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UI Dermatology Clinic: (319) 356-2274
UI Health Access: (319) 384-8442 or 800-777-8442

Becky Soglin
2130 Medical Laboratories
Iowa City IA 52242
(319) 335-6660

Release: April 26, 2000

New laser treatment at UI effectively removes tattoos, skin lesions with minimal scarring risk

IOWA CITY, Iowa -- In recent years, getting a tattoo or permanent make-up has gained in popularity. However, with that increase comes a growing number of people who later decide they do not want the skin decoration for a lifetime or, for health reasons, need to have the tattoo removed.

A new laser treatment offered by University of Iowa Health Care dermatologists can help effectively remove tattoos for many people reconsidering their body art. Called the Q-switched Alexandrite laser, the treatment is also effective in treating liver or age spots, freckles and certain types of non-cancerous pigmented skin lesions as well as accidentally caused coloration such as when a chemical or asphalt becomes imbedded in a person's skin.

"The new laser treatment at the UI offers many advantages over older treatment methods such as surgery and dermabrasion, in which the skin is mechanically sanded or salt is rubbed into the skin to leach out pigment," said Christopher J. Arpey, M.D., UI assistant professor of dermatology. "These older methods can often remove the color but leave a noticeable scar."

In contrast, the Alexandrite laser has very little risk of scarring or bleeding, and no sutures are needed. It removes most color, leaving only a residual color or shadow in a small minority of cases. The treatment was developed by researchers at Harvard and Tufts medical schools with additional early study at several other medical centers.

"Some individuals need to have tattoos removed because of a delayed allergic reaction to the inks used," added Duane C. Whitaker, M.D., UI professor of dermatology. "However, for most people, getting rid of a tattoo is a personal choice, sometimes made when a person makes a career change."

In a few instances, a person attempts to remove the tattoo at home, then infection sets in and the tattoo must be removed by a medical professional.

Whitaker said the new laser treatment works well on most tattoo colors -- blue, black and green -- but is not as effective on red. However, most tattoos have no or only small amounts of red ink.

The procedure is also more effective in removing amateur or older tattoos compared to professionally applied or newer ones. However, the Q-switched laser should be used cautiously on double tattoos. When one tattoo covers up another, high-density pigment can absorb the energy from the laser, and the potential for scar formation increases. Typically, the risk of scar formation is less than one percent.

While the decision to get a tattoo is sometimes made on the spur of the moment, getting it removed by the new method requires planning for multiple treatments over as long as one year.

Arpey said a professionally placed tattoo may require as many as 10 treatments performed at six to eight-week intervals. A smaller, amateur tattoo may require four to six treatments, also at six to eight-week intervals.

The laser does not remove the pigment by extracting color through the skin but breaks it into small pieces that are then absorbed by the blood.

"A helpful way to understand how the treatment works is to think of a boulder," Arpey said. "If you want to get rid of a boulder, it is hard to lug it away. However, if you smash it into pebbles, then it is easier to remove."

The laser seeks out the "boulder" of pigment, then breaks it into "pebbles" that white blood cells pick up and cart away for disposal through the liver.

"Because the treatment is not happening at the skin surface, you cannot see the results right away," Arpey said.

The procedure stings slightly, and the skin may bruise, swell or slightly blister in the few days to week following the procedure. Rarely will a person have an allergic reaction to the tattoo pigment as it is broken down.

"Patients say the feeling during the laser treatment is about the same or slightly worse than getting the tattoo," Arpey said. "Yet they also say the treatment becomes less painful over the course of treatments."

The UI dermatologists spend a good deal of time assessing each patient for laser removal of tattoos, freckles, age spots or pigmented skin lesions. The assessment includes determining the patient's expectations and timeframe for outcome. A small part of the tattoo to be removed is often tested to ensure that the person can tolerate the procedure and that the results will likely be satisfactory.

As with all medical treatment, it is best to consult your personal physician before making any changes in your health care.

For more information about the new laser tattoo removal treatment at the UI, contact the dermatology assessment consultation at (319) 356-7684.

Arpey is also a staff physician at the Veterans Affairs Medical Center in Iowa City.

University of Iowa Health Care describes the partnership between the UI College of Medicine and the UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide.