Debating the merits of tattoo removal

“People should be happy with the tattoos they wear.”

Andrew Sharpe, a 23-year-old Buffalo native, might stand by this statement more than anyone. The heavily inked West Side resident not only brandishes an array of artwork across his body, but he works as an artist at Rise Above Tattoo just shy of the Kenmore border. He’s not concentrating on any new additions to his personal walking, talking portfolio, though. Sharpe, right now, is in the process of a removal.

“If you have to look at a tattoo everyday and are not satisfied, it’s priceless to be able to replace it with something you can enjoy,” says Sharpe. The tattoo in question, a Japanese style sleeve up and down his left arm, isn’t quite what he had hoped it would be. So short of his expectations fell the tattoo, in fact, that Sharpe is investing months of treatment through laser removal sessions—at a few hundred dollars a pop—to have the unsightly scene gone for good.

Sharpe is far from alone. The Nieman Center, a Williamsville-based dermatology clinic specializing in cosmetic surgery including hair transplantation, botox, and tattoo removal, reports that about half of the 20 million or so Americans with tattoos desire to do without them. “I think people are not really instructed when they are young about the consequences of what they do, and they wind up with something that they really don’t want,” says Dr. Joseph B. Neiman, MD F.A.A.D, a board-certified dermatologist who has practiced in Western New York for over 30 years. “There’s not enough consulting of people that get these things, and if you look at the people that are actually doing the tattooing, they don’t look like somebody that wants to consult anybody. They just want to do it.”

Karen Arcangel has worked as a registered nurse under Dr. Neiman for a decade now, and say’s that 20-somethings with terrible tribals are far from the bulk of their clientele. “Most common patients are females in their 20s that are going to get married within the next year,” says Arcangel. “Middle-aged married men in their 30s or 40s men who are having children of their own and don’t want [their tattoos] anymore make up a good chunk of the patient population, too. As well as someone who is going into the military or wants to be, say, a state trooper.” Both professions require that the applicant be free of visible tattoos, which leads to many applicants considering tattoo removal.

The Neiman Center has done laser removal for 13 years now, most recently with the aid of a RevLite Q-Switched YAG Laser, an instrument specific to tattoo removal, and according to the clinic, the best option when it comes to removal. “Those are some pretty serious lasers,” says Arcangel.

With millions of Americans attempting to opt-out of what was once believed to be a permanent form of body modification, Arcangel and the doctor urge that you think about your options and consider the severity and seriousness of removal before going under a laser, especially when a professional might not be present for the procedure. “You can really cause some damage to the skin and you really need somebody who knows how to operate a laser, and not a technician that had one or two training classes…It doesn’t work that way,” says Arcangel. According to the RN, it’s typical for a patient in their clinic to show up after suffering a botched removal at the hand’s of a tattoo artist in their shop. “You don’t want to be exchanging a tattoo for scar tissue. You really need to know what you’re doing and go slowly and progressively and increase the level of aggressiveness.”

Lasers, she says, are serious business.

When someone goes under a laser, a beam is projected at the ink and breaks it down into tiny particles, where the body’s lymphatic system takes away what’s left, says Arcangel. Due to the rate at which the body works at removing the ink on its own though, treatments must be done around eight weeks apart to efficiently rid the skin of the ink. “There is no way to rush the process, so to treat every four weeks doesn’t do it,” says Arcangel. The average tattoo, she says, takes eight to 10 treatments to be totally removed. With the clinic charging around $250 a session for what Arcangel considers a “normal size” tattoo, an investment of a few grand might be needed to eliminate the ink. “People will spend $100 to get a tattoo on and then spend a fortune to get it off,” she says.

On top of not being cheap, many find the treatment painful and debilitating, as, depending on the person, after-effects can vary. Sharpe was finally convinced to opt for a removal after seeing how well the process was working out for a fellow tattoo artist that was visiting him in Buffalo. He expected some slight swelling in the vicinity of the tattoo, but his hands ended up swelling tremendously too and prevented him from doing most anything. “I had massive King Kong-sized blisters all over my forearm that took a week to go down. Can’t do too much when your arm is a huge alien looking mess,” says Sharpe. Arcangel says it might take up to 10 days for post-session blistering to diminish, which leaves a good month of healing before the next treatment is performed.

And while laser removal might be the most effective method of removal, the safeness of the procedure is still uncertain, given the relative modernity of the technology. Arcangel stresses that laser removal is FDA approved, but it’ll take years before any long-term side effects are fully realized. “Are they going to come back 25 years from now and say it causes cancer? I can’t tell you that,” she says. In the meantime, removal with a YAG laser is, most say, the best bet for removal.

Other routes do exist for those weary of going under a laser, but the results are nowhere near as guaranteed compared to what Dr. Nieman and other area dermatologists can offer. Many people still opt for the do-it-at-home method of salabrasion—removal performed by sanding the skin with table salt—but Dr. Nieman thinks of it as simply “archaic.”

Wrecking Balm, a product sold in the first-aide aisle at Wal-Mart, advertises itself as a “unique, devastatingly effective tattoo fade-removal system that is unlike anything ever seen from the far-reaching corners of the earth.” Dr. Nieman says the product sounds more like “hocus pocus” than an actual solution, and mixed online reviews show that many feel the same way. The product, which retails for a fraction of the cost of laser removal, bundles a topical, FDA-aproved cream with a mechanical hand-held medical device that grinds the top layer of the skin away and draws the embedded ink toward the outside. One customer posted on Consumersearch.com that, “If you were to buy sandpaper, pumice stone, some sort of scrub, a vibrator, and skin lotion it would roughly be the same thing.”

Arcangel says that two patients have so far come to the Nieman Center to get laser removal after Wrecking Balm was unable to provide effective results, and the professional procedure was made more difficult because of damage to the skin caused by Wrecking Balm. According to Dr. Nieman, any at-home method of removal is “futile.”

In the meantime, between sessions with his own clients that he hopes don’t make the same mistake he did, Andrew Sharpe is continuing to undergo tattoo removal treatment. “I would recommend it to others,” he says, “only if they go to a person that’s experienced and well known for laser removal. It takes dedication to continually get work done, and can take a year or two to fully remove a large tattoo.”

And what about when the removal is finally done? “The plan for my arm is to get new tattoos,” he says.

Arcangel makes a point of mentioning that the first laser session can’t be performed until 90 days after the initial inking, though, so Sharpe and others should be ready to sport their presumably permanent tattoo for at least three months. Here’s hoping for longer, though.