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Almost half of Americans sporting tattoos are changing their minds, according
to some estimates, most often because they change romantic partners whose names
are emblazoned on their bodies. Increasingly, they seek out plastic surgeons
and dermatologists who specialize in tattoo removal.
Removal techniques -- always more expensive than having tattoos applied in the
first place -- range from excisional surgery and dermabrasion to the newer
lasers. And while patients may no longer have a tattoo after these procedures,
they almost always emerge with some kind of scar or mark, say physicians at the
University.
Add those reasons to the ever-present threat of infection, and Robert Tomsick,
associate professor of dermatology at the School of Medicine, makes a case for
thinking twice before going under the needle.
"What you're doing is breaking the skin and introducing pigmented material into
the area," Tomsick said. "Even though the needle only goes in a little way,
anytime you break the skin, you have a risk of bacterial or viral infection. I
think it [getting a tattoo] is generally a risky thing to do."
Tomsick said he's especially concerned about methods amateur tattoo "artists"
use to introduce pigment into skin. "I've even heard of people using wooden
sticks and forcing in the pigment," he said. "Once pigment is in, even if
there's no infection, there's always the chance of contact allergies,
dermatitis and allergic reactions that can cause skin to get red, swollen,
crusty and itchy."
Such reactions, which occur more often with red and white pigment than with
blue and black tattoos, generally continue until the pigment is removed,
Tomsick said. He also cautions dark-skinned people that they are at risk of
getting raised scars that keep growing.
"These begin with pain and tenderness and can get to be so big that they can
interfere with movement on certain body parts," he said. Laser ablation is the
newest and best for tattoo removal, but the process requires expensive
equipment, including multiple lasers -- each specially tuned for the various
pigment types to be removed, the physician said. Because of high equipment and
maintenance costs, he and his colleagues at the University have not pursued
this work. "Nonetheless, for the patient who wishes the most `elegant' and
least scarring tattoo removal, laser is the way to go."
Lynn Damitz, assistant professor of plastic surgery, said her department is
looking at the possibility of purchasing laser equipment necessary for tattoo
removal. "Lasers designed for this purpose have gotten much better at tattoo
removal," she said. However, tattoo removal lasers are not yet standard at most
hospitals. Such surgery takes multiple sessions, with each costing from $250 to
$400.
"It's very expensive, and most of the patients I've talked to say it's more
painful than getting the tattoo was," Damitz said. Tomsick described the most
common types of removal: Tattoos can be cut away with an excision that goes
through the full thickness of the skin. All the skin is pulled off and then
pulled together again. Excision on small tattoos can make the area less
conspicuous, but "a scar will always be there when you take scalpel to skin,"
he said.
Dermabrasion involves a hand-held tool that sands off the tattoo along with the
skin, he added. The procedure can remove most of a tattoo, but residual pigment
often is left behind, along with a scar. Damitz advises those who are
determined to get a tattoo: "Go to someone reputable, a professional whose
health record you've investigated. And if you think you might change your mind
about your tattoo, don't get a red or yellow one. They're the hardest to
remove."
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