shoulder to the wrist, are becoming more popular for taking off — people get into a working profession like the police department. Or maybe you’re just at the point where you want to be able to see yourself in a cocktail dress without a scorpion on your shoulder.” And sometimes, people don’t want to be tattoo-free; they just want a change of scenery. “They come to us, and we fade the tattoo they have so it can be covered up with a different tattoo and not show through.”

Removal is a process, said Speaker, and it starts with a consultation. “We tell the patient, in realistic terms, what we can and cannot do. We’ll discuss your health history and look for immune deficiencies. We use a state-of-the-art-laser, which breaks down the tattoo ink into tiny particles. Then your body takes the ink away. The closer the tattoo is to your heart, the better the circulation, so the lower down the tattoo is on your body, the harder it is to work on. If you have a name on your chest and another on your ankle, I guarantee the name on your chest will come off quicker.”

Skin tones can also present difficulties. “The laser removes color. We can work on a lot of ethnic skin — Spanish, Filipino, Korean — but we cannot do African-American skin. There are two problems: one, you end up with a white or pinkish spot where the tattoo was; two, the possibility of keloids, which is a type of scarring specific to African Americans.” Among colors, “red and black are the easiest to remove, while green and sky blue are the most challenging.” And sometimes the ink itself is problematic. “We’re running up against chrome tattoos that glow in the dark. When a laser comes in contact with ink that has a metallic base, it can actually turn it darker. Before we do any treatment, we’ll test the ink. We can usually still get it off, but it’s going to take much longer. And if I find it’s unworkable ink, I’ll refer the patient to a good cosmetic ink person. They have a removal technique where they perforate the skin to leach out some of the ink. The laser is the gold standard, but if it’s not going to work, it’s good to give people another option.”

Speaker lets the patient know that “when you’re doing tattoo removal, time is your friend. Most tattoo removals require between five and ten treatments, though we’ve had plenty that came off quicker. Each time we work on your tattoo, it’s going to fade, but we recommend a minimum of 6 weeks between each treatment, and most of the time, 8 to 12 weeks. The area needs time to heal between sessions. So, it typically takes about a year to a year and a half to get the majority of tattoos off. Someone else might be willing to use a really powerful laser and take your tattoo off in fewer treatments, but you can get a ghost image of where the tattoo used to be.”

On the matter of price, “We look at a tattoo, figure out how much time it will take and what’s involved, and price it accordingly. Treatments are going to range from $250 to $850. But if you’re going to need more than five treatments, we’ll reduce the price after the fifth, as a good-faith gesture. We’re trying to get your tattoo off as quickly as we can.”

Next come the sessions themselves. “Often, we apply a topical numbing agent — which looks like hair gel — two hours before the treatment. The patient can take off during that time; we suggest that they eat something. The topical gel reduces your pain by about 60 percent. We also use a modified Zimmer C6 Cryo cooler, which blows cool air on the tattoo while we’re working on it.” For small tattoos, the nurse practitioner might kill the pain with an injection of lidocaine. “We use that only for small tattoos, because too much lidocaine can make the patient antsy. But if we do use it, you won’t feel a thing.” The experience varies person to person, said Speaker. “Plenty of people laugh and communicate, but some are more concerned. The pain is generally no greater than it was getting the tattoo; except when you get the tattoo, you feel a more lingering, vibrating effect that you get used to. For the laser, getting snapped with a rubber band is a good analogy. But we haven’t had any trouble with someone not being able to get through the removal.”

Sessions are scheduled for one-hour periods. “We really take our time. Patricia Rubin, our laser operator, is a nurse practitioner who is board certified in dermatology, and she’s very thorough. She doesn’t go back and forth like an Etch-a-Sketch; she actually traces out the tattoo as it was put on you. And the Q-Switched Nd:YAG laser that we use doesn’t put out as much heat as other lasers — too much heat can cause scarring or lightening of the skin.” And after each session, “we provide a customized home-care kit for the patient, things like antibiotic ointment and nonstick bandages.”