Tattoo Removal Methods: History, Techniques, and Laser Technology

Introduction: The Ancient Origins of Tattooing

One of the most prominent and permanent proofs of the ancient existence of tattoos is the body of a man discovered near the foot of the Alps at the border of Austria and Italy, who had various markings — 59 in total — on his frozen body. The age of the frozen corpse was estimated to be at least 5,000 years old. Researchers had long believed that the tradition of decorating or tattooing one's body was as old as the human race itself and were therefore unsurprised by this find. Nevertheless, the discovery prompted more extensive research into the origins of the practice (George, 2005; Kirby & Desai, 2005).

The origin of the word tattoo is a combination of the Tahitian word "tattau" and the Polynesian (Marquesan) word "tatu," both of which mean "to mark" or "a marking." James Cook was the first Western explorer to encounter this phenomenon during his voyage to the South Pacific in 1769. He understood, however, that the tradition of tattooing was ancient, originating as far back as the Stone Age — approximately 12,000–13,000 BC. The tattoo industry has expanded enormously in recent decades. Today there are approximately 4,000 tattoo parlors in the United States alone, and a notable 5–7% of adults have tattoos for purely ornamental purposes (Kirby & Desai, 2005).

Types of Tattoos

There are various types of tattoos, the most common being decorative, traumatic, and accidental tattoos. Of these, only the decorative or ornamental tattoos are applied intentionally by the individual (Better Health Channel, 2007). These tattoos are typically drawn by professionals who use needles drenched in colored ink to create the design.

Both traumatic and accidental tattoos are essentially scars embedded in the skin as a result of an accident — for instance, when bare skin rubs against a road surface during a fall, driving carbon particles into the skin, or when debris from an explosion penetrates the upper layer of skin and leaves a permanent mark (Better Health Channel, 2007).

Most tattoos are permanent, and this permanence is part of their appeal for many individuals. Tattoos consist mainly of small particles of pigment stored within macrophage cells in the skin. The primary function of macrophage cells is to defend the skin against harmful objects such as microorganisms; however, the particles used in tattooing effectively immobilize these cells, halting their protective function. This is why tattoos remain permanent and why attempts to remove them almost always leave a scar (Better Health Channel, 2007).

Early Tattoo Removal Methods

Although the permanence of tattoos is attractive to many, it also leads some individuals to regret their decision over time. The presence of a tattoo may strain interpersonal relationships and can sometimes serve as an obstacle to meaningful employment. While most people keep their tattoos for life, it has been estimated that approximately 50% of tattooed individuals eventually regret their decision to decorate their skin. Over the years, various methods of tattoo removal have been attempted (Adatto, 2004).

Removal methods in earlier eras were more varied. Options available to those seeking removal included skin implantation, dermabrasion (eradicating the upper layers of skin), acid de-tattooing, and the use of infrared, argon, and carbon dioxide lasers.

Of these methods, dermabrasion was the most popular and perhaps the most widely practiced. The procedure involved peeling away successive layers of skin until the tattoo ink became visible, typically using a sharp or pointed instrument. In the 1950s and 1960s, practitioners began using wire brushes or spinning wheels to remove skin that had been frozen solid beforehand, making the process somewhat easier. The psychological impact of the procedure was considerable. Moreover, it was extremely hazardous given the risk of severe infections from viruses and bacteria. Enlargement of skin pigment cells was a common side effect, the pain was often unbearable, and the resulting scar was frequently worse than the tattoo itself (Adatto, 2004).

Aetius, a Greek physician in the Byzantine court, was the first to describe a salabrasion procedure, doing so in 543 AD in the 16th volume of his medical text titled Medicae Artis Principes. Salabrasion differed methodologically from dermabrasion, though the goal was the same: to remove layers of skin. In this procedure, the inner layer of skin was abraded using a damp yet abrasive pad and salt. Salt was applied to the tattooed area, and that portion of the skin was then sealed off from moisture and air for up to 36 hours. After the covering was removed, the tattoo remained, though with notable changes in both color and skin texture (Adatto, 2004; Kirby & Desai, 2005).

Other historical tattoo removal techniques included thermal damage through the use of fire, burning coals, or cigarette butts. All of these methods resulted in severe scarring and excruciating pain. Additional techniques — used infrequently due to their unpredictable results — included thermal cautery, electro-cautery, and infrared coagulation (George, 2005; Adatto, 2004).

Liquid nitrogen was another tool used to remove various forms of surface skin damage resulting from either the application or attempted removal of tattoos. This method proved effective for tattoos applied digitally. However, the side effects of liquid nitrogen treatment are highly unpredictable and can result in extensive discoloration, skin damage, abrasion, and a prolonged healing period — which may explain why it was rarely used (Adatto, 2004; George, 2005).

Conclusion

The application and removal of tattoos is not a new phenomenon. The methods, however, have drastically changed with the passage of time and the advancement of technology. Laser technology has transformed the tattoo removal industry and has become arguably the dominant method employed today, primarily because it offers a low-risk, relatively inexpensive, minimally painful, and effective solution (Kirby & Desai, 2005).