There are creams and balms that promise to lighten or erase a tattoo.
But now you’re a 30-year-old man and you’re wondering why you have a Tasmanian devil on your left calf.
You could try to laugh about it, but some tattoos are so prominent—or get so much commentary from other people—that you want the thing gone.
Question is, can you fully erase a tattoo? How long will it take, how much will it hurt, and how do you avoid becoming a horror story like the woman whose tattoo removal cream burned off her skin?
If you’re thinking making your ink disappear, here are the facts you need first.
There are creams and balms that promise to lighten or erase a tattoo. Don’t bother.
“I don’t believe in any of them,” says Hooman Khorasani, Chief of Dermatologic and Cosmetic Surgery at Mount Sinai’s Icahn School of Medicine in NYC. “I’ve heard of patients trying them, but the science behind them is not really great.”
Your only option is a laser, but there are different types. Nanosecond lasers have been used for many years—they deliver pulses of light in nanoseconds.
But now there are lasers that deliver the light even faster, in picoseconds, which are trillionths of a second.
Cost depends on how many treatments you need, which depends on the size of your tattoo.
For a small tattoo, you're looking at four pico laser treatments, or eight nano laser treatments, at a couple hundred bucks each.
"If you have a massive snake on your back that covers your whole butt, it will be more," says Khorasani. "But a hand-sized tattoo should cost $200-$400 per treatment. The tattoo when you got it might have been $400, but the removal could be $2,000."
Different colors are absorbed by different wavelengths of light, so there isn't one laser that works for everything.
"It's very hard for a medical practice to buy every single wavelength for every single color," says Khorasani. So most end up buying a laser that works best on black or blue.
Other colors, like red and yellow, can be particularly tricky. Let’s hope you didn’t get a tattoo of Elmo.
If you get your laser treatment in a doctor's office—and you should—it will start with a shot of local anesthetic like lidocaine.
Here’s how one patient describes treatment.
He asked to remain anonymous due to his shame about having a popular TV catchphrase tattooed on his collar bone.
"They numb you up," he says. "Then you go into the room with the laser, which is very warm because the laser generates a lot of energy.
You put on protective eyewear so you can't see anything. You lie down and it's over in the time it would take you to trace the tattoo with a pen."
While you won’t be able to feel your tattoo removal, you may be able to smell it.
"When you fire a laser at the skin, there's something called a laser plume which is released into the air," says Jeremy Brauer, Director of Clinical Research at the Laser and Skin Surgery Center of New York.
"We wear masks and have a smoke evacuator in the room."
But recent innovations have improved things.
DeScribe, a silicone patch applied to the tattoo during laser treatment, traps whatever is ejected off the skin, shielding you and your doc.
When it attacks your ink, the laser also attacks your skin’s pigment. That means people with darker skin may see a lightening effect.
"The darker you are, your own pigment is going to react to this light coming in," says Khorasani. "It's going to get your own pigment first before it gets the ink."
His fix? Use a longer wavelength laser with darker skin types.
Or, afterward, use a UV laser designed to treat eczema to bring pigment back.
It's uncommon, he says, because many practices don't have the eczema laser, but it's something to ask about.
The farther your tattoo is from your heart, the harder it is to get your body to digest the ink after it’s been broken down.
"Areas that are more vascular are easier," says Khorasani.
"The face is actually easier than the trunk, which is easier than the buttocks or upper arms. Hardest are the hands, feet, ankles."
If you paid for the Picasso of tattoo artists, sorry about that. If you got the thing in a crappy tattoo shop—or from a friend with a safety pin—you should feel thankful.
"If it's a professional tattoo, they're usually laid in much deeper, with much better ink," says Khorasani. "If you got a tattoo in jail and your cell mate did it, that's super easy to get rid of."
Your skin needs time to recover between laserings. Which used to mean hanging out at the doctor’s office for hours if you wanted multiple passes in one visit.
Now, the DeScribe patch can protect the skin and cut recovery time, so you can take multiple laserings in one visit.
And with faster lasers, you need fewer treatments total.
"Prior to advances like DeScribe and pico lasers, it wasn't unusual for people to undergo tattoo removal for a year or more," says Brauer. "Anywhere from 10 to 20 sessions wouldn't have been an uncommon scenario. Now we can reduce that number."
The big question: is it ever truly gone? Yes and no. Even once removal is complete, you’ll have a faint shadow where the tattoo was.
"You, or people who have stared at your tattoo, you'll be able to make out where it once was," says Brauer. "But if you had a tattoo on your lower back and you're at the beach, people's eyes will no longer gravitate there."
When the anesthesia wears off? Well, it will feel kind of like when you first got your tattoo.
"You put gel on it to help it heal and prevent scarring,” says one patient, “and it stings for a couple days."
The familiar sensations might take you back to the time you made this decision. Why did you do that again? And why did you choose a Dave Matthews Band Fire Dancer logo?
If you ever get another tat, think about how you might feel a few years later. "I'm a big Rangers fan," says Khorasani, "but I wouldn't put a Rangers tattoo on myself because what if I hate the next owner. Who knows?"