Erasing the past
Tattoo removals, Olivia Berckley will tell you, are a pain -- physically, mentally and financially.
On a recent afternoon, the 25-year-old Los Angeles women was trying not to wince as the doctor aimed a laser at the multicolored, fire-breathing dragon covering her otherwise porcelain-skinned upper arm.
Within minutes, the skin surrounding the 4-by-4-inch tattoo glowed a deep sunburned red. With each rat-a-tat of the laser, a tiny dot of skin puffed up like a blister and wept a droplet of blood.
“Next time I want the numbing cream,” Berckley told the doctor tersely.
Like legions of Americans, Berckley is willing to endure repeated discomfort, shell out thousands of dollars and devote considerable time to having her body art relegated to nothing more than a memory. Across the country, tattoo removal is skyrocketing. Almost all of the procedures now are laser removals, which increased 27% from 2001 to 2003, according to the American Society for Dermatologic Surgery.
The trend comes hand in hand, of course, with a growth in the number of people getting tattoos. No one keeps official statistics on tattoo application or removal, but the American Academy of Dermatology says the number of tattoo studios in the United States increased from 300 to more than 4,000 in the past 20 years. An estimated 10 million Americans now sport tattoos.
But that 5-inch surfboard adorning a college student’s arm may not look so great when he’s 28 and seeking a promotion at his accounting firm.
People who regret their tattoos are highly motivated to get rid of them, doctors say. “They’ll spit blood to get them off,” said Dr. Harold Lancer, a dermatologic surgeon in Beverly Hills.
The explosion of laser technology has made it possible to do just that. Almost a decade of studies on laser tattoo removal has taught doctors how to remove a wide variety of inks and colors from a variety of skin types while minimizing the risk of scarring.
With two treatments behind her -- and six to eight more ahead, Berckley can’t wait to wear short-sleeved shirts without worrying what people will think of her tattoo. She had chosen the dragon after spending an hour browsing among the sample artwork provided at a local tattoo parlor one week after her 18th birthday, the legal age for obtaining a tattoo without a guardian’s permission. She began to wonder if she’d made a mistake when she got home that evening and showed her mother.
“My mom said, ‘I can’t believe you got it on your right arm -- and I can’t believe it’s a dragon,’ ” Berckley recalls. “At the time, I couldn’t wait to get one.... I thought I’d never get tired of it.”
By age 22, the tattoo had become “less appealing.” When she was married last year, Berckley selected the bare-shouldered wedding dress of her dreams but added shoulder-length gloves to cover the tattoo.
“I started thinking of the way people perceived me; something I didn’t think of when I got it,” she said.
Berckley paid $100 for her tattoo and will part with close to $3,000 for the removal. Each laser session is about $300. “It’s worth it to me to have it removed,” she said, while Dr. Stuart Kaplan of Beverly Hills applied gauze to her lasered shoulder. “A little bit of scarring isn’t going to bother me as much as the tattoo.”
Gilbert Arias, 38, is also a different person than he was at 14, when he got his first tattoo. He is no longer a gang member; he’s a phone technician supervisor with a wife and three daughters. “I’m a family man now,” he said recently in Dr. Gary Lask’s office at the UCLA Dermatology Center.
“About seven years ago, I started thinking about removing some of them,” the Whittier man said of his 12 tattoos, which include a teardrop under his left eye, praying hands on his neck (which once landed him in jail because it was similar to a tattoo worn by someone wanted by the police), a peacock on the right arm, “I’ll always love my momma” on the left arm and a gang symbol, also on his left arm.
“I grew up,” said Arias, who proudly displayed before and after photos of his disappearing tattoos. “And people stereotype people with tattoos.”
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Technique takes off
Tattoos are created when colored pigment is injected into small holes in the dermis, the deep layer of skin under the top layer. Prior to the advent of high-tech lasers about a decade ago, removing ink from the dermis was a nasty process. Smaller tattoos were usually cut out; larger tattoos were scratched off, along with layers of skin. Scarring, sometimes severe, was inevitable.
Although lasers have been used to remove tattoos for about 10 years, mastery of tattoo removal has been gradual and consumer acceptance of the procedure has been slow.
Now, skilled doctors with the most sophisticated laser equipment can typically remove 95% of a tattoo. (Often, barely visible bits of ink remain in the skin.) Scarring occurs in only about 5% of cases because the lasers pass through layers of skin -- for the most part without damaging them -- to destroy the ink by blasting it into tiny fragments.
“With the laser you aim at a color,” Kaplan said. “You set the laser to affect the color you want to reach. The color attracts the laser. The laser goes through the skin and leaves much of the skin and destroys the pigment.”
In a demonstration, Kaplan waved the laser over normal skin below Berckley’s tattoo. Because the laser was targeted to reach only colors on a blue-black wavelength, nothing happened. When he pointed the laser at the dark blue in her tattoo, the blistering-bleeding reaction occurred.
To reduce the risk of scarring, only a limited amount of laser power is applied per treatment. After each treatment, the tattoo area remains inflamed for several days, then a scab forms and eventually flakes off -- sometimes with bits of ink in it. Typically, 10% to 20% of the tattoo is destroyed with each treatment. Gradually the tattoo begins to look broken up; solid lines, for example, become dotted lines. Colors fade.
The best lasers to reach a full spectrum of colors are the Nd:YAG and Alexandrite lasers, Lask said, adding that some doctors have a laser that will remove some, but not all, colors.
Berckley said one doctor told her he could remove the blue and black inks (the easiest colors to erase) but not the red, turquoise and green. Kaplan, however, says he can remove the vast majority of Berckley’s tattoo.
Not all tattoo removals are the same. Some colors change as laser treatments are applied. Green and yellow are particularly resistant to complete erasure. And because tattoos applied with machines deposit more ink into the skin, they’re more difficult to remove than those applied with a needle.
Although small, black tattoos sometimes require only three or four treatments, larger tattoos can need as many as 10, Lask said. With patience, repeated treatments will usually remove most of the tattoo. But progress is somewhat unpredictable. “When you tell people you can remove a tattoo now without scarring, they say, ‘Oh good, now I can get one without having to worry about that.’ But it’s not that simple,” Lask said.
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A barrier to progress
For some people, removing a tattoo becomes essential to moving on with life.
It took one Pacific Palisades man, who asked not to be identified, several years to save the money for removal and, almost a year into the treatments, he still is not finished erasing the mistakes of his past.
Influenced by fellow inmates during a jail stay, he decided to have the words “White Pride” emblazoned on his upper arm. He said he wasn’t a white supremacist. “I just wanted something shocking,” the 38-year-old said. “But I didn’t think it would create such a fervor.”
He once was stabbed at a party after a crowd of men saw the tattoo and became enraged. After that incident, he spent years hiding it with clothing. “I would feel self-conscious,” he said. “I stigmatized myself by getting this tattoo.”
Last year, his brother gave him $500 to start laser removal treatments, which he began in February. The tattoo has been difficult to remove.
“This tattoo cost me $100, and it’s going to cost me $5,000 to have it removed,” he said with a sigh. “But I’m being proactive about correcting the mistake I made. I feel like a millstone has been lifted from me.”
For a Sherman Oaks woman, who asked not to have her named used, the four tattoos on her body represent more than bad memories. She got her first tattoo -- her boyfriend’s name -- implanted on the right side of her abdomen at age 16. “He was very controlling,” she said. “He made me get the tattoo to prove to him that I loved him.”
They broke up two months later, and she had the name covered with another tattoo, a common tactic among people who regret a tattoo but one more than doubles the difficulty of removal. The coverup of moons and flowers, a blur of blue-black ink, she said, “didn’t turn out as well as I hoped.”
Addicted to drugs and hanging with a rough crowd, she had more tattoos applied by a new boyfriend who used a homemade machine. Within weeks she was adorned with a ring tattoo on one finger, a butterfly on her ankle and the boyfriend’s name in her pubic area. After two months, that relationship ended and she began a long climb to sobriety and a more stable life.
However, the tattoos left her “depressed and ashamed,” a constant reminder of the past. In October, she began having laser removal of all four tattoos. The treatments will take about a year, at $600 per session.
“I don’t want to see those tattoos any more and remember ... that time in my life,” she said.
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Tips to consider when deciding to remove a tattoo
Select an experienced doctor. Usually a dermatological laser surgeon has the most experience. Ask the doctor how many removals he or she has done.
The removal should be done in an appropriate medical setting, such as a laser clinic or a doctor’s office.
Find out if the laser system the doctor plans to use is right for your skin type and your kind of tattoo. How many lasers does the doctor have? More lasers sometimes mean a greater ability to treat a wide range of tattoo ink colors and skin types. Some doctors have more experience than others with darker skin.
Ask how many treatments will be involved and what the side effects and risk of the treatments are, such as scarring and white spots where the tattoo was removed along with some of the skin’s natural pigment.
Ask whether a test spot is necessary. Doctors will sometimes treat a very small patch of the tattoo to determine the result before moving ahead with a full treatment. Test patches are often performed on facial tattoos and tattoos on people with darker skin types.
Find out what the total cost of the removal will be.
Call the doctor if you experience pain, discomfort or discoloration after the procedure.
If you opt for a tattoo, remember that yellows and greens tend to be the hardest colors of ink to remove. (That information might come in handy down the road.)
Source: American Society for Dermatologic Surgery and Times sources
