Assuming you are standing between two adults aged 26–40 years old, turn to the person on your left, and then turn to the person on your right. Statistical probability suggests that one of those people will have a tattoo. There is no denying the surge in popularity of body ink; it has spawned magazines on the subject, countless websites, and numerous television programs like “LA Ink”.
According to Pew Research Center, about $1.65 billion dollars was spent by Americans last year on tattoos, with the total number of people sporting at least one tattoo pegged at 45 million. Perhaps more interesting and relevant to physicians is the fact that 17% of people with tattoos polled indicate that they have at least some regret over their tattoo, and 11% suggesting they have or will have a tattoo removed by laser.
Tattoo Craze Ends In An All-Too-Common Story
Jessica Doyle felt pretty special in college when she had Chinese script inked into her ankle. However, the positive emotions experienced in her youth turned more to embarrassment as she became an adult working in Philadelphia.
“I was told the symbols represented power and intelligence,’’ said Doyle, 35, a Financial Analyst working on the Main Line, “but truthfully I had no way of knowing at the time what it really meant. It wasn’t until years later that an Asian person in my gym approached me asking why I got a tattoo that said ‘Brave Clown?’”
Doyle began concealing her art at her place of work with either appropriate clothing or a well placed bandage. However, like many who feel only regret when looking at their body art, removal became a necessity. For what initially cost Doyle about $150 at a tattoo salon eventually cost $2,200 to remove with a series of laser treatments. Her story is repeated in ever increasing numbers as estimates released by the American Society for Dermatologic Surgery suggest that 61,535 laser tattoo removal procedures were performed in 2009 by their members alone.
Tattoo Craze Leads To Opportunity
The tattoo craze has created an undeniable upturn in the demand for professional tattoo removal. What is equally interesting is the surge in the number of patients looking to reverse a previously botched removal job. In terms of the revenue potential for a physician offering this service, like many aesthetic procedures cost can vary from region to region. However, a good estimate starts at about $40 per square inch of inked area, per treatment. Therefore, to remove a 3”x3” tattoo, a patient should expect to pay about $360 per treatment. However, tattoo removal is not a one treatment protocol. The best lasers for removing all colors of ink still typically require 4 – 6 treatments to adequately clear the ink. Therefore, using the above example, the physician could expect to generate between $1,440 to $2,160 on this one patient.
As with any aesthetic procedure, the key isn’t measured so much in the financial return to the physician as it is by the satisfaction expressed by the patient. Therefore, choosing the right laser technology is tantamount in providing a safe and effective treatment.
Choosing the Right Technology
Lasers are now considered the gold standard of treatment to remove a tattoo. However, there are numerous different wavelengths available, each of which reacts differently to pigments in the tattoo’s ink. All lasers will require repeat visits ideally spaced no sooner than eight weeks apart.
As physicians with lasers likely already know, a single wavelength is capable of many different indications. However, if you have a long pulsed laser of ANY wavelength, treating a tattoo with this device will not only provide an undesirable result, but it may also very well result in scarring, hypo or hyper-pigmentation, and other negative outcomes. According to the National Institute of Health, the latest technology using Q-switched lasers have been determined to be not only the most effective at lightening or removing ink, but also the safest with risks of scarring considered to be very rare.
Lasers emitting visible light to near-infrared are used for tattoo removal with tattoo color often determining which works best given the specific circumstance.
• Q-switched Frequency-doubled Nd:Yag: 532 nm. This wavelength is particularly well suited for red and orange tattoo pigments.
• Q-switched Ruby: 694 nm. Creating a red light which is highly absorbed by green and dark tattoo pigments, the Q-switched Ruby is limited to only the lightest skinned patients due to its nature of being highly absorbed by melanin.
• Q-switched Alexandrite: 755 nm. The Q-switched Alexandrite is generally considered the most appropriate wavelength for blue, green, and black inks. However, when applied with appropriate pulse duration this may very well be the best technology for removing the widest array of ink colors.
• Q-switched Nd:YAG: 1064 nm. Occupying the near-infrared spectrum, this wavelength is poorly absorbed by melanin which makes it a suitable option for darker skin types. However, this laser wavelength is mostly appropriate for dark colored inks only.
While wavelength is the first consideration for effective laser tattoo removal, pulse width or pulse duration is an equally critical consideration for the treatment parameters. Regardless of wavelength, all Q-switched lasers are programmed with appropriate pulse duration for tattoo removal. However, lasers that have options for shorter pulses are superior in safety and efficacy since the peak power of the pulse is greater than longer pulses.
The long and short of any discussion about incorporating a laser into your practice for tattoo removal is if you choose a well equipped laser for tattoo removal, your practice could easily see a highly valuable new revenues stream.