Tattoo removal has been increased over 400% the last decade at USA for professional or emotional reasons. Surgical excision, deep peeling or laser removal are the treatments of choice. Q switch ND-YAG laser is most successful with dark black and blue pigments. Bright colors such as red, green and yellow are better removed by Q switch Alexandrite or KTP laser. 8-12 treatments are usually required to remove tattoos and the intervals between them is 4-6 weeks. The R20 method (we make 4 different passes every 20 minutes, Kossida T Rigopoulos D Katsambas A Anderson RR. Optimal tattoo removal in a single laser session based on the method of repeated exposures. J Am Acad Dermatol. 2012 Feb;66(2):271-7) or the use of silicone patches with Perfuorodecalin at every session can shorten the treatments in 4-6 (Biesman BS, O'Neil MP, Costner C.Rapid, high-fluence multi-pass q-switched laser treatment of tattoos with a transparent perfluorodecalin-infused patch: A pilot study. Lasers Surg Med. 2015 Oct;47(8):613-8). Sometimes, the skin is paler in the area where the laser removed the tattoo. This is called "ghosting".
Immediately after tattoo removal, the skin will look pink and slightly swollen, similar to sunburn. This will subside within a few days or weeks and the skin will return to normal. Occasionally, a patient may have pigment changes, blistering, or scarring although this is rare.