Dr. Hubert studied medicine at Cornell University and is a practising dermatologist in the USA. He has more than 20 years of clinical experience in medical and surgical dermatology.
He takes us through the 20 questions you should ask before you go ahead with laser tattoo removal. These questions should help you understand the treatments and removal process generally, as well as a way to sense check you’re getting the best possible expertise, with the best possible technology. If you’re not sure where to begin, take a look at our guides before you dive in.
1. What results can I achieve?
It’s always best to ask this up front. Not all technology will give you the results you want - whether that’s to fade your ink for a new tattoo, or remove it altogether. Make sure you check whether your tattoo can be removed entirely given its type and colour, as well as your skin type. Different lasers have different levels of effectiveness - you can read more about the most effective tattoo removal here.
2. What are the possible side effects?
Your side effects really depend on the technology being used (as well as your skin colour, and how much training and experience your laser technician has). Pain, bleeding, scarring, discolouration and infection are all potential side effects - but their likelihood depends on several variables. Higher energy lasers can cause bleeding and scarring, while modern, lower energy lasers generally don’t cause side effects.
3. What kind of laser do you use?
While you are not expected to be an expert in the specifications and physics of the laser device, it is important that the laser technician uses the latest technology - the faster, lower energy technology tends to be much more effective.
4. Is the technology being used FDA or CE approved?
Not all laser devices have passed regulatory testing, which means their safety and effectiveness are not guaranteed - so this is a really important question to ask. Unfortunately there are knock offs out there, which can really damage the skin. If the price seems too good to be true - it often is, and it’s often because the technology being used hasn’t been through all of the regulatory steps. If you’re in the UK, that’s the CE mark, if you’re in the US, that’s FDA approval.
5. Does your laser treat all the colours in my tattoo?
Not all lasers are made equal. And the majority won't treat coloured ink. Certain colours respond better with certain lasers, so it’s worth asking this question to sense check you’re going to get the best results. Although some clinics have more than one laser, the vast majority just have one system - so make sure that system is going to be able to remove your ink effectively.
6. How many laser tattoo removal procedures has the clinic performed?
Many clinics who offer laser tattoo removal offer lots of other aesthetic treatments too - for instance injectables, dermabrasion or laser hair removal. This means the laser technician treating you may not have lots of experience with laser tattoo removal specifically. Experience and knowledge is important in any procedure that can have serious side effects and which involves complex equipment, so make sure you’re confident the clinic in question has lots of experience with successful ink removal.
7. Who will be performing the tattoo removal treatments?
Similarly, check the person treating you is a trained, certified and experienced laser operator. They may have more experience in other treatments, and may be less confident with laser tattoo removal. In the UK, your technician should have an NVQ level 3 for Beauty Therapy and have also completed CPD (Continued Professional Development) for a minimum of 3 days.
8. Is the treatment painful, and what can you do to make it less painful?
Pain really varies from person to person, but also depending on the kind of laser device being used. Lower energy devices tend to cause significantly less pain than those which use higher levels of energy. It’s worth having a conversation with your laser technician about pain management. Sometimes Cryo Therapy cooling devices are used to prevent excessive heat (this tends to be the best way to manage any pain) while other times topical or injectable anesthesia can be used.
9. How long is each treatment session?
An individual treatment session will last from a few minutes to an hour, depending on the size of the tattoo and the specifics of the laser, and also whether your laser technician can pass over your tattoo twice (this is only possible with low energy laser tattoo removal like the technology at NAAMA).
10. How many treatment sessions will be required to remove the tattoo?
There’s a lot of different factors which determine how long tattoo removal will take. The characteristics of the tattoo are important, but as are the technology being used. Generally, it can range from just 4 visits, to over 20 sessions. Remember, it's important to take into account how quickly you can come back for each session - this massively varies depending on the laser used. You can read more about that here.
11. How long between treatment sessions?
Some lasers require 6-8 weeks between treatments, while more advanced lasers only need 1 week between sessions. Clearly this really impacts your overall removal timeline, so make sure you ask the question before you go ahead. (And remember, the reason some technology requires such a long wait between sessions is because that's the time needed for your damaged skin to recover - which isn't ideal!)
12. How do I prepare for tattoo removal?
One of the most important things you can do before getting laser tattoo removal is to avoid sunlight and tanning on the area. This can interfere with the laser energy, making the treatment less effective. It can damage your skin too, sometimes causing hypopigmentation or hyperpigmentation. Check out our post on aftercare here.
13. How should I take care of my skin after a laser treatment?
In addition to sun avoidance and being very diligent with sunscreen, often topical ointments are recommended to facilitate healing. Reputable clinics will include these creams within the treatment cost. It’s also generally important to look after yourself - your immune system is going to be working hard to process your ink, so it’s wise to eat well, exercise and get lots of sleep.
14. How will you monitor my progress?
Baseline pictures prior to treatment should be captured, so that progress can be compared to the untreated tattoo. Top clinics will use dermoscopy, which magnifies the skin, to take photos of the tattoo, so that the ink removal can be very closely monitored - so look out for this and ask ahead.
15. What will you do if my skin doesn't react well to treatment?
Every person and every tattoo is unique, so everyone reacts differently to treatment. If your skin reacts negatively, it could be that laser tattoo removal just isn't right for you, or that you need some more time for skin recovery between sessions. Reputable clinics will monitor progress closely, and iterate your treatment plan as you go, perhaps switching up the lasers being used, the treatment protocol, and your prescribed aftercare.
16. Does smoking affect tattoo removal?
In addition to the many well-documented negative health effects of smoking, there is evidence that smokers heal more slowly, and this can make tattoo removal more challenging. It is strongly you stop smoking prior to your first treatment, and for the duration of the removal process.
17. How much will it cost to treat my tattoo?
We offer a number of different pricing options. You can look at a full pricing table here.
18. Do tattoo removal creams work?
Generally tattoo removal creams do not work. There are no FDA approved tattoo removal creams because these creams can be unsafe, ineffective, and can cause long term damage to the skin. So be careful!
19. Can I get another tattoo in the same area once the treatment is complete?
This depends on whether you have any damage to the skin after being treated. Laser tattoo removal technology has advanced hugely in recent times, so it is now very much possible to have a new tattoo over the treated skin, as well as have your ink faded for a cover up tattoo. If this is your aim, it’s better to go for the most advanced technology available, to limit the risk of any skin damage.
20. Will the treatment be covered by my insurance?
Tattoo removal is considered a cosmetic procedure and is generally not covered by insurance. In the UK, the NHS suggest there are some circumstances in which tattoo removal is covered.