Tattoo Remorse - Better Think Before You Ink
Written by Maria Gaura
SANTA CRUZ (October 2009) - Tattoos have waxed and waned in popularity over the centuries, but the current craze for body ink took off in the late 1980s, and Harvard dermatology professor Richard Rox Anderson, M.D., often wonders if he was partially responsible.
Anderson developed the modern tattoo-removal laser in the late 1980s, a technology shift he suspects touched off the tattoo tsunami.
“The popularity of tattooing soared in the US shortly after laser tattoo removal was commercialized,” Anderson said. “Nobody knows exactly why. (But in) my opinion, one of the deterrents to getting a tattoo – its permanence – was removed in the public’s collective mind.”
If the possibility of easy removal kick-started the tattoo trend, celebrity role models and reality TV shows have since driven tattoos from a fringe activity to near-ubiquity. An estimated 40 million American adults now sport at least one tattoo, as do more than a third of Americans between the ages of 25 and 29.
ACRES OF DAMAGED SKIN
Unfortunately, as Anderson and many other dermatology professionals expected, the tattoo trend has left acres of damaged skin in its wake. An estimated seven million Americans now have tattoos they wish they could erase but, due to economic barriers, most probably never will.
Far from being a high-tech magic wand, laser skin surgery can be a painful, lengthy process - and prohibitively expensive. As an added complication, tattoos are trending larger and more brightly inked, making them increasingly difficult and costly to remove.
“You can get a tattoo for $30, and end up spending thousands of dollars getting it removed,” said Zuzana Likar, R.N., a tattoo removal expert who works for William H. Brown III, M.D., with clinics in Palo Alto, Fremont and Monterey. “Green and turquoise inks are really hard to remove, and the big tattoos, like the ones you see on reality (TV) shows like LA Ink, are a nightmare.”
MEANT TO BE PERMANENT
To create a tattoo, ink is repeatedly jabbed deep into the skin, below the epidermal layer that constantly sheds and renews itself. The ink is absorbed into the dermal cells where, if undisturbed, it stays pretty much permanently.
Before modern lasers were introduced, tattoo removal was a far more desperate undertaking. Small tattoos could be cut out and the skin stitched together. Larger tattoos could be scraped away, and replaced with a skin graft.
Earlier generations of lasers were damaging to skin, leaving burns and scars where the ink had been.
COLORED INK VS COLORED LIGHT
But in 1981, Dr. Anderson conceived the theory of “selective photothermolysis,” which explained how different-colored lasers could be used to superheat colored particles deep within the skin, without damaging much of the surrounding tissue.
When a burst of laser light of the correct wavelength is aimed at a dot of tattoo ink, the ink particles absorb the light and are instantly heated to temperatures greater than 300 degrees Centigrade. The cell cytoplasm boils, bursts, and sprays the remaining fragments of tattoo ink into the surrounding tissue.
Some of the ink fragments are carried away by the body’s lymphatic system, some rise to the skin surface and are shed in the crust or scab. Some ink remains in the dermis, and is reabsorbed by surrounding skin cells, which explains why a healing cycle and repeated laser treatments are needed to completely erase a tattoo.
Interestingly, homemade tattoos and those improvised in prison, using India ink, charcoal and graphite, are easier to remove than professionally-applied tattoos.
That is because the carbon in India ink and charcoal simply burns when exposed to extreme heat. Home-applied gang tattoos can vanish with two or three laser sessions, Likar said, compared with five to 12 sessions needed for professional tattoos.
COSTLY TECHNOLOGY
Unfortunately for those marked with an unwanted tattoo, this technology doesn’t come cheap. While a complete tattoo kit can cost as little as $99, a modern medical laser costs around $120,000. A single treatment session for a large, colorful or densely-inked tattoo can cost as much as $1,000, and complete removal requires multiple sessions spaced six to eight weeks apart.
Adding to the disincentives, laser treatment hurts. “It’s like frying something, and getting splattered with hot oil,” said Likar. “It’s way more painful than getting the tattoo in the first place.
“We can use numbing crème or injectible Lidocaine,” Likar said. “But if we’re dealing with a whole arm or back, there’s a limit to using Lidocaine, because it’s toxic to the heart.”
And fancy technology doesn’t guarantee unblemished skin. Sometimes a shadow or outline of the tattoo remains even after the ink is gone. Sometimes the tattoo itself causes scarring.
“The tattoo surface is sometimes higher than the surrounding skin, like a layer of plastic,” Likar said. “The insult to the skin from the tattoo makes a scar right under the color, and you’ll still have those elevations after the color is removed.”
FEW LOCAL OPTIONS
In Santa Cruz the options for tattoo removal are limited. It costs $100 just to get an estimate of tattoo removal costs at the Palo Alto Medical Foundation’s dermatology clinic in Soquel, and removal is not covered by medical insurance.
And the very-low-cost tattoo removal clinic offered by Dominican Hospital is limited to removing visible gang tattoos from former gangsters.
Dominican charges a token $10 fee per laser session, and requires community service, drug and alcohol rehab, and a break from gang life. But that doesn’t deter pleas from people desperate to shed non-gang tattoos.
“I get the calls every spring from women who want their bikini line done, so they can look good at the beach,” said Sister Maureen Keeler, who administers the Domincan program. “I tell them they can go see the dermatologist and pay $500 per session if they want it removed. This is an outreach program for people who want to change their lives.”
WORKPLACE PROBLEMS
Decorative tattoos and piercings can cause career or relationship problems. But gang tattoos on the hands, face and neck are a barrier to normal employment.
“Society is changing, and tattoos are more acceptable in a lot of workplaces,” said Bobbi LaPlante, a human resources specialist with decades of experience in Silicon Valley. “But nobody wants to deal with gang tattoos. Even if you’d like to cut the person a break, all of their co-workers are going to be terrified about workplace violence.”
Founded 12 years ago by a coalition of law enforcement, doctors, businesses and social workers, the Dominican tattoo removal program has erased gang markings from nearly 1,000 former gang members, prisoners, and kids who made really dumb choices.
“I’ve had kids who got the gang dots on their hands just so they’d look like they were in a gang,” said Vickie Powell, an original founder of the TagAway tattoo removal program, which now raises money for the Dominican Tattoo Removal Program.
“I had one kid from the Youth Authority show up with the F-word tattooed across his forehead,” Powell said. “Really stupid stuff.”
More recently, Powell was at a local restaurant when a young female employee bent over, exposing gang tattoos on both of her breasts.
“I asked if she’d thought of getting them removed, and she said “If I had $5,000 to take them off I’d do it,” but she was working for low wages, and she had a child.” Powell said. “When I said we could help her out, she started crying.”
TATTOO REMORSE
Santa Cruz dermatologist and TagAway founder Morgan Magid, M.D., who volunteers as medical director of Dominican’s removal program, believes most people eventually wish they hadn’t gotten a tattoo.
“We all change as we go through life, and having something forever on our skin often serves as a negative reminder of who we were, but are not now,” Magid said.
Researchers are now working on easily-removable and non-toxic tattoo inks, Magid noted. But until ‘disappearing ink’ is available, anyone seeking a tattoo should keep in mind that red ink is the most likely to cause a reaction in the skin, and green inks are the hardest to remove.
“Skin on the back, chest and shoulders is more likely to scar than other areas,” Magid said. “And more darkly-skinned people are more likely to form thickened or keloid scars.”
YOU’RE GOING TO SEE IT EVERY DAY
Anyone considering engraving the name of a lover on their skin should consider the high divorce rate – removal of a name is the most common reason behind tattoo removal.
Keep in mind that fashions change rapidly. Would you want to wear a Betty Boop t-shirt every day? For the rest of your life? If not, you might choose another image for your tattoo.
If the tattoo you want is X-rated, consider how you’ll feel showing it to your children someday – another common reason for tattoo removal.
And the cardinal rule with tattoos – it’s not an impulse buy.
“I had a woman recently who came back from Anaheim with Mickey Mouse tattooed on her shoulder,” said Likar. “She regretted it right away.”
Set as favorite
Bookmark
Email this
Trackback(0)
TrackBack URI for this entryComments
(2)
Subscribe to this comment's feed
written by Maria , May 25, 2011
yes, aging skin is another big disincentive! Try drawing your proposed tattoo on a balloon first, then gradually let the air out, to get an idea of your tattoo in a decade or two ... :
Votes: +0
report abuse
vote down
vote up
