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3 Big Reasons Why Your Tattoo Could Be Impossible to Remove

by Dr Wan Chee Kwang
December 10, 2022

Laser tattoo removal technology has improved tremendously. Given adequately advanced laser equipment and enough time, tattoos can mostly be removed or significantly lightened. Why, then, are some tattoos virtually impossible to remove?

In my experience, it often boils down to these 3 common stumbling blocks.

Pain During Tattoo Removal

patient crying during laser tattoo removal
The pain of laser tattoo removal can be unbearable for large tattoos

Many patients that seek laser tattoo removal aren't that worried about pain - they've already endured the tattooing process and come out stronger. Sadly, tattoo removal is exponentially more painful than getting a tattoo.

Laser tattoo removal for small tattoos is relatively quick and generally tolerable. While intense, the painful part of the process is over relatively quickly for small areas. Large tattoos, such as full sleeves or those covering large areas like the chest or thighs, take much longer and can be excruciating.

It is difficult to convey the pain involved but tattoo removal essentially involves using a powerful laser that passes through the top layers of the skin to explode the underlying tattoo pigment particles into dust. Imagine your skin getting snapped by a strong rubber band many, many times. It takes a lot of mental fortitude to endure this over the area of a large tattoo. Many patients would find the discomfort hard to tolerate, and this is a significant reason why such tattoos may not be removed successfully.

How can we overcome this problem? The most comfortable way to remove such tattoos would be to do them under general anesthesia or sedation. However, this would introduce significant additional costs for anesthetic drugs, monitoring facilities, and medical professionals (such as anesthetists and registered nurses), making the process even more expensive. Local anesthesia injections can also be used. For small tattoos, this is relatively simple. For large areas, this can be complicated, time-consuming, and costly.

Cost Of Removing Tattoos

hand tattoo with a money design
The price of removing this tattoo carefully and thoroughly with no scarring may exceed the value of depicted cash rolls.

Speaking of cost, money is another significant reason why your tattoo may be impossible to remove. When we consider the cost of laser tattoo removal in Singapore, it is important to look at the overall cost rather than overly emphasize looking for the clinic that charges the least for each session. More advanced and meticulous methods with powerful new lasers invariably cost more.

Laser energy is output from the laser machine in the form of a laser beam which is then moved across the entire tattoo. More superficial layers of tattoo ink would be broken up in the earlier sessions. In later sessions, the tattoo pigments are deeper in the skin and more difficult to remove. As the laser beam passes through a thicker layer of overlying skin to reach the deeper remnant tattoo ink, it loses power due to scattering and absorption.

In order to have adequate power delivery at the point of laser-tattoo interaction, we would have to increase the intensity of the laser energy within the laser beam so that enough power is able to reach the deep layers of the tattoo. As each laser has a maximum rated power output, the diameter of the laser spot would have to be reduced accordingly to concentrate the laser energy. A smaller spot size would take longer to cover the same surface area and the later sessions would usually take much longer to do than the initial sessions.

Large tattoos are thus very tedious and laborious to laser off and doctors tend to charge accordingly. This drives up the cost of each session of tattoo removal significantly, well beyond the reach of most patients.

Of course, we could simply run the laser through the tattoo quickly with a large spot size. It would be much faster to do and we can charge less per session. However, that will also result in less tattoo breakdown per session. You will end up requiring more sessions with an overall higher price.

Scarring After Tattoo Removal

keloid scarring in a thai lady after amateur tattoo removal
Poor healing after tattoo removal may make it impossible to get a good outcome

Given the costs and discomfort of laser tattoo removal, it is natural for patients to seek out cheaper alternatives such as getting their tattoos removed at beauty salons or with their tattoo artists. Of course, cheaper and faster do not always mean better. Bear in mind that tattoo removal is a delicate process, and you are taking a big risk having your tattoo removed by these non-medical providers. Even when laser tattoo removal is performed by an appropriate licensed and qualified doctor, over-zealous treatment with excessive power can result in scarring.

Once scarring occurs, the tattoo becomes much more difficult to eliminate because scar tissue effectively blocks the laser energy from penetrating deep enough to break up the tattoo pigments. While simply spending more for further laser sessions will usually result in more complete tattoo removal, it is difficult to reverse scarring even despite spending a fortune. Hence, preventing scarring is always top of mind for me when performing laser tattoo removal. Various techniques have been described in medical research to reduce the chance of scarring such as fractional laser pre-treatment, shockwave therapy, etc.

What To Do If You've Got A Tattoo To Remove

With advances in laser technology, many patients have the misconception that tattoo removal is a simple affair, like changing clothes. Unfortunately, it is not as simple as that. Laser tattoo removal should be done cautiously by qualified doctors as there are many things that have to be taken care of for an excellent result.

I hope I have given you insight into the common obstacles to achieving safe and effective tattoo removal that patients in Singapore face. If you have a tattoo that you are worried about removing, feel free to drop us a line or call us if you would like to find out more!

References

  1. Kaminer, M. S., Capelli, C. C., Sadeghpour, M., Ibrahim, O., Honda, L. L., & Robertson, D. W. (2020). Increased Tattoo Fading in a Single Laser Tattoo Removal Session Enabled by a Rapid Acoustic Pulse Device: A Prospective Clinical Trial. Lasers in surgery and medicine52(1), 70–76. https://doi.org/10.1002/lsm.23163
  2. Marini, L., Marini, S., Cutlan, J., & Hreljac, I. (2022). Q-S laser micro-drilling and multipass full-beam Q-S laser for tattoo removal - a case series. Lasers in medical science37(3), 1763–1771. https://doi.org/10.1007/s10103-021-03431-w
  3. May Ong (2017, May 17). Thai student suffers painful scars after non-laser tattoo removal treatment. Retrieved from AsiaOne.com: https://www.asiaone.com/asia/thai-student-suffers-painful-scars-after-non-laser-tattoo-removal-treatment

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