The best methods of tattoo removal

Synonyms in the broader sense

scientifically also Tatauierung = tattoo
English: tattoo


There are several methods for tattoo removal. Not only because newer methods of tattoo removal have evolved and refined over time, but also because not every method is perfect for any distance.
Therefore everyone has to find the individually optimal method for removing the tattoo. The combination of different methods may be the best option.

    The goal of the treatment is however always the same: the removal of the color particles of the tattoo. They are stored as bundled color pigments in the skin. There they are surrounded by a solid collagen layer and encapsulated against the surrounding tissue. This makes a tattoo so long lasting and resistant. Removal can be done by the following methods:

    1. surgery
    2. laser therapy
    3. Non-surgical extroverted methods without laser

    Surgical removal of a tattoo

    The surgical removal of the tattoo is particularly suitable for small-scale tattoos on inconspicuous body parts. Residual pigments after a laser treatment and minimal tattoos can be removed with a skin punch.
    It is particularly favorable if the tattoo has an elongated shape. Here, the skin piece can be well removed and the skin sewn well later. For medium-sized tattoos, the skin should first be pre-stretched for several weeks with the help of an expander and if necessary operated on in several steps (serial removal). Surgical tattoo removal is, in the truest sense of the word, an incisive method that completely removes the tattoo in the operated area, but not without scars. The wounds heal quickly with good care, hygiene and dressing control and after about 10 to 14 days, the threads can be removed. A skin graft, especially for larger tattoos, is possible, but should be avoided for aesthetic reasons. The costs are approximately at 1500 to 3000 euros for a palm-sized tattoo.

    laser therapy

    The laser therapy for tattoo removal is today the most common and effective method and also very gentle. It needs no special skin preparation.

    Let us remember the construction of a tattoo: The color pigments are encapsulated in the skin and surrounded by a layer of collagen. The light of the laser penetrates the skin and is absorbed by all color pigments. This shatters the color pigments and there is a short burst effect, which may feel like a needle stick during treatment - akin to a tattoo. This principle is also called " photoselective thermolysis ". The particles are crushed, the encapsulation dissolves and the free color parts are transported away by the body's own immune system ( macrophage system ) via the lymphatics. The skin areas on which no tattoo is, remain unaffected by the laser effect.
    It caused by this irradiation no injuries. In addition, a laser in a certain wavelength bundled light, thereby representing a very high-energy light source. The skin is therefore not exposed to X-rays or UV rays of ionized radiation. Cell changes on and in the skin are therefore not expected.

    With regard to the course of treatment, the length of the treatment session depends on many factors and can not be precisely predicted. However, the type and depth of pigmentation, which color was used, the quality of the tattoo and the responsiveness of the immune system have an effect on the duration. Basically, all colors are removable. But colorful tattoos can be a problem. So the color "yellow" is bad or impossible to remove. Also mixed and dirty colors can be problematic. Best suited are black tattoos, as they absorb all wavelengths of light.

    The right choice of laser is generally crucial for the treatment. Depending on the color of the tattoo that is to be removed, different laser types are used. For dark and green colors are Alexandritlader or ruby ​​laser. It is best to remove red tattoos with a neodymium YAG laser. Only laser therapy centers holding these laser types can completely remove colorful tattoos. For the first laser, the fading effects are often stronger than for the subsequent treatments, as fewer color pigments are now available to absorb the energy. Often, a gray veil remains behind, depending on the laser type and energy intake occurs a skin lesion (scar) on the tattoo.

    In general, superficial skin irritation and redness, which is comparable to sunburn, occurs after treatment with the laser, depending on the skin type. Swelling and blisters can form. These should under no circumstances scratch or open. Also, any scab must not be scraped off. After one to two weeks he falls off of his own accord. After the treatment you should cool the place and disinfect regularly for the first 2 days, avoid sports activities for one to two days, do not use creams or ointments and definitely refrain from sunbathing and sunbathing. If the affected area is exposed to extreme sun, it is advisable to use a sun protection factor of 60. Only after the third day can soothing ointments be applied, such as cortisone-containing ointments (eg Ebenol®). At the earliest after 28 days and after complete healing, a new session may take place. Therefore, large colored tattoos may require months of treatment.

    The age of the tattoo is also discussed in the treatment. In general, it does not matter how old it is, but the older the color pigments are, the deeper they are in the skin. This can increase the number of treatments needed. Four to six are usual, in rare cases up to 12 pieces are possible. But at least 28 to 40 days after the tattoo should have passed, so that the skin has time to regenerate.
    During tattoo removal, scarring of tattoos may now be visible, especially in multiple whitening. Other risks include shading (hypo-or hyperpigmentation) of the skin due to the use of an unsuitable laser for certain color pigments. In addition, laser therapy can often not be sufficient if color pigments were applied improperly. A skin graft is then often necessary and ugly scars the consequence. Dark-skinned or tanned skin may show pigmentation after treatment, but dark-skinned or Asian people may also want a tattoo removed. Depending on the pigment composition, pigment spots may remain. However, the skin pigment (melanin) is always re-formed and thus weakens pigmentation disorders. Let's summarize another favorable case for a tattoo removal:

    Ideal case

    • Laity tattoo / engraved himself
    • only black color (biodegradable)
    • Once and far pricked (like shades and the like)
    • Not deeply engraved

    Here, after three to five treatments, a 100% success is usually recorded.

    Worst case:

    • Narrow and multiple stitched tattoos
    • Green and blue, as well as yellow colors (not biodegradable)
    • Very old tattoos (older than 35 years) usually very deeply engraved
    • unknown composition of the color
    • in very sensitive areas (crotch, genital area, etc.)

    The best way to estimate the course of a removal after the first treatment. All statements before are based mostly on empirical values.

    The cost of treatment depends on the size / area and the number and length of treatments. The prices are between 50 - 250 euros per single treatment and about 300 euros per 20cm 2 . The health insurance companies do not take over these services.

    All in one, everyone must individually find the right method for themselves. Here is a brief overview of the advantages and disadvantages of the individual methods and techniques:

    Non-surgical extroverted methods without laser


    • Elimination of the colors to the outside
    • all colors are captured
    • painless
    • even with large tattoos, where no surgery is possible


    • increased requirements ( qualification ) to the practitioner
    • Wound management as after tattooing



    • complete removal of the tattoo


    • only useful for small tattoos
    • not possible on all body parts
    • Scar management sophisticated
    • surgical intervention

    laser therapy


    • relatively closed wound conditions
    • short duration of a treatment session
    • narbenarm
    • painless (depending on personal pain threshold)


    • Cleavage products of the colors often contain carcinogenic amines (carcinogenic)
    • Main elimination of colors via the lymph (lymph nodes)
    • relatively unsuitable for colorful tattoos
    • Color change possible through oxidation
    • expensive

    Non-surgical extroverted methods without laser

    This possibility of tattoo removal is one of the earlier therapies and can be briefly referred to as skin abrasion (" Dermabrasio "). The tattoo ink is eliminated here over the skin surface mainly to the outside. This is done by a removal of the uppermost skin ( dermis ) by chemical (by a modified tattoo machine and an agent, or purely chemically with a strong acid), mechanical (diamond cutter Dermabrasio ieS) or thermal (by high-frequency fine flow (special cautery) or by cold (cryosurgery) or a combination, that is with the Dermabrasio the skin is sanded off until the pigments are exposed, forming a deep abrasion that needs to be wet and takes several weeks to heal Scab and embedded with the crust at the end of the healing with a wound, which resembles a medium-grade burn, so the patient should pay attention to the greatest hygiene so that it does not come to an infection up to three sessions, the resulting scars may remain red for months until slow The most accurate working allows the bloodless high frequency tattoo removal treatment with the fine flow cautery.
    Contrary to opinion, the removal of non-laser tattooing / tattooing against laser treatment is becoming increasingly important as the tattoos become more and more colorful and the dyes become more light stable and difficult to laser. Overall, the method is the most expensive, since many post-treatment and dressing changes are necessary.

    Removal with lactic acid

    Lactic acid belongs to the so-called liquid tattoo removers. The solution usually contains 40% L (+) - lactic acid.
    For tattoo removal, this concentrated solution is injected into the top layer of skin ( epidermis ) using a needle similar to the actual tattoo piercing. As a result, the color pigments are to be repelled by natural means.
    It should be noted that this lactic acid solution, according to the Federal Institute for Risk Assessment from a concentration of 10% has a harmful effect on the eyes, and even from 20% also irritates skins and mucous membranes. It can lead to severe inflammatory reactions and scarring.
    Tattoo removal with the help of lactic acid is not among the medically recognized procedures.

    Results at a distance with lactic acid

    As a rule, three to five sessions are offered to remove a tattoo with the help of lactic acid. The lactic acid should serve as a natural remover. However, good results with this method are rarely heard. If the acid gets a little too deep into the skin, a strong inflammation develops.
    The color pigments crust and thereby actually fall off. What remains are often disfiguring scars. Anyone who wants to remove his tattoo is only to be advised to select a medically tested procedure for it. Especially recommended today are the laser processes.

    Removal with citric acid

    Citric acid is an aggressive remedy that harms the body's cells. This is the idea of ​​tattoo removal with citric acid. The acid is said to destroy the pigmented skin cells of the tattoo. The destroyed skin cells should then be transported away from the body itself.
    The citric acid can be mixed with acetone, which allows the acid to penetrate the skin better.

    The tattoo removal with citric acid is not one of the established methods and poses health risks for the skin. If you want to have your tattoo removed, you should consult a doctor with years of experience to prevent such risks as deep skin inflammation and disfiguring scarring.

    Cream profade

    Removing a tattoo does not always have to be painful and expensive. Novel lotions and creams promise that unpleasant tattoos can now also be removed painlessly without the use of a special laser. Above all, the so-called "Profade ® cream" should help to facilitate the removal of a tattoo.
    The manufacturer of the Profade ® cream states that tattoos can be removed reliably regardless of their color and the material used. In addition, the amount of color introduced and the age of the tattoo should play no role.

    When removing a tattoo with Profade ®, three different creams must be applied regularly to the colored skin areas. The active ingredients contained in these lotions penetrate through the skin surface into the deeper skin tissue, directly attach to the color pigments of the tattoo and dissolve them very gently. The gentle action of the Profade ® cream for removing a tattoo is mainly due to the fact that their ingredients are 100 percent natural.

    Furthermore, the results of previous research and evaluations by the users do not suggest that regular application of the Profade® cream causes side effects. So far, no local skin symptoms, such as rashes, have been observed. The removal of a tattoo with Profade cream should therefore be possible in the face area without hesitation.
    However, users must be careful that none of the three lotions comes into contact with the eyes or lips.

    With regular use of the Profade ® cream, the first results should be visible after the first application. However, completely removing the tattoo may take up to four months.
    Whether the regular application of Profade ® cream really leads to results that are comparable to a laser treatment, remains controversial. However, Profade ® cream can also be used as a supportive laser treatment. In this way, the number of individual sessions can be reduced. However, users must be aware that the lotions must not be applied 10 days before the laser treatment.

    Aftercare after a tattoo removal

    The tattoo removal takes the skin heavily. It can lead to unwanted side effects, such as infection of the affected site. This then heals in the worst case, scarring and the skin is disfigured. To prevent this, cooperation is required. After a session, the skin may be red and swollen, which is normal. In this case you can cool the affected areas.
    It is also normal for scabs or a proper crust to form. These should not be scraped off as this will allow germs to enter the wound and cause inflammation. Scarring can then result in scarring. You should just wait until the skin dissolves by itself.

    Daily showers are allowed, whereas visits to the solarium, swimming pool or sauna should be avoided first. In sunlight, a sunscreen with high SPF is recommended.
    In addition, a wound protection cream may be applied to aid healing of the skin. Fresh air is good for the skin, so bandages or bandages should be avoided.

    Cost of tattoo removal

    If you want to remove a tattoo, the upcoming costs of the treatment also play an important role. It is important to know that due to the different methods that exist to remove a tattoo also different high costs can arise.
    Basically, a rough distinction is made between two methods of tattoo removal. A tattoo can be removed either by a surgical procedure or by laser radiation. Not only in terms of cost, these two methods differ, but both methods have different advantages and disadvantages that should be considered when removing a tattoo.

    When surgically removing a tattoo, the entire tattoo is cut out. However, this method is only possible with small tattoos, otherwise the skin defect would be too large to sew him properly. When removing a tattoo surgically, the cost may vary greatly depending on the size and location of the tattoo. For a palm-sized tattoo, you should allow for a surgical removal costs of about 1500-3000 euros. In addition to these costs, the cost of needed anesthesia comes to the patient. Depending on whether one chooses a kind of twilight sleep or a general anesthetic, additional costs of about 300-800 Euro arise here.

    The cheaper option is the distance by means of laser radiation. Here come to each session about 50-250 euros to one. Here, the prices are very different, especially from practice to practice. For tattoos at least three to five sessions should be scheduled, for larger tattoos but eight to twelve sessions. If the tattoos have been stung by a professional, it may be possible to have more sessions, as the color may be in deeper layers of the skin making it harder to remove.
    If you let go of your tattoo, you have to keep in mind that you have to pay for the entire costs yourself, as these are usually not borne by the health insurance companies.

    How many sessions are necessary for removal?

    How many sessions are needed to remove a tattoo depends on several factors. These include the size of the tattoo, how deep it was stung in the skin, the choice of colors and the strength of the body's immune system. There are eight to twelve sessions in laser procedures.

    How long does the tattoo removal take?

    A session lasts about 10 to 30 minutes. If a tattoo is very big or very deep, you need more time for the removal. It should be noted that there must be a certain amount of time between sessions. During this time, the treated skin should recover. In order not to stress the skin too much and to prevent scarring, there may be several weeks between sessions. Thus, a tattoo removal can extend over a whole year.

    Pain during tattoo removal

    Even the stinging of a tattoo is perceived by many as very painful. Especially on body parts that have a large number of tiny nerve fibers, the pain can be particularly pronounced. Removing a tattoo is no different. The laser pulses used so far to remove a tattoo penetrate deeply into the skin surface and attack the nerve endings. For this reason, removing a tattoo causes severe pain. In general, it can be assumed that the laser treatment in tattoos with dark colors is much easier and less painful feasible. The removal of light colors, however, usually causes severe pain. This is especially true for tattoos that contain red fractions.

    In addition to the occurrence of pain should be noted that after laser treatment usually clearly visible scars remain. The intensity of discomfort caused by the removal of a tattoo depends largely on the body region. Especially tattoos in the area of ​​the inside of the upper and lower arm can usually be removed only under enormous pain. Removing tattoos from the décolleté is also considered to be extremely painful by most people.

    In addition to the well-tried methods, it is now also laser treatments that allow a gentler removal of tattoos. In this process, the color pigments of the tattoo are treated with a special picosecond laser. With the help of this laser, the color pigments can be literally shattered with ultrashort, high-energy laser pulses. Subsequently, the residue-free removal of the color fragments by the body's own phagocytes takes place. By the action of the picosecond laser on the skin surface, in comparison to the original laser treatment, hardly any pain should occur. However, total freedom from pain can not be assumed. In addition, it remains to be discussed whether the color pigments shattered by this method may contain toxic or carcinogenic components.

    Which home remedies help with tattoo removal?

    There are no home remedies with which you can simply conjure up the tattoo of your body at home. At least no methods that do not bring a significant health risk.

    A tattoo should always be removed by a trained specialist or a doctor.
    But there are ways to assist with simple means the healing of the skin during a tattoo removal.

    On the one hand, it helps to cool the skin after ice treatment. Water and heat in excess should be avoided. Short shower after one or two days is fine but bathing in the tub or swimming pool is not good for the healing of the skin.
    Similarly, direct sunlight and sauna visits should first be avoided.

    Helpful, however, are fresh air and an antibacterial cream from the pharmacy against the formation of crust. Crusts, once they emerge, should not be scraped off, as this promotes scarring.
    Otherwise, one should make sure that the skin is not irritated by tight-fitting clothing or exercise and sweat and can heal in peace.


    In all methods of tattoo removal no miracles can be expected. An attempt with a laser treatment is almost always recommended before deciding on a surgical procedure. Nevertheless, significant pigmentation of the skin in the form of tattoos and scars can also occur during laser tattoo removal. Even after many laser sessions, the tattoo can still be clearly seen, depending on the tattooed pigments, the laser device, ... and and and. In addition, beware of the mushrooming "experts" from the ground! The competence of each should be questioned, as well as the duration of the training, the duration of the experience and the technique (number of available lasers, at least 3 are necessary).
    Tattoo removal is not a simple business without risk.

    Tattoo Removal Laser Surgery (February 2020).

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