Tattoo Removal: From Pain to Cost, What You Need to Know

In a perfect world, we'd all love every tattoo we have for the rest of our lives. Unfortunately, that's a pretty unrealistic idea. You can cover up a tattoo you don't like with a different one, but that involves getting something larger and darker, and for many people, that isn't a viable solution.

Maybe your tattoo is in too obvious a spot on your body, maybe your skin reacted badly to it, or perhaps you just aren't the tattoo type at all; there are plenty of reasons why someone would seek removal. So what does it cost, how much does it hurt, and what should you prepare for? Keep reading to learn all about tattoo removal from board-certified dermatologists Kseniya Kobets, MD, and Navin S. Arora, DO, FAAD.

Meet the Experts

• Kseniya Kobets, MD, is the director of cosmetic dermatology at Montefiore Einstein Advanced Care.

• Navin S. Arora, DO, FAAD, is a board-certified dermatologist with Borealis Dermatology.
  

What Is Tattoo Removal?

Tattoo removal is a permanent process that involves removing a tattoo through a series of sessions, typically with a laser. There are a few different methods for this. Before we get into them, it's worth noting that home remedies, such as tattoo removal creams, are not the answer here. There aren't any DIY remedies for tattoo removal that work like the professional options do—and they can potentially create skin issues.

Lasers

Laser tattoo removal is by far the most popular removal method. "Laser therapy uses focused highly energized light beams to shatter the tattoo ink particles, which are then absorbed by the body," explains Arora. "It's the most common method and has significantly less scarring if any, than surgery." Kobets also thinks it's the best option overall, telling us that "one of the brilliant things about laser tattoo removal is that laser technology specifically targets the pigment in the skin to remove the tattoos. Depending on the tattoo color, a specific wavelength can be used; for example, a 1064 nm wavelength for black and dark tattoos specifically targets the tattoo color pigment, sparing the skin around it."

Surgery

Yes, under the right circumstances, it's possible to have a tattoo cut right off of your body. "Surgical excision of the tattoo is the most invasive treatment, which requires cutting out the whole area of the skin surrounding the tattoo," explains Kobets. Surgery "leaves a linear scar and can be associated with other potential complications of skin surgery, such as keloids and hypertrophic scars, as well as infections and skin discoloration." Arora adds that it is only appropriate for small tattoos.

Microdermabrasion

You're probably familiar with this term as an option for a facial treatment, and using it to remove a tattoo functions similarly to that. "Microdermabrasion uses abrasive materials to exfoliate the top layer of skin, gradually fading the tattoo," explains Arora, who notes that it was more popular before lasers took over. It's generally not considered the most effective option. "Microdermabrasion is generally a non-specific treatment and removes top layers of the skin along with the tattoo nonspecifically, which I do not recommend as first-line treatment for tattoo removal," says Kobets.

Other Methods

While lasers are the general standard for tattoo removal due to being effective and not leaving scarring behind, there are additional lesser-used modalities. These include chemical peels, subcutaneous injections, and cryotherapy.

Because lasers are the norm, that's the method we'll focus on from here on out.

Cost

Laser tattoo removal can start at $450 per session, "depending on the laser, the practice, and the provider doing the treatment," says Kobets. Arora notes that prices can reach $1,000 per session. The darker, bigger, and deeper a tattoo is, the more removal is likely to cost.

How to Prepare

There are a few steps you can take to make sure you're ready for your tattoo removal sessions. "Before a session, avoid sun exposure and tanning to prevent complications," instructs Arora. "You should also shave the area no earlier than three days before the treatment if it's hairy and keep the skin clean. Follow any specific instructions provided by your tattoo removal specialist," he adds. Kobets says you'll also want to avoid self-tanners before the sessions and ensure your skin isn't irritated.

You should also consult with your provider about what laser they'll be using. Since "some lasers are better at removing tattoos [than others]," Kobets says it's important to discuss whether you should consider another type or wavelength of laser to optimize the removal process.

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What to Expect

First, you'll be numbed. "Topical numbing is usually applied for 30 to 60 minutes (sometimes under occlusion like plastic wrap) before tattoo removal," says Kobets. "Sometimes additional local anesthetic shots with lidocaine can be used under the tattoo to minimize and avoid any pain during the treatments. But, of course, you feel the initial couple of shots."

Next will be the laser process. "Tattoo removal sessions with lasers can take anywhere from 20 minutes to 30 minutes or longer depending on the tattoo size," says Kobets. Arora notes they may be as short as 15, but you'll be best off expecting up to a half hour for yours.

Of course, one session of removal isn't going to cut it. According to our derms, you're looking at anywhere from five to 12 sessions. "Sometimes tattoos that are done nonprofessionally or with various colors can be more challenging to remove and may require several sessions to remove, and may even never be able to be fully removed," explains Kobets. "Expect gradual fading over multiple sessions," adds Arora.

Laser tattoo removal sessions are typically scheduled with 4-8 weeks between each. Because of the number of sessions required, you should plan on the better half of a year, if not longer, to complete the removal process.

Pain and Side Effects

The pain of laser tattoo removal will be mitigated by the numbing agents, but you still might feel it to an extent. "Laser tattoo removal can be painful, with a sensation similar to rubber band snaps," says Arora. "The discomfort is usually brief during the session and may last a few hours to a day afterward." Where the laser hits your body will also make a difference. "There are certain areas, like bony areas of the ankles and spine, which may be more tender and require local anesthesia shots," says Kobets.

Within hours after your session, you should feel some relief from the pain. There are other side effects to be aware of, however. "Common side effects may include redness, swelling, blistering, and scabbing. Uncommonly, some individuals may experience changes in skin pigmentation, scarring, or infection," says Arora, who notes that scarring and infection mostly tend to occur in surgical removal, not laser.

Aftercare and Recovery

After your session, Kobets recommends using an ice pack to ease the discomfort and prevent swelling. Then, be kind to your skin. Tattoo removal aftercare "is gentle skin care with the application of Vaseline or Aquaphor, or sometimes a topical antibiotic after washing gently twice a day, and keeping it covered to prevent irritation or rubbing on clothes," she suggests. You'll also want to avoid the sun until your removal session has healed.

The Final Takeaway

Tattoo removal can lighten your tattoo, potentially even removing it completely. While there are numerous methods available, the standard one is lasers. That's because it is highly effective and leaves no scars. You can consider surgical removal for a small tattoo (if you don't mind scarring).

Laser tattoo removal lasts 15-30 minutes, costs anywhere from $450-$1,000 per session, and requires five to 12 sessions on average. Prepare for your appointment by consulting with your provider and following their instructions, avoiding the sun, and preventing irritation to your tattooed skin. The process will be uncomfortable, but numbing agents applied beforehand will help. After each session, treat your skin gently and avoid the sun. With the info you now have, removing that pesky tattoo you're dying to get rid of can be a bit less intimidating.

Related: Can You Get Laser Hair Removal Over a Tattoo? We Investigate

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