Tattoo Removal

The Modern Guide to Tattoo Removal and Fading

By: Pete Peterson

Copyright TATTOO REMOVAL: A MODERN GUIDE TO TATTOO REMOVAL AND FADING. Copyright byPete Peterson. All rights reserved under International and Pan-American CopyrightConventions. By payment of the required fees, you have been granted the non-exclusive,non-transferable right to access and read the text of this e-book on screen. No part of thistext may be reproduced, transmitted, downloaded, decompiled, reverse engineered, orstored in or introduced into any information storage and retrieval system, in any form orby any means, whether electronic or mechanical, no known or hereinafter invented,without the express written permission of the author.

Nobody can go back and start a new beginning, but anyone can start and make a new

ending. - Maria Robinson

The information we explore together in this book is the latest and most up to dateavailable. It is my sincere hope that it will help you to make informed decisions aboutchanging things or improving your life - right now! Lets get started. Pete Peterson

Disclaimer The author and publisher of this book have used their best efforts to obtain and providethe best possible and latest information available. The author makes no representation orwarranties of any kind with regard to the completeness and accuracy of the contents ofthis book. All product names, logos, and artwork are copyrights of their respectiveowners. None of these owners has authorized, sponsored, endorsed, or approved thispublication. This book is not intended to be a substitute for qualified professional medical advice nordoes the information found in this book constitute medical advice. You should alwaysseek and follow qualified professional medical advice before beginning any tattooremoval strategy. Never disregard qualified professional medical advice even if it is incontradiction to the information presented in this book. No part of this book is to be taken as medical advice. The author and publisher accept noliability of any kind for any losses or damages caused, or alleged to be caused, eitherdirectly or indirectly, from using the information contained in this book.

Table of Contents Part One Why This Book Will Save You Money Inked and Repentant? A Little Bit of History Free Tattoo Removal Top 10 Reasons for Getting a Tattoo Top 10 Reasons for Getting a Tattoo Removed Religion and Tattoos How Tattooing Works Part Two Tattoo Removal:

Laser Treatment 10 Questions to Ask a Laser Clinic

Infrared Coagulators (IRC)

Intense Pulsed Light Treatment (IPL)

Chemical Extraction: Rejuvi

Tattoo Erase Surgical Excision Salabrasion Dermabrasion Cryosurgery Part Three Home Tattoo Removal and Fading Products: The Acids Inkbusters Nuviderm RX-Tattoo Glycolic Acid Wrecking Balm The Creams Tat B Gone Tattoo-OFF Dermasal Profade Tat-Med Fadeplex

Tattoo Fading Part Four Tattoo Alternatives 5 Ways to Identify Dangerous Black Henna 5 Tattoo Removal Tips Covering Up Glossary

Part One

Air

Image credit: deviantart.com

Why This Book Will Save You Money

I wrote this book because there is so much misinformation out there regarding theimportant subjects of tattoo removal and tattoo fading. Everyone makes a decision in hisor her life, usually when younger, that they may now, with the hindsight of years, regretin some fashion. People grow and their tastes and views change and that tat you got onspring break after a few too many beers may not be representative of who you are today.Its time to move on. Aside from making a lifestyle change, maybe you need to get de-inked in order to achievethat promotion or find a better job. You dont want a tattoo holding you back from abetter life. Your Boss Hates Your Tattoo Everybody complains about work but the reality is that to survive you pretty much need ajob. That means most of us fall into one of two groups: those currently without a job andwho want one, and those with a job who want a better one. In todays economy andhypercompetitive job market you need every edge you can get. One thing you dont wantholding you back is ink. In all surveys one message rings loud and clear: employers hate tats! You may love yourtattooI mean, you chose to get it done and you chose the design so, yeah, that makessense. But that doesnt mean your boss feels the same way. This is especially true oftattoos in highly visible places, like forearms, hands, ankles, or necks. God forbid youhave any tats higher than your neck. If you do, you can forget about meaningful

employment in most cases. So you want a job or you want a better job but youve got ink thats holding you back.What do you do? That is the main question. You need to do something about it. Here areyour two choices: cover it up with clothing or get it removed permanently. Doing nothingis an expensive choice. Think about all the money you arent making right now becauseyou are being held back. Add that up over a lifetime and you could buy a housesomewhere. The sooner you take action the better off you will feel and the better off youwill be financially too. Where Can You Get the Full Story? Fine. You have made the decision or are considering making the decision to have thattattoo removed. Where do you start? For tat removal, any product you find online willonly tell you how great that product is and how all the other ones suck. If you talk to alaser clinic, they have an agenda too. It shouldnt surprise you that they will stronglyrecommend laser treatment at their clinic. A plastic surgeon is likely as not to recommendsurgical excision or cryotherapy. And so on. Some of these methods are good ways tochange or remove an unwanted tattoo but they can be expensive. In this book we willlook at and review all of them, and more. What About Fading? Perhaps you want a cover up tattoo and need to fade the original. Tattoo fading isanother option for changing or hiding a design you no longer want. In many situations,you dont need to remove the entire tattoo in order to replace it. Lightening a tattoo isrelatively easy to do and we will look at all the latest options for this that are on themarket today. Fading a tat before getting a cover up or before starting other treatmentsfor complete removal can also be a good strategy. Although laser treatment is becoming more and more popular, it is expensive. What arethe more budget-friendly products or ideas available on the market? If you search theinternet for tattoo removal products you will be flooded with promotions for this creamand that acid and this solution with all natural ingredients, blah, blah, blah. Do any ofthese things work? How do they work? Everyone wants to sell you something. Many ofthe so-called informational sites on the internet which call themselves foundations orinstitutes that research and review tattoo removal products are just fronts for thepromotion of a single producttheir own. Who do you believe? Who can you believe?This book features full and unbiased reviews of the major products on the market todayin order to help you make the right choice. Whats My Agenda?

I wrote this book to provide an independent voice. This is an agenda-free and totally upto date modern guide for tattoo removal and fading. There are many tattoo removal andfading choices out there and you should review ALL of whats available and make theright decision that best fits your wallet and your skin. Whats my agenda? Full disclosure:I have no connection whatsoever to any service or product provider. I will not sell youanythingexcept this book. After reading Tattoo Removal The Modern Guide to Tattoo Removal and Fading you willsee that there is no one-size-fits-all solution. Depending on variables such as your skintype and your budget, some strategies will work well for you while others wont work atall. Removing a tattoo or even fading one can be an expensive proposition, especially ifyou dont have all the facts. This is where my book will save you money. You can literallyspend $10,000 or more on laser treatment in order to remove a large tattoo and stillhave less than satisfactory results. Or you can spend $1,000 on a cream that doesnt doanything at all. Before committing a large amount of your hard won cash on somethinglike that, read this book. The Guarantee I hope this book answers your questions about tattoo removal and fading and clearsthings up for you. It took a long time to write and to sort through all the bullshit floatingaround in the marketplace. I honestly believe you wont find anything else like it.However, if after reading my book you are unsatisfied or think it was a total waste ofyour time, I will be happy to refund your money. Thanks again for reading.

Pete PetersonSeattle, WA April 2012

Inked and Repentant? Tattoos are a very personal expression of who we are and how we see ourselves. Gettinga tattoo often marks an important point in our lives, and the design we choose mayrepresent special people or memories we dont want to forget. But sometimes we changeand what was cool or awesome when we were twenty isnt so great when we areolder. That is part of life: we grow, stuff happens, and we have to change with it. Tattooregret is a very common phenomenon. According to recent polls almost 50% of peoplewho have ink have thought about getting it removed; a recent survey of 163 men andwomen with ink showed that a full one-third regretted getting ink done. Look no furtherthan the following celebrities:

Angeline Jolie. After her divorce from Billy Bob, she removed the dragon tat andhis name from her shoulder (left image) and replaced them with a list of latitudesand longitudes of where her children were born (right image).

Image credit: alteredidentity.com

Eva Longoria. After her divorce from Tony Parker she had his number nine tatremoved. His initials were also removed from an undisclosed part of her anatomy.

Megan Fox is removing the Marilyn Monroe tat on her right forearm.

Britney Spears and Pamela Anderson are two other celebrities who have hadsuccess in removing tattoos they no longer wanted. Johnny Depp has over a dozen tattoos. His most famous was the WynonaForever tat on his right bicep. When they split up, he had it changed to WinoForever!

Other famous people who have successfully moved beyond the tattoos they no longerwanted include 50 Cent, Billy Idol, Eminem, Charlie Sheen, and Kobe Bryant.Mark Wahlberg decided that he would teach his kids a lesson and brought in two of hisfour children, Ella Rae, eight, and Michael, five, to watch more than twenty of his painfullaser treatments. His tats are gone and his kids are scared straight! As he says,

I dont want my kids getting tattoos. If I fail as a father, then its all been fornothing. Thats by far, the most important role that Ill ever play in my life ... being aparent and a husband.

Image Credit: Marty Katz photography

One-third of all people in the UK under the age of 44 have at least one tattoo. The Britsare the most tattooed people in Europeeven the wife of the Prime Minister has one! 33-year-old Knicks point guard Mike Bibby is keen to remove some of his tattoos, but hesays that the tattoos of his children on his back will remain. Glen Davis, 26-years-oldand a forward for the Orlando Magic like Bibby, plans to get rid of some tattoos on hisright arm within the next few years. Reasons? As he says of Bibby,

Hes on the last limb of his career as far as basketball. Now he has to go in theworld and know to work. And how do you do that? You blend in with the guys whohave done itwho come in with a suit and tie with no tattoos.

These celebs and hundreds of thousands of other people just like you have made thedecision to remove a tattoo and move forward with their lives. A tattoo that no longerrepresents who you are is worse than annoying; it is a constant reminder of somethingthat holds you back. In some cases, people have sought removal treatment right aftergetting a tattoo. If this describes your situation, experts caution that it is best to wait fourmonths or more after the tattoo is finished in order to allow for proper healing beforebeginning the removal process. The good news is that tattoos are no longer permanent. Tattoos often mark a phase inyour life but they shouldnt become an obstacle to your happiness. You dont have to livewith a choice you made years ago that now makes you unhappy. You can free yourself.This book will show you the many ways it is now possible to safely remove or fadeunwanted tattoos from your skin. Do Something About It Just like getting inked in the first place, the removal of a tattoo should require thought.You didnt think much before you got that tattoo you now hate? Join the club! Manypeople in that situation have successfully de-inked and are happier for it. They did

something about it and you can too.

Keep in mind, your health insurance will almost never pay for tattoo removal. It isconsidered elective surgery or cosmetic treatment not required for your physical health.Since you have to pay for tat removal completely out of your own pocket, you need topick the right treatment for you. Reading this book is the first big step in that direction.You cant make the right move without all the facts.

Whats the fastest and cheapest method of tattoo removal?

Photoshop!

If you look anywhere on the internet you can find lots of examples of promoters that usePhotoshop instead of whatever product they want you to buy for perfect 100% tattooremoval. Dont fall for this. It is highly unlikely that you can remove 100% of your tattoowithout some residual colors or slight scarring (from the original tattoo needle) beingvisible. Anyone who promises perfection regarding tattoo removal should be viewed witha healthy dose of suspicion. Tattoo removal, or just the idea of tattoo removal, can arouse strong negative emotionsand sometimes outright hostility from the tattoo community. But getting a tattoo is apersonal choice and so is removing one. A lot of people have more than one tat, somehave dozens. They may decide to remove all of them or just one they dont like anymore. Either way, it is their decision and others shouldnt judge them for it. The information presented here in this book will answer most if not all of your questionsregarding tattoo removal and allow you to choose the method that best suits you. Likethe tattoo itself, there is no one size fits all removal method. There is no perfect answerand there are no guarantees. Again, if anyone guarantees that they can remove 100% ofyour tattoo, you should walk away. Successful treatment depends on a lot of factors,including the chemical composition of the ink and your skin type. Some treatments work

well on some people but wont work so well on others. Today, the difficulty facing peoplewith an unwanted tattoo is the sheer number of removal choices out there. Recent Advances in Science In the last five years great advancements have been made in the science of tattooremoval. Until this book, however, there was no unbiased single source to help youdetermine the treatment that fits you best. Everyone assumes that laser treatment is theonly way to go. Laser treatment for tattoo removal is the fastest growing area ofdermatology, with clinics sprouting up all across the country. Yes, those clinics provide aservice, but they are there to make money and they cant make money unless they sellyou that service. Thats great if you are rich and have lighter colored skin with a black inktattoo, or if the tattoo is not on your ankle. But what if that isnt you? What about the various creams on the market? Some do what they say and some dont.Some are downright dangerous. Each marketer will give you a song and dance about whytheir cream is the only way to go. Again, their basic motivation is to sell you their cream. What about surgery, or tattoo excision? After talking to a surgeon, you may walk away(probably after paying several hundred dollars for a consultation fee) thinking thatsurgery is the only way to go. Remember, that nice surgeon needs patients like you; hehas a mortgage and car payments too. I am not criticizing the many different hard-working service providers and productmarketers in the business of tattoo removal, but remember, it is a business. It is hard, ifnot impossible, to get unbiased advice. This is why I wrote this book. I am not going tosell you anything, and I am completely disinterested about whether, after reading thisbook, you choose laser, Tat B Gone, surgery, or a cover up. Most importantly, afterdigesting the latest information found within these covers you will have the informationto make a much better and more informed decision than if you just speak with oneproduct guy or one service provider. Read on and get the information you need to makethe right choice for you. Note: Please re-read the Disclaimer section. You should always seek and follow qualifiedprofessional medical advice before beginning any tattoo removal strategy. No part of thisbook is to be taken as medical advice. The author and publisher accept no liability of anykind for any losses or damages caused, or alleged to be caused, either directly orindirectly, from using the information contained in this book.

A Little Bit of History How many of us have tattoos and how common are they? According to the Pew ResearchCenter, about one-third of Americans between the ages of 18 and 40 have at least onetattoo. The highest rate of ink among the population is found within people between theages of 1829, 38% of whom have at least one tattoo. The Pew Research Centerindicates that 23% of all Americans have tattoosthat is almost one in four people! Wecan see that tattoos are very popular in the US today but where did the practice begin? The Very First Tattoos Tattoos have been with us for at least 10,000 years. Some speculate that the very firsttattoos were actually war wounds from rough wooden spears. Ancient peoples used tofire harden their wooden arrows and spears, leaving the end of the implement covered incarbon or ash. Getting stuck like a pig with one of these weapons would not only hurt but,if you survived, the wound would most likely retain some of the black residue that hadpenetrated your skin. Recovering from something like that back in the days beforeantibiotics would demonstrate an almost supernatural healing and survival ability. Plus,showing off scars and wounds is a pretty cool way to pass time around the campfire andimpress the ladies as well. This is easy to believe because in todays world just gettingstabbed accidentally by a pencil will leave a permanent black mark. I have one of thoseon my hand but it doesnt impress women that much. As many people know, the word tattoo comes from the Polynesian language of Samoa. Itwas introduced into the English language after Captain Cooks early voyage there on theHMS Endeavor in 1769. Samoan tattoos, called Pea, are famous. Getting a tattoo isntsomething Samoans do when drunk, or visiting Coney Island. Tattooing is a sacred ritefilled with many taboos (another word we get from that language), and the wholeelaborate process takes months. Traditional Samoan tattoos are only in black, and theystart at the waist and finish at the knees. Men who have undergone the tattoo ritual arehighly respected in the community. Men who havent undergone the very painful processof getting inked by means of handmade bone tools and wooden mallets are considerednaked. Unlike in our culture, the tattoo artist himself occupies a prestigious place inPolynesian society and the hereditary title master tattooist, passed down through thegenerations in Samoa, is held by only two families. Other famous tattoo designs from Polynesia come from New Zealand. The Maori peopleunderwent the tattoo ritual on their faces in order to create the feared ta moko.

Image credit: Wikipedia

But despite the importance of tattoos in Polynesia, we know that tattoos were in use allaround the world long before Cook stumbled across Samoa. The Romans were heavilyinto tats: all soldiers had tattoos on their handsa place you cant hideto prevent themfrom deserting. If you think that is a bit harsh, consider their poor slaves (Romans werebig on slaves too). A common practice of early Roman times was the tattooing of thewords Stop me, Im a runaway! on the FOREHEADS of slaves! As the Roman Empirebegan to embrace Christianity, tattooing was first frowned upon and then outlawed.Interestingly, the ancient Greek word for this type of marking on the body is stigma, andthis is where we get the negative term in English to stigmatize.

Image credit: superfuture.com

Ancient Japanese tattooing, or horimono, is an art form that employs bamboo needles. Itdates back to prehistory, or what we call the Stone Age. Tattoos were widespreadthroughout the Pacific Islands as well as in ancient India, Europe, and Africa. Althoughtattoos were also common in ancient Egypt, today in Egypt and Ethiopia, people whobelong to the minority Christian Copt community often sport a Coptic cross tattoo on theinside of their right arms or right wrists. Native Americans Early on in American history, trappers and adventurers came across the Native Americanart of tattooing. Indian tribes often practiced tattooing in order to commemoratesuccessful battles. A wandering trapper would find friends amongst Indians of a certaintribe if he too had one of their tattoos. Of course, if he ran into the wrong tribe his futuremight not have been so bright. At the same time, American whalers from New Englandwere roaming far and wide into the Pacific and beyond, coming into constant contact withtattooed Polynesians and Melanesians. When they returned from their long voyages, theybrought this art form back to the ports that were scattered along the east coast. The invention of the electric tattoo machine in 1891 sped up the process of getting atattoo. In a single day an artist could ink many more customers than ever before.Business for tattoo artists boomed during World War I, and it was reported that a goodartist could make up to $100 a day, which was a lot of money back in 1918. How much isthat now? About $1,500 in todays money!

Sam OReilly

Today, instead of using bone needles and wooden mallets for tattooing, artists usean electric tattoo machine that moves a solid needle up and down like a sewingmachine. The needle can penetrate the skin up to 3,000 times a minute but it onlygoes in a little bitabout one eighth of an inchand deposits a tiny drop of pigment(ink) into the dermis. This machine hasnt changed very much since Irish immigrantSam OReilly invented it in 1891 in New York. His machine, modeled on ThomasEdisons rotary electric engraving device, attracted a lot of attention not only for itsincreased speed but also for its accuracy. He was a success at painting people butpoor OReilly died in 1908 from a fall when he was painting his house.

Most of us are familiar with the idea of gang tats, especially teardrop tattoos, which canmean that the person who wears this tattoo is a murderer, with the number of teardropsindicating the number of his victims. Each tattoo carries a message and marks anexperience in a mans life. A spider or spider web signifies drug addiction, while a cat

denotes a thief. Tombstones represent time behind bars.

Image credit: russiancriminaltattoo.com

Gang tats are common not only among criminals in the US but in Russia too. Russianmafia tattoos are just now being studied. They have a long history going back to thegulag, or Soviet forced labor camps of the 1930s. Surprisingly, for a country that bannedreligion, religious symbols are quite common. Churches and cathedrals are popular, withthe number of spires indicating how many times the convict has been to prison. Captainsin the Russian mafia often have a star tattooed on their knees, meaning they bow to noone. These things are taken very seriously: if someone gets a tattoo to bolster hiscredentials without having earned it, the punishment is death! Tattooing became even more popular in the US during World War II when soldiers andsailors went on active duty in the Pacific. At that time, tattooing was associated with themilitary, and you could usually find a tattoo artist anywhere there was a military base.After the war and with the beginning of the ultra-conservative 1950s, tattooing entered aquiet phase. This changed with womens liberation in the 1960s, which opened up awhole new market to an activity previously restricted to men. Janis Joplins famous roseand vine tattoo, inked on her wrist by Lyle Tuttle in San Francisco, became a potentsymbol of that liberation. She followed that up with a few more small tats, including asmall heart tattoo on her left breast, or as Janis put it:

Image credit: Rolling Stone Magazine

I wanted some decoration. See, the one on my wrist is for everybody; the one onmy tit is for me and my friends.

Tuttle went on to tattoo other celebrities of the time, including Peter Fonda. He also didone on Chers posterior (since removed).

Free Tattoo Removal If you have gang tattoos and are determined to leave a dark past behind, you shouldknow that you can get them removed. You are probably aware that you will find getting ajob almost impossible with a gangland tattoo, doubly so in a tough economy. Manychurch organizations offer free tattoo removal to those who are turning over a new leafin their lives.

Clean Slate LA is one such organization. It is located in Los Angeles and offers low-cost orfree tattoo removal for ex-gang members who want to turn their lives around. See theirwebsite at www.cleanstlatela.org.

Image credit: erasethepast.org

Dr. Bryna Kane is a practicing dermatologist and professor of dermatology at both UCLAand UC Irvine. Her grandparents died in Nazi concentration camps, but her parentssurvived. Growing up, she remembered stories of the branding of camp victims and thenegative effects that tattoos can have on peoples lives. With her partner, Dr. Glassberg, Dr. Kane founded the charity Erase the Past in 1997.Young people at risk are able to get unwanted tattoos removed at Kane and Glassbergslaser clinic for free. Well, not exactly free: for every visit to the clinic the patient isrequired to perform five hours of community service. This does not mean picking up trashon the side of the road but involves service that teaches. Examples given by theorganization include working at the health department to learn more about sexuallytransmitted diseases or how to become a better parent. More than 4,000 people havebeen treated by Erase the Past and the program boasts a less than 20% dropout rate.

Dr. Kane comments that 80% of the young people she treats in the program are peopleof color. She tells us that the good news is many gang tattoos are homemade, andhomemade tattoos are usually easier to remove than professional tattoos. She also saysthat those with homemade tats are getting complete eradication with minimal scarring. This is a great program that young people who are serious about turning their livesaround should consider. You can check out this organization at www.erasethepast.org.

The Top 10 Reasons for Getting a Tattoo The word chickenshit has probably caused more people to get tattooed than any other

reason. - Lyle Tuttle

Image credit: Prick Magazine

Lyle Tuttle 1) To Look Cool:

This is me and Im awesome. 2) Memories:

Auntie Em, RIP 3) A tribute:

Heavy Metal Rocks! 4) To rebel:

Screw you. Im going my own way. 5) Peer pressure:

All my friends are getting them! 6) Boredom:

Why not? 7) To identify with a group:

Just joined a gang, so 8) To express individuality:

I need to be me. 9) Liked the design:

I love butterflies. 10) To make a statement:

I just had to Tattoos are a personal choice and the reasons for getting them are equally personal.There are probably as many reasons for getting tattoos as people who have them.

Top 10 Reasons for Getting a Tattoo Removed

Change your thoughts and you change your world. - Norman Vincent Peale

Image credit: Wikipedia

Norman Vincent Peale 1) Broken Relationship:

Cursive names of a past boyfriend or girlfriend are among the most commonlyremoved tattoos. Many see the old flames name branded on their body as unfair tothe new partner.

2) Job:

Employers hate tattoos! If you want a better, higher paying job it can help to losethe tat. Both the police and the military have severe restrictions on tattoos. A tattoocannot be visible during a military salute.

3) Change in Lifestyle:

What interested us years ago feels a little foolish now. Band names are a goodexample of common tattoo removal requests. Frankie Goes to Hollywood, anyone?

4) Bad Artwork:Lets face it, nothing is worse than a bad tattoo. Did you know that David Beckhamhas his wifes name misspelled in Hindi tattooed on his left arm?

5) Wedding:

Many women feel that unmarked skin looks best in a white wedding dress. 6) Fashion Issues:

This is for women in particular. Choosing clothes to either hide or flaunt the tattoo

on a daily basis becomes a pain. 7) Role Model:

Many people regret having tattoos once they have children. See the Mark Wahlbergexample I mentioned earlier.

8) Leaving a Criminal Past:

Whether it is no longer true or not, visible gang tats shout to everyone that you area gang member.

9) Being Judged: Being judged by others every day gets tiring. 10) New Religion: Some religions permit tattoos and others expressly forbid them.

Religion and Tattoos

Image credit: Wikipedia

Since Roman times wherever Christianity has entered the picture tattooing has beenfrowned upon and discouraged. Devout Christians point to Leviticus 19:28: Do not cutyour bodies for the dead or put tattoo marks on yourselves. I am the LORD. Thats prettyclear, I guess. Tattooing is forbidden to followers of the Jewish faith. Orthodox Jews also look toLeviticus 19:28 for their reasoning. More recent Jewish law, however, permits tattooing ifthe tattoo has been forced upon someone. An example of this is the number with whicheach victim was branded when they entered a concentration camp during the Holocaust. The two main sects of Islam, Sunni and Shia, disagree on many things and tattoos are noexception. Sunni Muslims believe that tattoos, as well as other permanent physicalalterations not connected with surgery or health, are forbidden. The Sunni Hadith do notpermit any disfiguring of the body, as these are haram. The Shias, on the other hand, aremore ambivalent about the subject. In Hinduism there are no religious police or any strict religious law. Hindus believe thatall rivers flow to the ocean and they take pains to point out how inclusive and toleranttheir beliefs are. There is no prohibition against tattoos or tattooing Hindu gods orgoddesses in Hinduism. However, if the design appears in one the wrong areas of thebody, they can cause offence, particularly if the image of a Hindu god or goddess is used. Buddhism, like Hinduism, is non-discriminatory when it comes to body ink. Tattoos arenot forbidden as long as the tattoos are not racist or do not incite hatred.

Sikhs are not supposed to change their bodies, which is why some men avoid shaving andlet their hair grow. However, browsing the various online forums about Sikhism, itappears that there are no restrictions regarding tattoos. Some symbols may causeoffence, but there is no blanket ban. If one converts to another religion, or a sect of a religion that does not permit tattooing,then something must be done to correct a tattoo problem. Such converts are often primecandidates for tattoo removal.

How Tattooing Works

Image credit: wholesale-in-china.org

A lot of people get tattoos or have had tattoos for years without really knowing how theprocess works. In order to better understand your choices for tattoo removal it isessential that you learn what a tattoo is and why they can sometimes be so difficult toget rid of. This is really a simple process, so dont be scared off and skip this part. You may not know it, but your skin is your largest organ. Human skin is composed ofessentially two main layers that sit on top of a third layer: the epidermis, the dermis, andthe hypodermis. The epidermis is the outer layer that we can feel and touch. It protectsus from germs, bacteria, and pollutants in our environment and it is our bodys first line ofdefense. The epidermis contains melanocytes, or cells that produce melanin, which is thepigment in our skin. The epidermis and the dermis sit upon the subcutis, or hypodermis,which is a thin layer of fat. This layer is often referred to as subcutaneous tissue but itreally is loose connective tissue and plain fat. We dont need to concern ourselves withthe hypodermis here. Our focus is on the middle layer: the dermis. The dermis is themiddle layer of skin, and it contains blood vessels, lymph vessels, hair follicles, sweatglands, collagen, fibroblasts, and some nerves. The dermis is where tattoos live.

Image credit: uchospitals.edu A tattoo needle penetrates the epidermis and deposits ink, or pigment, into the dermis.The introduction of foreign material into the body activates our immune system and ourwhite blood cells quickly ride to the rescue. These cells are called phagocytes, whichname comes from the Greek word phagein, to eat; the suffix -cyte is used in biology torefer to a cell. (One quart of healthy human blood is estimated to contain six billionphagocytes, and the discovery of these guys led to the 1908 Nobel Prize for Medicine.)Phagocytes basically eat any bacteria or foreign material so as to protect us frominfection. Normally, phagocytes eat and move foreign particles to places where they canbe washed away internally by our lymph system. However, ink particles are too large forthis to happen, which is why the majority of tattoo ink remains stable and in place in thedermis forever. Over decades, the pigment tends to sink deeper into the dermis andbecomes less visible when viewed from outside through the epidermis. This explains thefading and fuzziness of old tattoos. After about two months the newly implanted ink pigment lying in the dermis becomespart of the connective tissue in the fibroblasts. (These cells produce collagen, which givesskin its elasticity). Fibroblasts last forever and this is why tattoos do as well. To remove a tattoo we have to go through the outer layer of skin, or epidermis, in orderto get at the ink. There are various ways of doing this; none are pain free and some carryserious risks of scarring and infection. Because they have sunk down deep into thedermis, older tattoos can take more time to remove. Why Do Old Tattoos Fade?

A tattoo is basically ink pigment embedded into your dermis below your skin. The inkmolecules are too large to be carried off by your immune system and unless disturbed,they lie inert in the dermis permanently. However, you havent fooled your body. Theimmune system knows that something foreign is sitting there and to protect itself thebody coats the pigments in cells over a number of years. This coating and covering over

of ink is what causes a tattoo to fade or become blurry with time.

Another thing that can happen is that the pigment may have been applied too deeply.The result, again over years, is a leeching of the ink into the fat cells beneath the dermis.No matter what, tattoo fading and blurring will occur over time. One of the variables, or unknowns, in tattoo removal is that the type of ink used for thetattoo determines how easy or difficult the design will be to remove in the future. Tattoo ink is a combination of pigment (coloring) and a carrier (solvent) and, because theink is injected into the body, in the US this process falls under FDA regulation. Accordingto the FDA, many ink pigments are industrial strength colors suitable for printers ink orautomobile paint. That sounds pretty toxic! This is why under Proposition 65 inCalifornia, all tattoo artists must warn customers of the inherent toxicity of tattoo ink. An Old Recipe But what is the ink made of? The Romans left us an ancient recipe for tattoo ink: One pound Egyptian pine bark Two ounces of corroded bronze, ground with vinegar Two ounces of gall (insect egg deposits) One ounce of iron sulphate After mixing, the area to be tattooed was washed in leek juice and the ink mixture wasthen rubbed into pricked and bleeding skin. We dont have to use insect eggs today, but since manufacturers are not obliged to revealthe ingredients of their inks we can only speculate about what is inside. We do know thatheavy metals are frequently used, including mercury (for red coloring), lead (yellow,green), nickel (black), copper (blue, green), and iron (black), among others. In fact, someof the metals have reportedly caused problems in MRI scans. At least there arent enoughmetals there to set off the body scanners at airports. And a New Recipe A recent advance in ink technology is Infinitink. The manufacturer claims that its ink iseasier to remove than traditional tattoo inks. This is because of their patented process ofencapsulating the pigment in tiny balls that easily break apart under a laser and releasethe coloring into smaller particles that the lymphatic system can then wash away.Currently, Infinitink is only offered in a small number of tattoo parlors in the US andAustralia. Infinitink only comes in black and maybe red. Time will tell whether this stuff isthe future, but right now it looks like it is very much a work in progress.

Part Two

Fire

Image credit: deviantart.com

Tattoo Removal

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Ok, weve come to the section that you are most interested in: How do I get this thingoff? Below we examine all the various choices for tattoo removal that are available today.As I said earlier, there have been advances in the last couple of years, especially in thelaser field, that have increased the success rate of the removal process. However, youneed to realize that there is no single best way to remove a tat. There is a best wayfor you, however, and it may be different than that one that worked for your friends.These differences have to do with your skin type, the age of the tattoo, the ink used, andother variables, which is why a thinking consumer should look carefully at all the optionson the table. Often a combination of removal methods works best. The Most Important Thing The most important part of the removal method you eventually choose is patience. Allsatisfying results take time. The reason why there is no best way of tattoo removal is because there are manyvariables at play. These variables are unique to each case and impact how successful ordisastrous a chosen method of removal may be. Not considering budget, the mainphysical variables that have to be accounted for are the following:

Your skin typeYour skin colorHealth of your immune systemAge of tattooDepth of ink

Type of inkProfessional or amateur tattoo

Early forms of tattoo removal ranged from the ridiculous (injecting pigeon poopreally!)to the sadistic (sanding it off). Today with advances in science there are many moreeffective and less painful choices on the market. One of the most important factors is your skin type. The US Food and Drug Administrationand the American Academy of Dermatology use the Fitzpatrick Scale to classify skin colorand the tanning behavior of various skin types. Dr. Fitzpatrick was the Chairman of theDepartment of Dermatology at Harvard Medical School. In the Fitzpatrick Scale there aresix skin-types: The Fitzpatrick Scale Skin Type Sun History Example I Always burns easily, never tans, Red-headed, freckled, Celtic, extremely sensitive skin Irish-Scots II Always burns easily, tans Fair-skinned, fair-haired, minimally, very sensitive skin blue-eyed Caucasians III Sometimes burns, tans gradually Average-skinnedCaucasians,

to light brown, sun-sensitive light-skinned Asians or skin,skin Hispanics

IV Burns minimally, always tans to Mediterranean-type Caucasians,

moderate brown, minimally light skinned African Americans sun-sensitive skin V Rarely burns, tans well Middle Easterners, some

sun insensitive skin Hispanics,African-Americans and Asians VI Never burns, deeply African Americans, Dravidians pigmented,

sun-insensitive skin Finally, no matter which treatment you choose, even if you get 100% of your tattoo inkremoved you will likely still have a small scar. In the best case scenario, this scar wontbe horrific. This is the scar left behind from the original tattoo needle piercing your skin.

Laser Treatment

Image credit: The Washington Post Many people automatically and incorrectly assume that laser treatment is the only sureway to remove a tattoo. Not so. Laser treatment is, however, now the most popularchoice. Lets look at the pros and cons of this relatively new method. What does Q-switched Mean? The word laser, like the word scuba, is an acronym for a longer term that doesntsound as cool: Light Amplification by Stimulated Emission of Radiation and Self ContainedBreathing Apparatus arent that easy to say. I like laser and scuba better. There aremany different types of lasers which fall into one of two broad categories, continuouswave and pulsed operation. Continuous wave lasers are just thatthe beam is ofconstant output power, is uninterrupted, and is monochromatic (i.e., it has an unchangingwavelength). Pulsed power lasers are what we are interested in; they work on peak pulsepower with short duration. Q-switched lasers are a prime example of pulsed powerlasers. What is Nd:YAG? The most common Q-switched lasers are Nd:YAG lasers, which, if you really want toknow, stands for neodymium-doped yttrium aluminum garnet. This identifies the crystalused in the solid state laser, YAG. The rare earth neodymium is doped into the crystalto improve its effect. The common wavelength is a frequency-doubled 532 nm, which

creates a greenish light. Other Q-switched lasers used for tat removal are Q-switchedruby and Q-switched alexandrite. Where did lasers come from? Santa Claus didnt bring them down from the pole. Theirbeginnings can be traced back to Einstein who established the theoretical foundations forthis new science almost 100 years ago. Various groups of scientists around the worldfooled around with these things after that, but the word laser didnt come along until1959. Nobody knew what to do with them at the time and they were referred to as asolution looking for a problem. Society in general came into contact with lasers with theinvention of the supermarket barcode scanner, which was introduced in the mid-1970s.Now, of course, we find them everywhere, from the ultra low-power laser pointers usedat boring conferences to the semiconductor lasers in our DVD players to the laser printersin the office. Lasers Get Cheaper In the 1990s lasers became cheaper and more widespread, which made them a viablemethod for many medical procedures including eye treatment, kidney stone treatment,and finally, tattoo removal. Lasers used in tattoo removal work by breaking down intosmall particles the pigment in the ink that is embedded in the dermis. This process iscalled selective photothermolysis. These particles can then be removed naturally by thebodys lymphatic system. In effect, once small enough, the particles are washed away bythe bodys natural immune system. As we just learned, the lasers now preferred in tattoo removal are called Q-switchedlasers. This type of laser is most suited to tattoo removal because it works using burstsof energy, or pulses, rather than one steady beam. By bottling up the energy and usingan attenuator to suddenly release the charge, the laser transmits much higher watts ofenergy during the pulse. Just enough energy is used to break down the ink pigmentwithout heating up and destroying the skin around it. This is where operator skill comesinto the picture. The more skilled the operator, the less chance scarring will occur fromoverheating of the surrounding skin. Each color of your tattoo requires a different laser color (or wavelength) to ensure thatthe ink itself is absorbing the energy and not the surrounding tissue. The pulse durationof the laser is measured in nanoseconds to allow just enough energy to break up thepigment as well as to allow heat dissipation from the surrounding tissue. If not enoughenergy is released, the pigment will not break up and the tattoo will remain in place. Iftoo much energy is used, the surrounding skin is cooked and scarring is likely to occur.Again, the skill of your practitioner is vital in minimizing the risk of scarring. What Color Ink Is Easiest to Remove?

Lasers work best on black ink. One of the arguments against laser treatment, other thancost, which I will come to later, is they are not as effective in removing certain colors:yellow and green in particular are more difficult to break up. Lasers manufactured after2006 have a better track record here. The newest lasers can produce four differentwavelengths in one machine. Some clinics have lasers with the correct wavelength thattarget these colors, or they have the correct dye modules. You need to confirm that thisis the case with your practitioner before you commit. White ink in particular is very difficult for lasers to break up. Some clinics will only workon white ink if at least five to ten years old. If you have a lot of white ink in your tat youwill want to ask about this first. The rest of the tat may eventually disappear with lasertreatment but it wont be a complete removal if the white ink is left. The other risk ofusing lasers on white ink is due to the higher incidence of iron oxide in this ink. Lasertreatment can cause this material to turn gray or black, and it will then never come out. If you have pastel colors in your tat there is a high likelihood that white ink is mixed withdarker colors in order to obtain that color. This is true with pinks and sky blues inparticular.

Make sure your clinic or dermatologist of choice uses a scientific predictive method toestimate how many treatments you will need to ensure successful tattoo removal. Themost well known method is the Kirby-Desai Scale, which was developed in 2009 by twodermatologists with tattoo extensive removal experience, Dr. Kirby and Dr. Desai.

Image credit: willkirby.com

You may recognize Dr. Will Kirby as a media personality with his own fan site. He hasappeared on the reality TV shows Big Brother 2 and Big Brother 7: All-Stars, amongothers. Dr. Kirby is also a part owner of the Dr. Tattoff laser tattoo chain of clinics foundin southern California and Dallas, Texas. The Kirby-Desai scale uses numerical measurements for six critical variables:

1) skin type2) tattoo location3) tattoo color4) amount of ink5) scarring6) layering

The resultant score provides an accurate estimate of how many laser treatments,spaced eight weeks apart, will be necessary for complete removal. Without the KDScale as a guide, your practitioner is just guessing about your treatment, and, given theexpense and time commitment you are making here, you deserve better.

Laser treatment is also less effective on darker skinned people. This is because dark skincontains more melanin, which diffuses and absorbs the laser radiation and results in theskin becoming cooked and then scarred while at the same time the ink does not receiveenough energy to break apart. A Q-switched Nd:YAG 1064 nm laser is often used in thisinstance. The wavelength of the Nd:YAG is half that of the normal green colored Nd:YAG532 nm laser, making it infrared and invisible.What is Hypopigmentation? Hypopigmentation, or permanent skin lightening at the area of treatment, is also a higherrisk for people with dark skin. In these cases, it is recommended that people undergotreatment intervals of longer than the average six-to-eight weeks to ensure properhealing. Another downside of laser treatment is that it works best on areas of thicker skin. Thatankle tattoo you now hate may not respond well to laser treatment and the risk ofscarring there is higher. Again, because of all the different variables that are unique to each patient, like age oftattoo, depth of ink, type of ink, color of ink, skin type, etc., laser clinics will not offer amoney back guarantee. Practitioners just dont know whether or not their process willwork 100% on a specific person. Laser treatment will fade a tat for all the reasonsmentioned but complete removal is still a crap shoot. After getting blasted by a laser some bleeding on the skin surface may occur. A whitediscoloration, which is thought to be caused by steam or gas released within the skinafter laser contact, is often observed. Afterward, a crust or scab forms over the treatmentarea; this will fall off about two weeks after treatment. Some ink pigment may be seenin the scab itself. In order to avoid the possibility of scarring, it is very important that youdont pick a the scab. Let it go, baby, let it go.

How Long Does It Take? Unfortunately, laser treatment requires multiple visits and is quite expensive. After eachtreatment, time is needed for the lymphatic system to remove the now shatteredpigment molecules from the dermis. On average, at least eight visits are needed with ahealing period of up to eight weeks between each visit. Anecdotal evidence suggests thattreatment at four-to-six-week intervals results in a much higher percentage of scarring.Depending on the color, complexity, and size of a tattoo, up to twenty visits may beneeded. Complete removal of a tattoo using a laser will therefore take between eight totwelve months for smaller tats and maybe two years or more for full trunk tattoos. Does It Hurt? Like all tattoo removal options, laser treatment is not pain free. It is often described asbeing like having your skin stunned by a big rubber band, or being splattered with hotgrease. Fun. Topical anesthetic gels are often applied for pain management purposes.Scarring from Q-switched laser treatment is reported in about 5% of all cases. Allergic reactions have been known to be triggered with the breakup of the ink pigmentand its release into the immune system. These can be controlled through the use of oralantihistamines and corticosteroids that are administered before treatment. Another potential drawback is the release of carcinogenic amines into the blood stream,which may occur when a laser breaks up certain azo dyes. Azo dyes and colorants havebeen banned in the EU since 2003 but tattoos that predate this may be at risk,particularly if colors such as reds, oranges, and yellows are present. People with diabetes may need to exercise caution when considering laser treatment asdiabetes can impede the healing process. The Stats: Cost: Each session will range from $250$850 depending on where you live, the size ofthe tattoo and other complications. According to the ASPS (American Society of PlasticSurgeons), a 2007 study found that the average cost of laser tattoo removal was around$2,500. This depends again on the colors and size of the tattoo, how deep the ink wasapplied, the kind and amount of ink used, and the type of skin of the patient in question.Also, there were wide regional differences in cost, with the lowest average cost of $2,250found in the mid-Atlantic states and the highest costs on the west coast of around$2,900. For large, multicolored tattoos, the costs could reach up to $10,000. A rough ruleof thumb for laser treatment is to budget about ten to twenty times what the tattoooriginally cost.

Time: This depends on the number of treatments required. For anything but the tiniesttattoos, it is best to budget on at least eight treatments each spaced six to eight weeksapart. Pain: More painful than other methods. It hurts! Pros: Second highest rate of success for complete removal. Cons: Expensive, painful, and takes eight to twelve months for full treatment. Guarantee: None. Effectiveness: Second highest rate of success for complete removal. Where: Reputable laser clinic or dermatologists office.

10 Questions to Ask a Laser Clinic Nothing in life is guaranteed and there is no guarantee that laser treatment will be thebest choice for your skin and your tattoo. This is why it is very important to have aconsultation with a trained and experienced laser technician or dermatologist in orderto get the answers you need before you commit to a lengthy and expensive treatmentprocess. These questions are examples of the major areas that you should cover in thisconsultation and they should be asked in person. The doctor or technician will only beable to give you an accurate assessment and estimate of effectiveness and cost afterseeing you and your tattoo. 1) Can you completely remove this tattoo using lasers? 2) How many visits will it take? 3) How long between now and total removal in your estimation? 4) What will the treatment cost? 5) Do you have payment plans or treatment package plans? 6) Would you recommend that I fade the tattoo using a tattoo fading acid or cream

before I begin laser treatment? 7) Will the lasers in your clinic be able to treat all the colors in my tattooincluding

the whites, yellows and greens? 8) I have dark skin. What are the risks of permanent pigment change to my skin? 9) What do you recommend in terms of aftercare? 10) Will my insurance cover this? (The answer is likely to disappoint you. Tattoo

removal is considered a cosmetic or elective medical treatment and is notcovered by most insurance policies.)

Infrared Coagulator (IRC)

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Like a laser, an infrared coagulator (IRC) uses light to attack the ink pigment lying inert inthe dermis. However, an IRC is not a laser as it uses infrared light to heat the tissue thatholds the pigment. A laser attacks the pigment directly by matching the laser wavelengthwith that of the ink color. Because it uses infrared light, the incidence of collateral tissuedamage using an IRC is likely to be higher than that of a true laser. The treatment procedure is similar to that of lasers. The area to be treated is cleanedand a topical anesthetic is applied to numb the skin. Very short pulses of infrared light areshot at the tattoo. A grid-like approach is used to target the tattoo with untreated spacesleft between treated spaces. After treatment a scab will form and eventually fall off. With the scab some of the ink willbe removed. At least three treatments are necessary for small tattoos.

The advantage of IRC treatment is that it attacks all ink colors. It usually requires fewervisits than laser treatment as well. IRC treatment should be cheaper than laser treatmentbecause the equipment costs much less. But there are also downsides to keep in mind.The chance of scarring using an IRC is higher than that of laser treatment, depending onwhom you talk to. This is because of the heating of the surrounding tissue rather thanjust the ink during treatment.

The Stats: Cost: Several hundred dollars per visit. Three visits are likely to cost up to $1,500. Time: One-month intervals for healing between visits. Three visits, or three months for asmall tattoo. Pain: Similar to laser treatment. Pros: Possibly cheaper than laser and faster as well. Cons: Higher risk of scarring. Guarantee: Unlikely. Effectiveness: Can be effective for total removal. Where: Any qualified clinic or dermatologists office.

Intense Pulsed Light treatment (IPL)

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Intense pulsed light therapy is another type of light treatment. IPL uses filtered xenonflash lamps, not lasers. The tattoo is covered in a special anesthetic gel, a prism is placedon it, and a light-emitting wand is passed over the area to be treated. IPL is less painfulthan laser treatment but more expensive, costing around $10 per pulse. If you have alarge tattoo you would need a lot of $10 shots and these can add up. IPL is sometimes incorrectly referred to as laser treatment. It is not. However, like a Q-switched laser, IPL is light transmitted in short bursts at high intensity. It is frequentlyused in hair removal. The debate about the relative effectiveness of IPL and Nd:YAG lasertreatment is ongoing. The consensus is that IPL is as effective as laser treatment but mayrequire more treatments. One thing everyone can agree on is that IPL is less painful thanlaser treatment. It described as feeling something like a light sunburn. Aside from hairremoval, IPL is often employed in the treatment of acne, spider veins, and birth markremoval. IPL skin treatment is also called photorejuvenation and is used to remove wrinkles andreverse some aging effect. This is achieved by causing controlled wounds to the skin,which then stimulates new skin production. How Does IPL Work? For tattoo removal, IPL works by sending light through a prism that is put on the skin.When this light hits dark areas such as the tattoo pigment, it breaks these areas apartand allows the lymphatic system to clear away the now-shattered and smaller pigmentparticles. The closer the tattoo is to your heart the quicker the clearing process occurs,meaning that ankle and wrist tattoos take longer.

As with laser removal, IPL works through the absorption of heat energy by the inkpigment. This is wavelength-dependent. Different wavelengths of IPL are also needed totarget and break up different tattoo ink colors. IPL works best on people with light colored skin and has a lower success rate on darkskin. This is because IPL targets the dark color in the dermis. The greater the colordiscrepancy between the tattoo ink and the surrounding skin, the more effective it is. Aswith lasers, those with darker skin who undergo IPL treatment are at risk ofhypopigmentation, or localized permanent loss of skin color. The risk of this occurring isless with IPL than with lasers. People with diabetes will need to exercise caution here as diabetes may impede thehealing process. How Long Does It Take? Practitioners claim that on average amateur tattoos require three to five treatmentswhile professional tattoos require five to eight treatments. Scarring is reported to occur inaround 2% of patients undergoing IPL treatment. After treatment the skin will turn redand swell a little. Blisters may form but the skin should return to normal in one to twoweeks after treatment. The reason IPL hurts less than laser treatment has to do with the main differencebetween them. IPL directs light to the dark areas of the skin, which in this case is thetattoo ink sitting in the dermis. It does not damage the epidermis, or outer layer of skin,in order to do this. Lasers, on the other hand, have to pierce the epidermis to reach theink in the dermis. This superheats and damages the outer layer of skin, causing morepain and more damage. Another advantage of IPL compared with lasers is that there is less down time betweenvisits. With IPL, treatments are usually performed every three to four weeks. Lasertreatments are more invasive and require a six-to-eight-week gap between treatments. IPL can cost anywhere from $250 to $600 per treatment depending on the variablesdiscussed earlier. Packages for treatment are often available and this can help lower theper treatment cost. All terms should be discussed thoroughly and fully understood beforeyou commit to treatment. IPL at Home

Image credit: hairlaserremoval.co.uk

Black Magic IPL, or Neodymium Magnetic Light as the product is also called, is marketedon the internet as an at home IPL solution. Details can be found atwww.neomaglight.com. The promoters, backed by venture capital firm Vydrogen, cautionthat the device is effective for small tattoos around the size of business cards only andwill not be effective on large body tats or full sleeve tats. Dark inks lighten the easiest. Despite the information publicly available, the website itself is poorly constructed andthere are a lot of spam comments. The before and after pictures are hardly convincing. The other issue with home IPL treatment is that the customers lack of training andexperience will probably result in less-than-optimal results. IPL bursts need to beadjusted in order to deal with different ink colors and the depth of the ink in the dermis.Only a skilled medical professional will be able to do this accurately. However, you arepaying this professional a lot of money for each visit. Keep in mind that most home-use IPL units are for hair removal purposes only. The Stats: Cost: Anywhere from $750 to $4,800 depending on the size of the tattoo. Time: Three to eight treatments at one month intervals. Pain: Less than laser.

Pros: Less painful and less invasive than laser treatment. Cons: Expensive but can cost less than laser treatment. Guarantee: No. Effectiveness: There is some dispute as to how effective IPL is compared to lasertreatment. Where: Spas and qualified clinics.

Chemical Extraction Chemical extraction is a method of tattoo removal that requires using a tattoo machine toactually tattoo over the existing ink. However, this time a chemical compound that bondswith the inert ink lying in the dermis is tattooed into the design. After bonding with theink the combined mixture is pushed up naturally to the epidermis and forms a scab. Acouple of weeks later the scab falls off, taking a large part of the ink with it.

Image credit: allposters.com

Over a hundred years ago in 1888, a physician in France, one Dr. Variot G. Nouveau,discovered that tattooing over an unwanted tattoo with an acid solution was aneffective removal technique. His process, the Variot Method, or the FrenchMethod, caused a large scab to form which, when it fell off, removed ink with it. Dr.Nouveaus formula contained a mixture of tannic acid, glycerin, and water. Tannicacid was found in the mid-20th century to cause cancer and is no longer used inmedicine.

Rejuvi

Image credit: Rejuvi.com

Rejuvi is a chemical extraction substance that is applied with a coil tattoo machine or arotary cosmetic tattoo machine and works by bonding with the ink pigment lying inert inthe dermis. Known as E-raze in Europe, the ingredients in the Rejuvi Tattoo RemovalSuspension Solution chemically bond with the inorganic metal oxides in tattoo ink, likeiron oxides, carbon black, chromium oxide and titanium oxide. Once the ink pigmentbonds with the suspension solution, the body pushes it to the surface. A scab, or crust, isformed and some of the original ink is removed when the scab falls off.

The treatment cant be done at home and requires a professional technician trained inRejuvi application in order to minimize risk of scarring. The four step process involves: 1) application of topical anesthetic, 2) the tattooing of Rejuvi into the skin, 3) the formation of a crust over one to three weeks, and 4) the falling off of the crust in fifteen to twenty-five days. Once the crust falls off the skin will be red and raised. The skin should return to a normalcolor over a period of a minimum of three to six months. How Long Does It Take? Due to the fact that professional tattoos lie just beneath the surface of the skin, onetreatment of Rejuvi usually results in an up to 60% removal of the unwanted tattoo.Older tattoos will require more work than newer ones. While one visit may result in a big

difference, the preferred method is the multiple session approach. The maximumrecommended area to treat at one time is two square inches. Large tattoos will betreated in separate sections and separate visits. Follow up treatments can be made onlyafter eight to ten weeks have elapsed in order to allow for sufficient skin recovery. A single treatment will take up to one hour for a two-square inch area (five-squarecentimeters). The company behind Rejuvi, Rejuvi Laboratory Inc., is based in California, and theproduct is the result of research collaboration between founders Dr. Wade Cheng, whoholds a Ph.D. in biochemistry from University of California, Davis, and Dr. Arthur Furst,who holds a Ph.D. in chemistry from Stanford University. The company has a whole rangeof cosmetic and skincare products with the tattoo removal system being just one of theirofferings. Aftercare Is Vital The company claims that there is a 92% success rate in removing tattoos with a scarringrate of 6%. Some users rave about their success while others have experienced severescarring, usually due to improper aftercare. The drawback of Rejuvi, other than itsexpense, is that aftercare is absolutely critical. Users complain that after treatment thescab, or crust, is itchy, and scratching it dramatically increases the risk of scarring. Thecrust must remain absolutely dry for the first seventy-two hours after treatment. Once itforms, users report skin tightness, which is uncomfortable. Ingredients: water, zinc oxide, magnesium, oxide, calcium oxide, n-propanol,Triethlaomine, and benzoic acid. Rejuvi treatments are performed at qualified clinics and spas. The treatment itself mimicsthat of getting a tattoo and the pain experienced should be similar. Much of the pain anddiscomfort involved comes in the period of aftercare. However, patients report that it isa lot less painful than having laser treatment. Three to seven treatments for tattoo removal are required, with three to four beingenough on average. Treatments can be performed only after complete healing of theprevious visit, or around every two to three months. The average cost per treatment will depend on where you live and whether you aretreated at a clinic, a dermatologists office, or by a trained tattoo artist. It is safe to figureon $125$150 per square inch.

Rejuvi Banned in Europe?

According to the Times of Malta, in 2010 the Malta Standards Authority ordered thewithdrawal of Rejuvi from the market. The reasons cited were that the product posed ahealth risk to consumers due to its pH-value of 13.8 and its highly corrosive potential. Icontacted Rejuvi about this and they denied it. According to the email I received fromone Jeanie Munich:

Why Rejuvi Tattoo Removal technique is popular in many European countries butis banned in certain part (sic) of Europe? Does this make sense?

I wasnt able to find any more information about a partial European ban of the product.I did learn, however, that Rejuvi at least responds to inquiries.

The Stats: Cost: At $125 to $150 per visit with up to four visits are required, budget on $600 toremove a one-inch square tattoo. Time: Up to 60% of the tattoo is removed with first treatment. On average, three to fourtreatments required for complete removal with each treatment interval being two tothree months. Pain: Same as getting the original tattoo. Skin tightness and itchiness a problem duringaftercare. Pros: Faster and cheaper than laser. More effective than creams. Cons: Complex aftercare required. Risk of scarring or ulcer development if infectionoccurs during aftercare. Guarantee: No. Effectiveness: Reportedly effective in most people. 100% removal is difficult. Where to buy: Only sold wholesale to qualified technicians.

Tattoo Erase

Image credit: tattooerase.com Developed by researchers in Germany, Tattoo Erase uses a very similar treatmentprocess to Rejuvi. The company behind the product claims that the ingredients used inthe Kataderm Fluid solution are all natural. However, the company does not provide anydetails about what those natural ingredients are. Similar to Rejuvi, the Kataderm Fluid is applied via a tattoo machine, placing thecompound beneath the outer skin layer so that it can bond with the ink pigment thatrests in the dermis. The bodys immune system then expels the newly bonded moleculesto the surface of the skin where they are removed when the scab falls off. Currently, the procedure is only offered in Europe and the UK. Costs will depend on theclinic you visit and the results of your consultation with the technician. One clinic in theUK was advertising this treatment for $100 for each fifteen-minute session. On average,one session will not be enough to remove all the tattoo ink. Treatments are done in fifteen-minute intervals, which is enough time for smaller tattoos.Up to one hour is needed for larger tattoos. At least eight weeks healing time isnecessary between visits. Aftercare is absolutely vital to avoid scarring. As the company soberly notes, It ispossible you may be scarred by this treatment. The Stats: Cost: Expensive: up to $400 per one hour session. Time: Four months for two treatments with two month intervals needed between futuretreatments. Pain: Similar to getting the original tattoo. Itchiness for several weeks as scab heals. Pros: More effective than creams.

Cons: Expensive. Only available in Europe. Ingredients unknown. Risk of scarring. Guarantee: No. Effectiveness: Can be effective. Where: Currently available at select clinics in Europe only.

Surgical Excision

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Tattoo excision is the surgical removal of a tattoo by a qualified surgeon. This is the mosteffective way to completely remove an unwanted tattoo. Excision, while invasive, is mostsuitable for smaller tattoos, which can be removed in one session. It is also the methodof choice for people whose tattoos are too deeply embedded to be removed effectively byany other means. Deeply embedded tattoos can be amateur tattoos or just old tattooswhere the ink pigment has sunk into the lower dermis. Its Fast After a consultation with your surgeon the procedure works like this. First, the area of thetattoo to be removed is shaved and cleaned. Local anesthetics are given. This numbs thearea in question only. You will be awake for the procedure so if you dont like blood,especially your own, you will definitely want to look away. Actually, bleeding is reportedlyvery light as blood vessels are cauterized during the procedure. For a small tattoo, a fullthickness removal occurs, which consists of removing the epidermis and the dermis. Theskin on either side is then stretched to close over the wound and held together withsutures. You are given antibiotics and are usually out the door in one hour. Stitches arenormally removed in a week to ten days. For larger tattoos this process is far more complicated. The center of the tattoo isremoved first and the wound allowed to heal. Several visits and operations may benecessary with skin graftsthe taking skin from another area of your bodybeingnecessary to close the wound. The pain, expense, and risk of infection are obviouslyhigher the larger the tattoo to be removed.

Scars? A slight linear scar is likely to result where the skin is sutured. The size and permanenceof the scar depends on the skill of the surgeon and how rigorous the aftercare is. Oftenthese small scars fade away with time; over a six-to-eight-month period. However, Asiansand other darker skinned people who are susceptible to keloid formation (heavy scarring)should carefully consider the risks involved in excision. The Stats: Cost: Around $1,000 for a small tattoo. Time: One hour for a small tattoo. Excision is also the fastest way to remove a tattoo. Pain: Minimal. Pros: Fastest and most effective method for complete tattoo removal. Cons: Invasive, expensive, and a small risk of a linear scar. Guarantee: Not likely. Effectiveness: 95% success rate. The most effective method of complete tattooremoval. Where: Any qualified surgeon or cosmetic surgeons office.

Salabrasion

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Salabrasion is the oldest form of tattoo removal known to man. Looking at the word willtell you all you need to know: sal (salt) + abrasion (rubbing). This can be a DIYprocedure but all you will end up doing is replacing that unwanted tattoo with anunwanted scar. Here is how it works: 1) The area to be treated is shaved and cleaned;2) A topical or local anesthetic is applied (if done by a medical professional);3) A gritty paste of salt and water is made;4) The paste is applied to a wood block wrapped in gauze;5) The tattoo is rubbed hard for 30 to 40 minutes. Enjoy. Intense bleeding will result. Healing time will be many weeks and the procedure almostalways requires repeat treatment (ouch!) to get all the ink out. The rubbing has to bedeep enough to reach into the dermis where the ink lies. This method may be the oldestand cheapest method of tattoo removal but it is probably the worst of all your choices.Heavy scarring is almost guaranteed and the risk of infection is high. Salabrasion shouldnot be considered by people who are prone to keloid formation. Salabrasion is not a DIYprocedure. Not recommended. The Stats: Cost: Less than $5 if you do it yourself (not recommended). Otherwise it depends on thepractitioner, if you can find one.

Time: Less than an hour for each treatment. At least two treatments are likely to benecessary. Pain: Painful aftercare if anesthetic used. Painful during procedure and after if not. Pros: Cheap. Fast. Cons: Highest risk of scarring (almost certain) and infection. Guarantee: Unlikely. Effectiveness: Effective. Where: May be difficult to find a clinic that still practices this.

Dermabrasion

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Dermabrasion is the rubbing away of skin to encourage new skin growth. For tattooremoval, this is usually accomplished by using a mechanical spinning brush that isdesigned to peel human skin. Yes, it is unpleasant and frequently the last ditch choice forthose who have tried everything else. Dermabrasion usually only works on tattoos thatare not very deep. Your doctor, or plastic surgeon, cleans the area to be treated and administers a localanesthetic such as lidocaine. Next, the skin is sprayed with liquid nitrogen to freeze thetop layer making it stiffer and easier to work on. Then the spinning abrasion brush isbrought out in order to grind away the epidermis and reach the dermis where the inkpigment is located. (Time to look away!) The process will take anywhere from a fewminutes to two hours depending on the size of the tattoo. Vasoconstrictors, such as ephinidrine, are also used to control blood flow to the treatedarea. Without these you will bleed a lot. They work by causing the veins that carry bloodto narrow and therefore reduce blood flow. Proper aftercare is critical and takes up to two months. More than one treatment isnecessary. The chances of scarring are very high, and this treatment should not beconsidered by people who are keloid-prone. Permanent change in skin pigmentation ofthe treated area is also a risk for people with darker skin. Dermabrasion is not a DIYprocedure. If all that doesnt turn you off, consider this: the cost is high. Each treatment session willcost several hundred dollars with repeat visits necessary. Some estimates put the

average cost of dermabrasion tattoo removal at around $1,500. The Stats: Cost: High. Around $1,500 on average. Time: Six months or more of treatment. Pain: Painful, expensive, and involves lengthy aftercare. Pros: Effective on shallow tattoos when nothing else works. Cons: High risk of scarring (almost certain) and infection. Guarantee: Unlikely. Effectiveness: Effective in most cases. Where: Qualified plastic surgeon or dermatologists office.

Cryosurgery

Image credit: uchospitals.edu Despite the name, cryosurgery isnt really surgery at all. It is also known as cryotherapy.Cryosurgery works by using a super cooled gas, such as liquid nitrogen, to freeze the skinabove the tattoo. This procedure has been around for over 100 years but is still arelatively uncommon way of removing a tattoo. Freezing the skin destroys the cells inside resulting in the peeling away of the skin. It issimilar to getting frostbite. The frozen tissue below the skin where the tattoo pigment liesis also destroyed and then slowly replaced by the bodys healing process. The procedure is not as painful as laser treatment but it is also not pain free. Chances ofscarring are minimal but there is a risk of damage to nearby tissue and nerve cells. Somepatients have experienced pigmentation changes in their skin after treatment andhealing. The risk here, as ever, will be greater for patients with darker skin. Several treatments will be necessary but the number and depth of treatments will dependon the size, location, age, and depth of the tattoo. Cryotherapy treatment on areas ofvery thin skin and no fat, such as the ankle, may be very painful and are not advisable.

The Stats: Cost: Less than laser treatment but not cheap. Cost is similar to dermabrasion. Time: Several months as more than one treatment will be necessary. Pain: Minor compared to laser or salabrasion. Pros: Less invasive, less chance of scarring. Cons: Risk of tissue and nerve damage. Some pigment change reported. Guarantee: Unlikely. Effectiveness: Reviews are mixed. Where: Qualified plastic surgeon or dermatologists office.

Part Three

Earth

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Home Tattoo Removal Products

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What about removing a tattoo at home? There are many options out there, most of whichare cheaper than those which require expensive visits to clinics.

Please Note: Used improperly, some of these treatments are dangerous. This isespecially true of the acids. Improper usage of acid on the skin will burn and causescarring. If you do not feel confident trying this on your own then dont do it! Also,please re-read the disclaimer page at the beginning of the book. I am notadvocating any at home treatment without you first discussing it with a qualifiedmedical professional.

So what are the choices for at home tattoo removal products? Generally, there are twotypes, peeling agents (acids) and creams. The internet is full of products that are guaranteed to completely remove your tattoowithout pain and in the privacy of your own home. The ads scream, No waiting in thedoctors office! Etcetera. Take these claims with a large grain of salt, or even a fewspoonfuls. There is no conclusive proof that these creams actually work in removingtattoos. Some of these solutions may work on some people and others may give youcancer. Used properly, however, these methods are less painful than laser treatment andvery much cheaper. UV protection is an important part of the healing process. After treatment bandagesshould cover affected areas and later a good sunscreen applied daily until healing iscomplete and normal skin color has returned. Recent medical research indicates that theuse of glycolic acid makes people more susceptible to UV damage and sunburn.

Lets look at what these acids and creams do and how they differ.

The Acids TCA The Poor Mans Laser

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TCA, or trichloroacetic acid, is a non-prescription skin peeling agent. Often called thepoor mans laser, TCA is also used for genital wart removal and comes in liquid form.TCA is the main active ingredient in the products Inkbusters and Nuviderm. It works bycausing a controlled inflammation to the surface of the skin above the tattoo, accordingto Inkbusters. New skin replaces the old skin, gradually covering the tattoo and resultingin tattoo fade. There is a chance of scarring using TCA products and they are notrecommended for facial cosmetic tattoo work. TCA may also cause hypopigmentation(white spots) on darker skinned (Type V, V I) people, among whom the results are moreunpredictable.

What is Hypopigmentation and Hyperpigmentation? Hypopigmentation is the permanent loss of your natural skin color, which results in theskin becoming lighter in appearance. This is caused by lack of, or depletion of, melaninin the skin. It is more common in people with darker skin (Type V, VI). Melanin is the pigment that determines skin, hair, and even eye color. Albinos, forexample, have little or no melanin. Melanin has special photochemical properties thatabsorb harmful UV rays from the sun and dissipates them as heat. This prevents directand indirect DNA damage to the skin that results in melanomas and other malignant

skin cancers. Hyperpigmentation is the darkening of skin and sometimes nails caused by an increasedamount of melanin. This can be caused in darker skinned people with excess sunexposure. Laser treatment can be a cause of hyperpigmentation as well.

Diluted TCA is also frequently used in dermatology clinics as a medium-depth chemicalpeel. It works, like other chemical peels such as glycolic acid, by burning off the toplayer of skin allowing healthier newer skin to come through. TCA is often used at skinclinics or spas in this fashion to remove fine wrinkles, acne scars, and other slightimperfections in the skin. TCA is less a cream and more a gel or a liquid. TCA is normally applied every six weeks; the skin should begin to peel about two weeksafter its application. The dead outer layer of skin will peel off, and this process takesanother two to three weeks. Further treatment cannot be undertaken until this happens.Unlike laser treatment, acids and peeling agents are color insensitive (i.e., it does notmatter what color your tattoo is). It will take more than two treatments to start to seeany fading of the tattoo under normal circumstances. The Most Common Method Before Lasers Before lasers, TCA was the most common method of tattoo removal and tattoo fading.Complete success with this method is rare and depends on the tattoo and the othervariables discussed earlier. The real problem with TCA and other chemical peels is thatthey do not reach down into the dermis where the ink resides. They only attack theepidermis, or outer skin layer. But they are effective in causing new skin to grow andgradually cover the tattoo. This rarely results in complete tattoo removal and usuallyresults in tattoo fade. Some of the ink in the dermis is disrupted and removed duringthe skin healing process, however. Remember that the A in TCA stands for acid and if used at full strength it will burn yourskin. Recommended dilution is at least 50% to 75%. In fact, most TCA is shipped at only50% strength that is then further diluted to a 15% to 30% concentration using waterprior to application. Patch testing should be tried at different concentrations in order tofind the optimal balance between pain and effectiveness for your individual skin. TCA Treatment: First, patch test different dilutions. Use water to dilute. Start with a mild 10% strength tosee how your particular skin reacts. Higher concentrations (25% and above) raise the riskof hypopigmentation occurring in darker skinned people.

Clean tattoo area with alcohol pad. (This often comes in TCA removal kits). Apply TCA with a Q-tip in properly diluted form and fan dry. Wait two to three minutes. Apply one to two more coats with same procedure. Treated skin should frost over. Full frosting usually occurs with 25% - 30%concentrations. Leave application on for about five minutes after this point. This is thecontrolled burn of the epidermis. Wash off with water and dry gently. Baking soda mixed with water can also be used toneutralize the acid. Peeling of the skin will happen within a week. Scabbing follows. Do not pick at peeling orscabbing skin. This will only stimulate the development of scar tissue and raise the risk ofinfection. Apply anti-bacterial ointment every day for one to two weeks after treatment. Emu oil isalso used as a post-treatment salve in order to enhance healing.

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Emus and Oil As you would guess, emu oil comes from the fat of emus, the largest bird native toAustralia, and the second largest bird in the world after the ostrich. As the bald eagle isfor Americans, the emu is a national symbol for Australians and is found on Australiancoins and the national coat of arms. Emu fat was used by early European settlers as lamp fuel. It was used much earlier by

Aborigines for medicinal purposes including the treatment of joint pain as well as cutsand sores. Emu fat is mainly oleic acid (42%). It contains antioxidants and has anti-inflammatory properties as well. The oil has been scientifically proven to stimulatehealing through a process that is not yet fully understood.

Patience Is Key As with all tattoo removal strategies, patience is the key to good results. Proper healingof the burned skin by means of correct intervals between treatments (four to six weeks)is necessary. Inkbusters recommends one treatment every six weeks. Also, dont feelhurried and increase the concentration to more than 50%. The real risk of private TCAuse in the home is just that: you may feel like doing too much too soon. This is an acidand it will burn and scar you if you are not careful. At higher concentrations the risk ofpermanent hypopigmentation or hyperpigmentation in darker skinned people is greateras well. Some users report a greater concentration tolerance after repeated uses, i.e.,they can gradually increase the concentration of the acid after they are several monthsinto the process. Post-treatment care is essential to ensure proper healing and scar avoidance. Itching isalso a common complaint after TCA treatment. This should go away in time. TCA treatments work well on areas of very thin skin, such as the ankle. Ankle tattoos arenotoriously painful and difficult to remove by laser. This has to do with the lack of bloodflow and the very thin tissue found in the area. One mother of three commented thatlaser treatments on her ankle tattoo were more painful than childbirth. It is believed that TCA is safe to use during pregnancy because it only works on the localcells to which it is applied but this is not recommended. TCA is not easily absorbed by thebody and doesnt enter the bloodstream. However, if you are pregnant it is best not totake any risks and to refrain from using such products unless first consulting a doctor. How Much Does It Cost? TCA kits come with the acid, applicators, emu oil for healing, and sometimes a small fanfor cooling the affected area. Kits come in various sizes with the smallest containing 10ml of TCA. This can be purchased on eBay for as little as $10 and will reportedly takecare of a one-inch square tattoo. A one-ounce bottle of TCA Chemical Peel for HomeUse at 25% strength can be purchased online through Amazon.com for $26. (At theother end of the scale you can also buy a YAG laser machine, made in China for just$6,000. Only for the very brave.)

Inkbusters

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Inkbusters is a TCA solution sold by a California company based in San Diego. Applicationoccurs once every six weeks, and the company claims that their one-ounce bottle ofmedical grade 50% TCA will be enough to radically fa