Tattoo removal

"Tattoos are becoming more and more popular. Often their creation arises from a momentary situation and years later they are perceived as disturbing. If the skin painting is then to be removed again, treatment with picolaser is recommended. It can blast the color pigments, while the surrounding tissue is not damaged. The goal is complete removal, even if a new tattoo is desired. We combine several techniques and devices in each laser session to achieve the best possible result."

C. Bettina Rümmelein, M.D., Medical Director
C. Bettina Rümmelein, M.D., Medical Director
How it works

Tattoo removal mode of action

First of all, it is important to understand how tattoos work. During tattooing, a thin needle penetrates the top layer of skin (epidermis) about 120 times per second, leaving ink in the dermis below. This denser, leathery layer of skin is about 1-3 millimeters below the surface of the skin and is where the ink pigments are distributed to form the tattoo. Each pigment has a diameter of about 30-50 nanometers, about the same size as a skin cell.

Once the color has been injected into the dermis, the skin reacts with an inflammatory response. The dyes are recognized by the immune system as foreign substances and macrophages, also known as defense or scavenger cells, surround the pigments of the tattoo ink. This process allows the pigments to remain permanently visible. However, some color pigments are absorbed by the macrophages over time and transported through the bloodstream to the lymphatic vessels, causing tattoos to lose color strength over time.

Tattoos have been around for thousands of years and are becoming increasingly popular. And yet tattoo removal is also becoming increasingly popular. Be it because of ill-considered motifs, poor workmanship or styles that have gone out of fashion.

There are a number of methods of removal, which are often quite brutal: Scraping, cutting out, etching with acid solution, etc.

By far the best method of removing a tattoo is laser treatment. The light absorption of the color pigments is important for the success of the treatment. The fragmentation of the color pigments into tiny particles enables them to be removed by the body.

It is important to note that some colors, such as yellow, are still very difficult or impossible to remove with laser treatment. In addition, complete and scarless removal of a tattoo usually requires several treatment sessions.

In our practice we use a special procedure which consists of three work steps within one session exists. This has enabled us to achieve the best possible results for years:

  • First step: Laser to blast the paint particles
  • Second step: Fractional CO2 Laser to prevent the formation of scars
  • Third step: AWT to support the ink removal
Treatment options

Tattoo removal treatment options

Laser tattoo removal

Laser tattoo removal uses high energy light beams to break up the tattoo. The ink used in the tattoo absorbs the light beams, causing the ink pigments to be crushed. These crushed pigments are then naturally eliminated by the body.

There are different types of lasers that are used for tattoo removal, including Q-Switched lasers and Picosecond lasers. Q-Switched lasers have proven to be effective for removing black and colored ink, while picosecond lasers offer an even faster pulse speed, allowing them to break up ink more efficiently.

Laser tattoo removal is a process that requires several sessions, depending on the size, color and location of the tattoo. The treatment may also cause pain or discomfort, but topical anesthetics can be used to alleviate this.

Dirty tattoos

Dirt tattoos or trauma tattoos are a special type of tattoos that often result from accidents or injuries. In these cases, dirt or other foreign materials are introduced into the skin and remain there, much like a regular tattoo. Dirt tattoos can be difficult to remove, especially if the invaded particles are deep in the skin.

For dirt tattoos, similar to ordinary tattoos, laser treatment can be an effective method of removal. However, it is important to note that some particles may not respond to laser treatment and therefore may not be completely removed. In some cases, it may be necessary to consider other methods such as surgical removal.

Permanent make-up

Due to the fact that permanent makeup is often placed on the face, greater caution is often required here than with tattoos. The placement of the color takes place using various methods and also in higher layers of the skin. We explain more on our page about PMU removal.

Procedure

Tattoo removal procedure

Our Three-step procedure for tattoo removal is a comprehensive method that aims to effectively remove the color while reducing the risk of Hyperpigmentation and Scarring to minimize. Here is a detailed description of what to expect before, during and after treatment.

Before treatment

Preparation for tattoo removal is an important step to achieve the best results. We recommend avoiding intense sunbathing and the use of self-tanning creams for a few weeks before the procedure, as they can make the skin more sensitive to the laser. Smoking and alcohol should also be avoided as they can interfere with the healing process.

During treatment

First step - laser blasting of the color particles: In the first phase of the treatment, we use a special laser to blast the color particles in your tattoo. This process is performed in two parts: First, part of the color is blasted by the laser. Then, there is a short pause to allow the color to return to the surface of the skin before it is blasted again.

Second step - CO2 laser treatment: In the second step of the treatment we use a CO2 laserto create tiny channels in the skin. These channels allow macrophages to remove even more color pigments while preventing hyperpigmentation and scarring.

Third step - Acoustic Wave Therapy (AWT): The third and final step involves AWT applied. This non-invasive treatment promotes blood circulation and lymph flow, which removes the destroyed color particles from the skin. It is an effective method to support color removal and promote faster recovery.

After treatment

After treatment, we recommend a wound-healing and moisturizing cream for the first few days, followed by a scar gel, which should be used until the next treatment. This should ideally take place after about 8 weeks. Note that complete removal of a tattoo usually requires 5 to 12 treatments and can take up to two years. Tattoo removal requires patience and time.

By performing these three steps in our clinic, we can effectively and safely treat almost any color while maintaining an optimal skin appearance.

Frequently asked questions

Tattoo removal Frequently asked questions

Which colors can be removed?

Black and red are the easiest colors to remove, whereas yellow is extremely difficult to remove. With all other colors, complete removal is not so certain and more sessions must be expected.

Does the age of the tattoo make a difference?

Older tattoos are usually already faded by the sun and are therefore often easier to remove.

How many sessions do I need?

This must always be considered on a case-by-case basis, but the rule of thumb is: ten sessions in two years. Ideally, removal can be successful after just 5-6 treatments.

Is it painful?

Tattoo removal with the laser is unfortunately painful, but only for a very short time. The skin is pre-anesthetized and treated under strong air cooling. It takes less than two minutes to remove a tattoo the size of the palm of your hand.

Can I get another tattoo at the removal site afterwards?

Yes, this is possible and is often used if you want to adjust the motif.
Further information

Further information

Publications
Tattoo removal with the laser - an update.
Adatto, M.A./ Krischer, J,/ Rümmelein, B. / Dermatologica Helvetica 2017:29 (1), 22-29.
Publications
When the tattoo no longer fits. Tattoo removal with laser.
Rümmelein, B. / Dermatologie Praxis, Issue 3-2013, 4-6
Article
3 Step Tattoo Removal Procedure
Dr. med. C. Bettina Rümmelein
Article
Preparation for Cover-Up Tattoos
Dr. med. C. Bettina Rümmelein

Further information

Publications
Tattoo removal with the laser - an update.
Adatto, M.A./ Krischer, J,/ Rümmelein, B. / Dermatologica Helvetica 2017:29 (1), 22-29.
Publications
When the tattoo no longer fits. Tattoo removal with laser.
Rümmelein, B. / Dermatologie Praxis, Issue 3-2013, 4-6
Article
3 Step Tattoo Removal Procedure
Dr. med. C. Bettina Rümmelein
Article
Preparation for Cover-Up Tattoos
Dr. med. C. Bettina Rümmelein