Tattoo removal is a booming business

National report – As Americans' taste for tattoos has grown, experts say, so have many tattoo wearers' regrets.

Nationally, says Eric F. Bernstein, M.D., M.S.E., "There's a total epidemic of people wanting their tattoos removed." He is clinical professor, Department of Dermatology, University of Pennsylvania School of Medicine.

George Hruza, M.D., M.B.A., says he commonly sees parents who want tattoos removed from children – who got them without permission – as young as 16. He is a Chesterfield, Missouri-based dermatologist in private practice. Dr. Bernstein adds that he's removed recent tattoos from patients from 14 years old to senior citizens.

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Regarding tattoo locations, Dr. Hruza says that as tattoos have grown more mainstream, he increasingly zaps them from highly visible areas such as the neck, once the wearers rethink their ink.

Roy Geronemus, M.D., adds that as people become more aware that lasers can safely and effectively remove tattoos, he sees growing numbers of patients with lip and eyeliner tattoos they want removed. He is director of the Laser & Skin Surgery Center of New York and clinical professor of dermatology at New York University Medical Center.

Treating tattooed-on cosmetics can be tricky, however. Frequently, explains Dr. Hruza, they contain iron oxide (for tan and rust tones) or titanium dioxide (for pastels and flesh tones). Immediately after Q-switched or picosecond laser treatment, he says, both materials often irreversibly darken to gray or pitch-black tones as refractory as genuine black ink. Dr. Bernstein says the darkened pigment can take double or triple the usual number of Q-switched laser treatments.

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When using such lasers for facial cosmetic tattoos, particularly with rusty hues, Dr. Hruza recommends first treating a small test spot – which one can surgically excise if it darkens. Alternatively, Dr. Geronemus uses an ablative CO₂ or fractional ablative CO₂ laser for tattoos containing iron oxide or titanium dioxide.

Dr. Bernstein says that although he has not yet treated cosmetic tattoos with the PicoWay 532/1064 nm picosecond laser (Syneron & Candela), he hopes that it simplifies the task. For now, he says that as tattooed Americans get older and perhaps wiser, "The tattoo-removal business is booming – and it's only going to keep booming as time goes on."

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Disclosures: Dr. Geronemus is a clinical investigator for Cynosure, Syneron & Candela and Cutera. Dr. Bernstein is head of Syneron & Candela's medical advisory board and received a research grant from the company to perform the PicoWay Phase III trial. Dr. Hruza reports no relevant financial interests.