With tattoos or permanent tattoos, color that the body cannot dissolve is introduced into lower layers of the skin so that they then shimmer through the epidermis (upper skin). The word “tattoo” originally comes from Tahiti from the word “tatau” – which means “to hammer artfully”. Nowadays, the color is introduced into the skin by means of needles. Needles of different strengths and shapes are inserted up to two millimeters deep into the skin – through the epidermis into the underlying dermis. In this way, motifs are created by means of ink, pigments or other colorants introduced into the skin. The following types of tattoos are known:
- Amateur tattoo
- Professional tattoo
- Cosmetic tattoos – so-called permanent make-up
- Dirty tattoos – after accident or injury.
Possible complications
- Infections due to bacterial contamination of tattoo inks.
- Allergic reactions
Notice: Wg. tattoos in the magnetic resonance imaging (MRI): as far as colors in tattoos contain pigments that contain iron, these can be attracted by strong magnetic fields in the MRI, which in turn can lead to patients feeling a pull on the tattooed skin or that the tattoo heats up. Some patients also report a “tingling sensation on the skin,” but this disappeared within 24 hours.Note: In the study, patients were excluded if individual tattoos extended more than twenty centimeters on the skin and multiple tattoos covered more than five percent of the body. In the Western world, the prevalence (incidence of disease) for tattoos is between 10-20%. Not infrequently, the desire arises to remove a tattoo again. There are now numerous techniques and methods for this.
Before tattoo removal
Before the treatment, an intensive anamnesis conversation should be conducted that includes the medical history and the motivation for the procedure. The procedure, any side effects, and the consequences of the surgery should be discussed in detail. It should also be asked whether the patient is prone to pigmentation disorders. Note: The requirements of the explanation are stricter than usual, since courts in the field of aesthetic surgery demand a “relentless” explanation.Furthermore, you should not take acetylsalicylic acid (ASS), sleeping pills or alcohol for a period of seven to ten days before the treatment. Both acetylsalicylic acid (platelet aggregation inhibitor) and other analgesics delay blood clotting and can cause unwanted bleeding. Smokers should severely limit their nicotine consumption as early as four weeks before the procedure to avoid jeopardizing wound healing.
The procedures
Tattoo removal can be performed using dermabrasion and laser therapy. In dermabrasion, the layers of skin are removed mechanically. Scarring is possible in this process. Another option is surgical removal of the discolored skin layers. This may require skin grafting and leaves unsightly scars.All types of tattoos can usually also be successfully removed by laser therapy. The energy of the laser allows the subcutaneous (“under the skin”) color pigments of the tattoo to break down into tiny particles and then be absorbed and removed by the body’s own tissue cells.Laser treatment is often easiest on lay tattoos. However, problems can still occur, especially with these lay tattoos, if the color is pierced too deeply into the skin.Even professional tattoos usually require several laser treatments, since the color pigment density is high and the color mixtures are complicated.The following lasers can be used:
- CO2 laser
- Argon laser
- Krypton ion laser
- Nd:Yag laser
- Ruby laser
Note: The removal of tattoo with high-power lasers is under doctor’s reservation. The treatment is performed on an outpatient basis and the success is visible immediately.
After treatment
- The superficial skin lesions resulting from laser therapy should be post-treated with an ointment containing dexapanthenol. After five days, the wounds are thus almost completely re-epithelialized.
Further notes
- The German Federal Institute for Risk Assessment (BfR) points out that ruby laser treatment produces fission products of the copper-containing pigment phthalocyanine blue, as used in tattooing. Among other things, 1,2-benzenedicarbonitrile, benzonitrile, benzene and hydrocyanic acid are formed. These substances formed in aqueous suspension are present in concentrations that would be high enough to cause cell damage in the skin.
