At Eden Tattoo Removal we have noticed our clients are more informed today when it comes to the different laser systems available. There is the older technology Nd:YAG Q-Switched laser and also the latest picosecond laser systems. There are an increasing number of different brands of the picosecond laser systems as well. I have many articles written about each of these below. However, clients are still in the dark and often surprised by what to expect after a laser tattoo removal session. I am going to attempt to answer all your questions and give the expected outcomes from both the older Nd:YAG Q-Switched laser and the picosecond lasers.
The bottom line here is, if the clinic is not using either the Nd:YAG Q-Switched or picosecond then the clinic is not using a FDA approved laser. You could end up losing thousands of dollars or worse, be scarred for life.
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What To Expect
Immediate Post Treatment Appearance
Immediately after laser treatment (both Q-Switches and picosecond) you will notice a white frosting where the laser has made contact with the ink. There is more frosting on black ink and less or none with coloured ink. The lighter the ink, the less frosting. There will be some swelling around the area treated even if there is minimal frosting.
Q-Switched laser; very white frosting due to the increased amount of heat.
Picosecond laser; noticeable frosting but less than Q-Switched due to less heat. The area will have swelling due to the laser interaction with the tissue.
Number of Treatments Required
Even though the way a laser works is based on science, there is no absolute answer to how many treatments it takes for a tattoo to be removed. The reason is, each person’s ability to clear a tattoo is based on their body’s immune system. As each person is different, even a twin that has the same tattoo on the same area could take different times. Health, medical history, amount of ink, the part of body the tattoo is on and type of ink are just some variables.
Q-Switched laser; can take from 8-20 treatments on an average sized solid black tattoo.
Picosecond laser; can take from 3-8 treatments on the same average sized solid black tattoo.
Cost depends on the amount of ink (size) in the tattoo and the number of treatments required. The size is measured width by length which gives a cm2 cost per treatment price. As explained in the Number of Treatments Required section, you multiply this by the cost per treatment. At Eden Tattoo Removal we give discounts based on a series of treatments purchased up front and you pay no more after 10 treatments. The key point here is to be careful when just looking at a low 'per treatment' price. A low single treatment price can cost you more when you need to have a greater number treatments over 10. Not many clinics offer a maximum treatment guarantee, so you can end up paying for 15-20 treatments.
Q-Switched laser; can end up costing you the same as picosecond laser or more as you require 8-20 treatments.
Picosecond laser; normally requires half the number of treatments than the Q-Switched laser so it can cost the same or less than Q-Switched laser.
There is discomfort with laser tattoo removal. Anaesthetic cream can help with the relief of the discomfort. As a consolation, the treatment sessions are relatively quick, dependant on the size of the tattoo. The time it takes to treat an average size tattoo (the size of postcard) is 10-15 mins.
Q-Switched laser; is extremely painful because there is a large amount of heat generated. The power (fluence) used is much lower to prevent tissue damage. This is a reason many more treatments are required.
Picosecond laser; has very little to no heat generated as it is the speed of the laser that is doing the work. The laser is fired at a picosecond (trillionth of a second) thereby creating a shockwave that shatters the ink instead of heating the ink. There is very little tissue damage caused by heat. This results in less pain when compared to the same power setting on a Q-Switched laser.
Blisters are rare, however this is a sign that the body is sending the lymphatic fluids to the area. Most colour tattoos will blister more, as the coloured ink can create an allergic reaction once it has been treated. Large blisters can indicate too much energy was used on the area. Unfortunately, in some cases a person can be prone to blisters. The ideal end point is to use just enough energy that is required to shatter the ink before the area blisters. If blistering occurs, the area needs to be kept sterile by the use of second skin product like Stratamed. Avoid popping the blister as it is your epidermis swelling from the lymphatic fluid. It is sealing your tissue to prevent infection.
Q-Switched laser; produces a lot of heat so even on low fluence it can blister the treated area.
Picosecond laser; produces little or no heat so more fluence can be used, resulting in efficient clearance on the area with little chance of blistering.
Bleeding should be very rare. Some small pin-point bleeding can occur when a clinician is using aggressive settings on stubborn tattoos. Bleeding occurs when the area has been traumatised, breaking the epidermis. This can cause texture changes in the skin after the tattoo is removed.
Q-Switched laser; causes more trauma in the tissue due to the heat and bleeding is a common outcome.
Picosecond laser; can send more energy into the tattoo with less trauma and bleeding is rare.
Post-Inflammatory Hyperpigmentation (PIH)
PIH occurs when melanin is stimulated by trauma and the skin develops a brown pigmentation similar to sun spots. Darker skin types are more prone to this condition. This normally resolves itself after the area is left alone, sometimes it needs to be months. Lasers sends energy into the skin to disrupt the ink pigment so it is unavoidable to cause trauma. PIH can be stimulated after all the ink pigment has been cleared. Some people think it is ink pigment and request continued treatment. However, PIH is completely different to the ink pigment and continued treatment on cleared skin only stimulates more PIH. PIH will clear over time when left alone, just like a tan or purple marks after a acne breakout. In some cases, skin care product can help with clearing PIH. This is a normal process for some people to clear the tattoo.
Q-Switched laser; produces a lot of heat when treating a tattoo. This means PIH is very common as the area is heated and melanin is stimulated.
Picosecond laser; produces very little or next to no heat and is less likely to stimulate PIH. Darker skin types are prone to pigmentation so PIH can still occur.
Hypo-pigmentation can occur when the body’s natural pigmentation is also cleared along with the ink pigment. This is more likely when the person has a tan or is naturally darker. The laser is attracted to pigment and can’t distinguish the difference between ink pigment or melanin. The result is the whitening of the skin where the tattoo was. This will resolve itself over time and can take months or years for the body to restore the melanin in the area.
Both Q-Switched and picosecond laser; can hypo-pigment the skin. It comes down to the client ensuring they keep the tattoo out of the sun 2 weeks before treatment. Also, the operator of the laser needs to use the correct laser on the correct settings to minimise the chances of hypo-pigmentation. The laser operator may need to use less power to ensure careful removal of the tattoo.
Scarring occurs went the tissue is traumatised to the point where the healing is not consistent and hardened collagen forms on the surface of the skin or sub-dermally. This can be a result of the tissue being treated too aggressively, causing the epidermis to the dermis to be damaged or from infection. Successful tattoo removal is when the skin integrity is left intact while clearing the ink.
Q-Switched laser; is very prone to scarring as it is very heat intensive. Even if the scar is not noticeable on the surface, you can feel the area treated is more raised due to the scar being sub-dermal. This is the result of heat in the tissue. This creates a complication in the full clearance of the tattoo due to the ink getting trapped in the hardened scar tissue, becoming more difficult to fragment the ink and to move the ink through the lymphatic system.
Picosecond laser; produces very little or next to no heat so the chance of scarring is very low.
Sun exposure - before, during and after
Any tan from the sun or spray tan will increase the chances of hypo-pigmentation. You must keep the tattoo covered or use SPF50 sunscreen on the area before treating. Stay out of the sun or cover the tattoo during and 2 weeks after treatment to avoid hyper-pigmentation (darkening of the area).
This applies to both Q-Switched and picosecond lasers.
Exercise after treatment
The tissue in the area that has been treated with laser energy is under trauma. Our advice is not to exercise for 24-48 hours after the treatment. Any exercise or strenuous movement will increase blood flow and increase irritation on the area. As well, any friction from clothing can increase blisters or remove the epidermis. This can lead to scarring if infected.
This applies to both Q-Switched and picosecond lasers.
How To Achieve The Best Result
Once you understand all these potential situations, you can make a informed decision to go ahead with laser tattoo removal. Removing a tattoo is a complicated process and one cannot expect it to be a simple step. In the majority of cases, the skin can return to the same condition as before the tattoo. But you must be aware that this is not 100% of the case, as like any medical grade procedure, there can be complications. The important thing is to choose a clinic that can minimise these complications and have healthy skin integrity post treatment.
You can see the progress after each session at Eden Tattoo Removal in the sequence pictures below.
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Eden Tattoo Removal has the industry leading PicoWay picosecond laser system. It is the quickest at 300ps and has 3 true wavelengths to treat all colours and skin types. Our clinicians are the most professionally trained and give expert advice on lasers as well as your skin. When it comes to your tattoo removal, you need to trust the expert specialists.
Call 02 8020 5805 or click the booking button below for your free consultation.