Hyper pigmentation : A temporary darkening of the skin. Commonly seen in darker skin individuals.
Hypopigmentation: a lightening of the skin is also a possible complication in up to 20% of the patients . Longer intervals between laser tattoo removal treatments and proper laser use will limit this potentially permanent complication.
After a tattoo is removed the skin occasionally has a slightly rougher appearance where the tattoo was. Currently the time for this to resolve is variable. In the future I will be doing a study to determine if this can be resolved by resurfacing the area.
Granuloma formation ( firm bumps) may form, most often with red inks and commonly if a chronic allergy exists from the red ink.
In the case where we are targeting red ink there is the potential that a red/black and blue may form in the area. Occasionally blistering may occur since the red ink absorbs the same wavelength as our red blood cell. Again, this blistering if it occurs resolves, normally without and scar formation.
A halo effect over the area where the tattoo was, often its temporary.
There is always a 1 in 1000 risk of developing a scar, most often this is a focal scar at the initial laser site.
Cosmetic tattoos seen in eyebrow and lip have been known to change color with laser removal. This is due to a chemical sometimes mixed into the cosmetic ink which is different than regular tattoo ink. They oxidise and can change color. If this happens they can take up to 20 treatments to remove but most are gone in only 2 to 3.
Oxidation of some of the ink particles, occasionally we see a darker colour change into a reddish colour and a red colour become blacker. This is due to a chemical change and often resolved by adjusting the laser wavelengths to the colour.
The risk of infection is greatly reduced by using proper bandaging and antibiotic ointments for the first 3 to 5 days post laser and avoiding picking at any scab.
Finally, some may experience a transient sensation of body aches and or joint pain. This is likely due to a reaction from the lymphatic's taking up the Ink. Again, it is rare and very easily treated with mild analgesics like Tylenol and antihistamines.

What are the contraindications to laser tattoo removal?

Laser tattoo removal is very safe yet, there are several instances where it is best to delay treatment or not proceed with laser tattoo removal at all.

Active infection at the tattoo site
Evidence of chronic allergic reaction to the ink (area looks very red)
Pregnancy, if someone gets pregnant during treatment there are no consequences to delaying the next treatment.
Breastfeeding
Keloid scar formation or any other abmormal healing process
Unrealistic expectations

Milestones in laser tattoo removal:

1930’s: surgical resection for unwanted pigments was the only option
1940’s: Chemical , acid compounds were found to possibly reduce pigments in the skin but were found to be very harsh on the skin tissue.
1970’s: Multiple abrasive treatments showed possible benefit for tattoo removal but were painful and possibly disfiguring.
Lasers especially q switched ruby helped remove tattoos, however pigment problems and scaring occurred.
Early 1990’s Q-switched lasers with longer wavelengths than the ruby laser were found to destroy tattoo ink particles by shattering them into pieces small enough for the immune system to carry them away. The risk of scaring and pigment changes sharply decline.
First treatment schedules were found to be too close ( 1-2 weeks) by allowing the tissue to heal for 6 weeks reduced the adverse effects of laser tattoo removal.
Lutronic develops a perfect laser beam pattern that delivers an equal distribution of laser power, making this the most accurate laser available. This is the laser uses in Messina Esthetic Medicine. The first of its kind on Long Island.

Recent studies are looking into different laser settings to shorten the time it takes to complete laser tattoo removal.

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