Laser Tattoo Removal Assisted with Microneedling

The average person knows that tattoos can be removed by laser, but what they don’t know is that it isn’t nearly that simple, not by any stretch. For one thing tattoo removal is more painful—and certainly more trouble—than getting the tattoo was in the first place. The cost, hassle and discomfort will depend on the size of the tattoo and the ink colors involved. Black ink and shading will respond more readily than yellows and greens, although some laser wavelengths may still be effective. Also, some tattoos never fully fade away, while others are very resistant to treatment.

Kristen Ward, head esthetician and office manager at Aesthetica Medical Spa in LindonMore than that, people tend to vastly underestimate the number of treatments it takes to get to the end. Laser manufacturers and some spas or laser treatment centers may claim to be able to remove a tattoo in five or six treatments. The actual number is more like 15 treatments on average, according to Kristen Ward, head esthetician and office manager at Aesthetica Medical Spa in Lindon, Utah. “People come in with unresolved tattoos and say someone else promised them removal in six sessions, and that’s just not the way it works,” she said. In truth, while some situations may exist where the size and color of the tattoo, the health of the individual and other factors come together to provide such an outcome in six sessions, it is not the norm or even close to it.

tattoo-micro-needling-removal-350Enter Dermapen. About the size of a large felt tip marker, the easy-to-use handheld device features a disposable, sterile tip with an array of eleven surgical steel micro-needles for safe fractional dermal-needling. It is minimally-traumatic fractional micro-wounding via piston-driven needle oscillation is safe to use and may be of benefit to the session, according to Ward who is currently overseeing the device used in that manner—on herself. “I have a 1” by 5” tattoo that’s been resistant to lasers, so we decided to try using Dermapen first, in the hope that it might improve the results.” Confident in its safety, Ward—who is also the staff trainer for every device in the spa—had one of her estheticians use Dermapen on her tattoo immediately before applying normal laser treatment.

After applying topical anesthetic, the user performed three passes of Dermapen (1.5 mm depth, 90 Hz needle insertion speed) over the area. Afterward, a combination vitamin C and E cream was applied, with normal laser treatment soon after (using the Alex TriVantage from Syneron-Candela, 755 nm wavelength, 4.5 mJ, spot size 3). The difference was more than noticeable. “I would characterize the result as at least 60% better improvement than with laser alone in this case,” she said.

While at this stage the result is preliminary (though encouraging), and no actual histological study or analysis has been performed, Ward has a few theories about how Dermapen may be positively affecting the tattoo area. First, the holes in the epidermis created by Dermapen may improve the penetration of laser light and/or improve absorption of the wavelength by the target chromophore (tattoo ink). Another is that Dermapen may break up or otherwise affect more superficial ink that the laser isn’t treating. “We adjust the spot size of the laser to treat different layers of implanted tattoo ink,” Ward explained, “and some ink may be too superficial to absorb enough energy to cause fracturing of the pigment for subsequent removal by the body’s natural waste removal processes. Dermapen may affect that layer of ink.” Another possibility is that because Dermapen wounding stimulates the healing and debris removal processes of the body, it may create a situation where this stimulation improves removal of fractured ink. “Simply put, fibroblasts are activated and they remove the particles of fractured ink, but only for so long. That’s why some of the tattoo removal result depends on the health of the individual, whose fibroblasts may activate in greater quantity and for a longer time than those of another person.” One, none, or any combination may be true and further study would be necessary before a real conclusion could be drawn.

Ultimately the hope is Dermapen might improve magnitude of outcomes possible with a single session, thus reducing the total number of sessions needed for clearance. It also may help fully resolve tattoos still mildly visible, even after numerous sessions. Ward will be able to tell you in several months. She’s continuing Dermapen of her previously resistant tattoo until it’s resolved. “I’m also going to have them work on another small tattoo I have as well and see how that goes,” she shared. Because of the success of the initial session with Dermapen, Ward expects to begin offering Dermapen-assisted tattoo removal by the end of 2013.

Micro needling before after tattoo removal