Dr. Adrienne Stewart, MD

Dermatologist in Denver, CO

Denver, CO 303-333-6060
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Adrienne Stewart MD

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What is PicoWay?

Approximately one in seven Americans who have gotten tattoos regret at least some of their ink. Many consider laser tattoo removal but find themselves anxious about whether or not it will be painful. The experienced team at Aesthetic Surgery and Dermatology of Cherry Creek in Denver CO is proud to offer PicoWay, a powerful and accurate laser technology that offers a more comfortable removal process than its counterparts.

With the advent of new laser technologies that have shorter pulse durations and powerful accuracy, tattoo removal is a much more comfortable experience than ever before. These newer lasers typically accomplish more in less time than traditional lasers, meaning fewer appointments and less investment in time and money, as well.

How Painful Is Laser Tattoo Removal?

While most people can probably agree that no one expects laser tattoo removal to be the most comfortable experience in the world, many actually report that it’s much more bearable than they anticipated. In fact, some patients report that the discomfort is similar to having a tattoo applied – and keep in mind, this is with traditional tattoo removal lasers. The Pico laser makes things even easier.

Today’s technologies not only reduce discomfort, but they also decrease the risk of scarring with no trauma to surrounding skin. During the removal session, a topical skin-numbing agent is offered prior to treatment, which minimizes discomfort even more.

Tattoo Location Makes a Difference

Depending on the location of the tattoo, it makes sense that some areas will have more sensation than others. The hands and feet have more nerve endings and touch receptors. The more receptors there are, the more sensitive that area of the body is. Having a tattoo removed that is located on or near a bone, or in an especially sensitive area like the armpits, will cause more discomfort than in other areas.

Laser Tattoo Removal: Understanding the Science

In decades past, the only options for tattoo removal were excision surgery or carbon dioxide lasers, both of which could be painful and leave behind significant scarring. Today, new technologies such as removable tattoo ink and the PicoWay laser treatment make the process easier and more efficient than ever.

Lasers actually work by breaking up the tattoo ink into tiny particles, which are then eliminated naturally by the body. The immune system activates, disposing of these particles as the body heals. The process is continued in phases, alternating between treatment sessions and healing breaks. The tattoo lightens more and more each time, eventually disappearing completely.

What’s in Tattoo Ink?

Tattoo ink is a solution made of a carrier liquid and a colorant. The colorant is dissolved in the liquid, which then carries it where it needs to go. Typically, colorants are either pigments or dyes, and carrier liquids are usually made from water, glycerin, alcohol, or witch hazel.

Why Ink Color Matters

You may recall from your high school science classes that colors absorb different wavelengths of light. Black absorbs all wavelengths, while white absorbs none. Believe it or not, this science is behind how tattoos are removed.

Lasers work by calibration, meaning they have to be programmed at specific wavelengths to recognize specific colors. For this reason, brightly colored tattoos are more complicated to remove than an all-black tattoo, which can require more removal sessions.  

How Tattoos Adhere to Skin

The outermost layer of skin is the epidermis. It is our first line of defense and acts as a waterproof barrier from the outside world. The layer beneath is called the dermis, and this is where the tattoo ink is delivered.

Tattoo ink is injected via needles that penetrate through the epidermis and settle more deeply into the dermis. As the skin eventually scabs over where the needles broke through the skin, the ink gets trapped underneath that second layer of skin. These foreign particles activate the immune response, which floods the area with white blood cells. Ironically, the constant white blood cell activity at the tattoo site is what actually keeps the ink in place.  

Tattoo removal works in a similar way. When the ink gets broken up by the laser, the immune system dispatches the white blood cells to the area, which then “eat” the ink particles and dispose of them.

How Many Laser Treatments Will I Need?

Several factors can influence how many sessions you will need, such as age and tattoo size and color, but tattoo removal typically requires multiple treatments. However, PicoWay guarantees shorter sessions and faster treatments. It’s picosecond Q switch laser targets the ink using photo-acoustic, rather than photothermal, technology. This means that the laser does not heat the skin, allowing for less discomfort, less intrusiveness, and greater accuracy.

Nonetheless, changes are immediate with the PicoWay laser, and will increasingly lighten the ink with subsequent treatments. The healing process after each session requires several weeks, and sessions must be scheduled accordingly. Between six and eight sessions on average, some cases require as many as ten or more. In addition, the number of sessions you’ll need depends on how deeply your tattoo was applied, the color and amount of ink used, and where it is located on the body. 

Factors Influencing the Treatment Process

Laser tattoo removal begins with the top layers of color and works its way down to the deeper layers. Only once the first layers of particles are flushed away can the deeper particles be targeted.

Remember that your body will need to heal between sessions, making the process a gradual one that requires patience. Understanding all the factors that could influence the duration and effectiveness of your treatment can help you have realistic expectations for your experience.

Tattoo Type

The older a tattoo is, the easier it is to break up the colors. In addition, since black is the easiest color to remove, an all-black tattoo that has faded or is less dense will be removed more quickly than others. Again, the amount of time it takes to remove a tattoo is also proportionate to its size.

Skin Color

Similarly, since lasers are calibrated to recognize color, it makes sense that the more contrast between skin color and tattoo color, the easier it is for the laser to find the ink. That being said, fair-skinned people have the advantage when it comes to tattoo removal. Darker-skinned people may require more treatment sessions and may also need to follow a few extra precautions to prevent skin discoloration.

Age and Health

It goes without saying that mature skin is less resilient than younger skin. Mature skin has had longer exposure to harsh environmental conditions, ultraviolet radiation exposure, and daily wear and tear. As we age, our skin loses important substances like collagen and oils that are necessary for bouncing back from damage.

That being said, it is important to take good care of your health and skin before undergoing tattoo removal. Since the immune response is important in helping the body rid itself of the ink particles created by the laser, it is helpful to support your immunity in a healthy and holistic way.  

Lifestyle

As with most things, lifestyle choices and unhealthy habits can challenge any medical or cosmetic treatment. High stress levels can encourage hormonal imbalances as cortisol rises. Habits such as tanning or smoking can actually accelerate the aging process, making the skin less amenable to the tattoo removal process.

Pre-Existing Health Conditions

Having a pre-existing skin condition doesn’t exclude you as a candidate for treatment, but it may make tattoo removal a little more challenging. Conditions such as eczema, rosacea, or herpes are common problems that can be worked around.

Healing Phases

Healing comes in phases during tattoo removal. You will need to wait several weeks between sessions to give your body’s immune system a chance to activate and then heal. Alternating between treatment sessions and healing phases is important for achieving optimal results.

Further, trying to schedule sessions too close together can result in over-treatment. This can introduce unnecessary side effects and lengthen your healing time. It can be a challenge to stick to an after-care plan between sessions, but it will be worth it to have patience and commitment.

The Tattoo Removal Process: What to Expect

Consultation and Pre-Treatment

In the consultation, you will have your skin examined and get a thorough medical history, including any media cations you are currently taking and any other skin treatments you might be receiving. If you are taking blood-thinning medications like aspirin or Advil, you may be asked to stop taking them in the days prior to your treatment. These medications can increase the risk of bleeding and bruising.

In addition, it is helpful to avoid any skin-irritating activities such as tanning, plucking, waxing, or bleaching near the tattoo area. The healthier your skin condition is, the less discomfort you will experience during and after treatment.

During Treatment

At your first appointment, you will have your skin tested to see how your skin responds to the laser treatment. This is a necessary step to make certain that the correct calibration and pulsation settings for your skin are being used. You may be offered a topical anesthetic cream for increased comfort.

The treatment is an outpatient service, and the whole process should last under an hour. There is little to no downtime, and you should be able to return to your normal daily activities as soon as your session is over.

Post-Treatment

You will have an aftercare plan designed for proper healing. You may be asked to avoid intense heat and exercise for up to a week after treatment. Hot showers, Jacuzzis, and chlorinated or saltwater should be avoided until the area is completely healed. You may also be given an antibiotic cream to prevent the risk of infection.

In addition, wearing loose-fitting clothes and using an ice pack can help keep irritation and inflammation down. Avoiding ultraviolet light and wearing sunscreen when you go outdoors will also help the skin heal more quickly.

Who Is a Good Candidate for Tattoo Removal? 

Age, general health, and lifestyle play a role in who might make the best candidates for laser tattoo removal. There is one caveat to this: if you are breastfeeding or pregnant, you may be asked to postpone treatment. Hormonal fluctuations affect skin quality and can increase the risk of side effects.

Learn More and Get Started

While laser tattoo removal can be uncomfortable, most people report that it is more tolerable than they expected. Laser removal is currently the best treatment option, and the PicoWay laser delivers the most comfortable experience of all. To learn more and schedule your consultation, contact Aesthetic Surgery and Dermatology of Cherry Creek in Denver CO

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Adrienne Stewart MD
Adrienne Stewart MD
3300 East 1st Avenue Suite 400
Denver CO 80206
Phone: 303-333-6060

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Monday 8:30am – 5pm
Tuesday 8:30am – 5pm
Wednesday 8:30am – 5pm
Thursday 8:30am – 5pm
Friday 8:30am – 5pm

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