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Tattoo removal has been performed with various tools since the start of tattooing. While tattoos were once considered permanent it is now possible to remove them with treatments, fully or partially.The “standard modality for tattoo removal” is the non-invasive removal of tattoo pigments using Q-switched lasers. Different types of Q-switched lasers are used to target different colors of tattoo ink depending on the specific light absorption spectra of the tattoo pigments.

Surveys of tattoo removal patients were done in 1996 and 2006 and provided more insight. Of those polled, the patients who regretted their tattoos typically obtained their tattoos in their late teens or early twenties, and were evenly distributed by gender. Among those seeking removals, more than half reported that they “suffered embarrassment”. A new job, problems with clothes, and a significant life event were also commonly cited as motivations.

Some wearers decide to cover an unwanted tattoo with a new tattoo. This is commonly known as a cover-up. An artfully done cover-up may render the old tattoo completely invisible, though this will depend largely on the size, style, colors and techniques used on the old tattoo and the skill of the tattoo artist. Covering up a previous tattoo necessitates darker tones in the new tattoo to effectively hide the older, unwanted piece. Many tattoos are too dark to cover up and in those cases patients may receive laser tattoo removal to lighten the existing ink to make themselves better candidates for a cover up tattoo.

Tattoo removal is most commonly performed using lasers that break down the ink particles in the tattoo into smaller particles. Dermal macrophages are part of the immune system, tasked with collecting and digesting cellular debris. In the case of tattoo pigments, macrophages collect ink pigments, but have difficulty breaking them down. Instead, they store the ink pigments. If a macrophage is damaged, it releases its captive ink, which is taken up by other macrophages.

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