Front View: Our Receptionist Liz on the Versatility of Laser Tattoo Removal.

Tattoos are pieces of art we often use to portray significant times, people, or things in our lives. Some tattoos are done purely for art's sake and broadcast our tastes and aesthetics.  But what we perceive as significant or beautiful can change, the same way other likes or dislikes shift with no apparent notice. Not a fan of the text under your portrait tattoo? Wish you could just erase those blue flowers that are clashing with the rest of your tattoos? Are your Roman numerals just plain wrong?

Things don't always go as planned, but don't worry! There's more to laser tattoo removal than just erasing tattoos! We quite commonly edit errors, misspellings, or anything unwanted. So you can keep what you love and remove what you don't. Laser tattoo removal also gives much more artistic freedom to cover-ups. They don't have to be bigger, darker, or limited to certain characteristics anymore.

As a tattoo collector, I see myself as a constant work in progress. As I grow and change, it's okay for my appearance and body artwork to change as well. Tattoo removal is not “anti-tattoo,” but the eraser to your ever changing self. No wonder it's gaining popularity among collectors!

Ask the Doctor: Why should a physician remove my tattoo?

Laser tattoo removal (LTR) has seen enormous growth since the early 1990s.  It's no wonder, since the tattoo industry has been riding a high wave just ahead of the lasers.  Seeing great opportunity in erasing unwanted tattoos, people from all backgrounds--and some with no relevant background at all--have been purchasing Class IV medical lasers and aiming them at tattoos their owners are sometimes desperate to remove.

These days laser tattoo removal is being done mostly by Certified Laser Technicians operating as estheticians, RNs, Nurse Practitioners, and others having no college degrees or advanced training before obtaining their certification.  They can be found in spas, salons, dermatology/plastic surgery practices, esthetic laser centers, stand-alone laser tattoo removal establishments, and tattoo shops.  They can be extremely experienced and competent, especially if they work in a setting that performs only laser tattoo removal, without a long menu of other services.

But experience is only part of the equation.  LTR, done conscientiously, calls upon knowledge of physics, anatomy, physiology, and psychology.  The physics alone can be quite dizzying, but an in-depth knowledge of the physics is essential to understanding any laser's strengths and limitations.  One must also understand the physiologic responses to the kinds of energy to which the tissues are being subjected.  This knowledge not only guides the choice of safe, effective energy, but it also informs patient qualification, personalized aftercare plans--and pain control, a crucial aspect of LTR all too often ignored.

Many states have been slow to regulate LTR and other uses of medical-grade lasers.  Rhode Island and Massachusetts allow persons with no medical background or licensure to perform laser procedures as long as there is a medical director.  The responsibilities of the medical director, however, are poorly delineated.  For example, there is no requirement that he/she be on-site, nor is any supervision required.  Patient cases and charts need not be physician-reviewed.  Indeed, there is no expected standard of medical record-keeping.  Laser technicians are not mandated to carry professional liability insurance, nor are medical directors required to add LTR activities to their malpractice insurance policies.

In addition, there is little to no oversight to ensure that lasers and other devices are being used in the manner for which they were FDA approved.  This point is very important to consumers, since any use outside of a device's FDA approval is tantamount to experimentation, and a patient's skin should not be the target of anyone's experiment, except in a proper research study under full disclosure.

When a licensed medical professional performs your procedure, you benefit from many years of hard-fought, rigorous study.  Prescribing power means better pain control, and therefore greatly improved satisfaction.  Extensive study of biostatistics confers a respect for sound, evidence-based practice.   With a State Licensing Board to answer to, higher quality is maintained through accountability.  Looking beyond that, a physician is ethically bound to take your well-being seriously.

A physician who will perform your procedure personally, while rare outside of the Providence area, is worth the search and will not necessarily cost more than a technician.  It's very important to shop thoroughly and ask the tough questions.

I believe that when a medical-grade laser is being used, a medical procedure is being performed.  Whether State and local regulators agree does not affect the importance of your skin and the knowledgable care it deserves.


Richard Rosol, MD, owns and operates TattooMedics Laser Tattoo Removal, in Providence, Rhode Island.

Ask the Doctor: Can I remove a tattoo and still have fun in the summer sun?

Summer is a time of long, sunny days and carefree displays of skin.  For tattoo collectors, it's prime time for showing off new acquisitions and letting it all hang out.

But summer can be stressful for owners of tattoos that are outdated, embarrassing, lacking in personal relevance, or just plain badly done.

A question we hear frequently is, "When should I start treatments to have a tattoo gone by summer?"  Sometimes people just want to know if it's practical to remove a tattoo when the sun and beach are calling, given healing times and required care of the treatment site.

Any time of year can be the right time to receive laser tattoo removal treatments, with a little forethought.  At TattooMedics, we help our patients plan their treatments around weddings, vacations and other important dates.

Special care must be taken to protect the treatment area from sun exposure.  Depending on the phase of healing, the tattoo can be covered with zinc oxide (for complete UV blockade) or conventional sunscreens with an SPF of 30 or higher.  It's true that a freshly-treated tattoo cannot be kept wet for the first few days after treatment (ruling out swimming, hot tubbing, etc.), but that doesn't cramp most people's style with a little advanced planning.  Unlike getting a new tattoo, the risk of infection is extremely low with laser tattoo removal, since the dermal barrier remains intact.

It can take up to a year to remove some tattoos.  So if you're feeling the pain of hiding an unwanted tattoo this summer, now is the time to act to get it out of your life for Summer 2017!

5 important things to know before choosing that new tattoo.

Permanent Schmermanent!

Think of this as a pre-nup agreement for your new tattoo. Sure, you want to love it forever, but what if...?

Here are 5 important things to think about when planning your next tattoo, just in case things between you and it get a little rocky.

We're not even going to talk about tattooing the name of your future ex on your body, because that one's pretty obvious, isn't it?

The focus here is removability. Safety and other considerations are for a different list.

1. Try to stick with black, blue, and green mineral pigments. They're fastest to remove. White can turn dark when lasered, just so you know, requiring more treatments.

And steer clear of plastic dye-based inks. Those can't be lasered at all. Usually those are the bizarre and awesome new colors, which is a bummer.

2. Always keep it close to your heart--literally! Did you know that the farther from your heart a tattoo is, the longer it takes to remove? That's because your lymphatic system (the one they were too scared to teach in school because it's a little complicated) is less efficient the farther south you go, and that's the system most responsible for carting away the old ink. Blood circulation is a lot more sluggish down there, too. In summary: Shoulder yes, ankle not so much.

3. Whoa, cowboy/girl! The thicker and denser the pigment, the more times you'll be marching back to TattooMedics. Go easy on the amount of ink. Just enough to make it look good. Fine linework and shading are the first to vanish, so more of those!

4. Less is more. If you end up hating a little tattoo, it's a little problem. What about a big tattoo? See what we're getting at? 
5. If you're covering up an old tattoo, think "twice." That is, you'll be left with twice the ink! Consider lightening it up at TattooMedics before covering it. The cover-up will look better, and a possible future removal will be a heck of a lot easier.

Now get out there and love that smart, new tattoo!

Front View: Our Receptionist Liz on Temporary Body Art.

People often spend lots of time trying to find the perfect tattoo artist, but they don't spend the time finding the right place to REMOVE tattoos. Getting a tattoo removed is just as big a deal as getting one put onto your body.

 

There are many things usually taken into consideration when choosing the right tattoo artist: experience, talent, and knowledge. If I decide to put art on my body, I'm going to do my research, ask friends, get recommendations, etc. to find that perfect artist to help in creating the artwork I would be totally me. When people love their tattoo artist, they tell the world. They recommend them to anyone and everyone looking for a tattoo because they have confidence in their artist. So, with tattoo removal on the rise, why do you never hear of anyone having their own tattoo remover? Why don't we ask the same questions in our search for the perfect remover?

If I love tattoos so much, why would I want any removed, anyway? If I believe it to be an art form, why would I support removal of it? Well, to me, there are many reasons.

I had given myself a tattoo 12 years ago. The meaning behind it was deep and personal to me, but as I grew older, I realized the tattoo itself really wasn't giving the purpose behind it any justice. Though I loved what it meant, and went through a lot of pain to receive it (sewing needle and India ink), if I still wanted to show my love for it, and love it again, something had to change. Being on my ankle, it wasn't a location that was visible to most; but to me, that's all I saw. If it WAS seen, it was always me explaining the same old story, explaining what it was, that I gave it to myself, and basically giving excuses as to why it was still there. 

Something I was once so proud to have given myself and that meant so much to me had become an embarrassing story of someone that just wasn't me anymore. Getting a cover-up seemed like a good idea, but maybe I didn't want it on my ankle at all. Maybe I wanted the design and location to be somewhere else entirely.

Because I had no good answer to these questions, I slipped into a habit of just hiding it.

 

Through a series of events, I became the receptionist at TattooMedics. How cool--an edgy, modern tattoo removal/medical office. I began learning more about laser tattoo removal. I didn't realize there are different types of lasers used and that training to use one is not required in most states. In fact, only 2 states (North Carolina and Texas) actually require a license and state test to use a laser. Really? Not only that, but if you DO decide to attend laser training courses, they're usually for only 2 weeks or so. Not here. Dr. Rosol is a licensed physician who performs all the treatments here with a PicoSure laser.  That means you're receiving the best treatment, by the best laser, from an actual doctor.

When I started working here at TattooMedics, the thought of removing my unwanted ankle tattoo came to mind. Thinking of how great it would be to not see it every time my ankle would show, or worry about trying to cover it (with makeup, clothes, or even another tattoo), or have to explain what it is and why.  It would just be gone.

 

Two months later, and I can now say that I not only have a tattoo artist, but I also have a tattoo doctor. That's right, not just a technician who (hopefully) took a training course, but a medical doctor. Using not just a laser, but the best laser. TattooMedics is not just about removing tattoos, its about loving the skin you're in, loving your canvas, and removing what just isn't you anymore. 

Knowing what I know now, there's no way I would trust a procedure like this to just anyone, with just any laser, at just any place. TattooMedics' slogan says it all: Love your canvas. And thanks to Dr. Rosol, I'm doing just that.

                                                                                                                                    -- Liz Thibault

Want to see me get my tattoo removed?

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Tattoo Removal Advances to 6,000 Years Ago, and TattooMedics Leads the Charge!

We are proud to welcome Dr. Sanjay Patel, formerly of ElectroChakra Therapy, of Mumbai, India.

“I think Dr. Patel will take us exciting, new directions,” said Dr. Richard Rosol, founder and CEO of TattooMedics, Inc, (NYSE: TMI) in Providence, Rhode Island.

Dr. Patel is a pioneer in the relatively new field of Complementary and Alternative Tattoo Subtraction (CATS). In his innovative method, he bends and “short-circuits” the body's natural energy fields to remove tattoos quickly, painlessly, holistically, and from completely within.

“Some form of this has been in use for over 6,255 years, though I'll admit not exactly applied to tattoos,” conceded Dr. Patel in a recent press conference given on the tarmac of T. F. Green Airport, on his arrival from India. “Back in my country I saw some very impressive results removing moles and freckles using The Chakratic Method.”

“So why not tattoos? I thought,” added Patel with a laugh.

This “technology,” as Patel puts it while directing a wry wink at his Western medical colleague, is not without limitations. For example, chakras are unpredictable and oft-times squirrelly, making his treatment difficult to focus on just one tattoo. Dr. Patel is quick to frame this as an asset, stressing that The Chakratic Method is perfect for people who want to remove all their tattoos at once—along with their moles, freckles, and even dental cavities.

"My therapy is so powerful," boasted Dr. Patel, "Henna tattoos usually go away themselves in the three weeks it takes to get an appointment with me."

When asked where the tattoos go, Dr. Patel explained, "I have no idea."

“Some might think this unorthodox approach is a bit at odds with TattooMedics' well-known evidence-based practices,” Rosol was quick to assert. “That's why Dr. Patel will head our new, wholly-owned subsidiary, TattooVedics."

Seven new TattooVedics locations are planned to launch in 2016.

“We will probably stop at seven,” chuckled Patel.

Ask the Doctor: Does laser tattoo removal hurt?

Yes.*




* But it doesn't have to.

It's on everyone's mind.  The pain.  People have described it as "a rubber band snapping on your skin," and "a spatter of hot bacon grease."  If that sounds harmless enough, imagine it happening ten times per second.  Even though the average tattoo we see here at TattooMedics takes less than one minute to treat, the pain would get old fast if it weren't for the prescription-strength numbing we provide.  It's called EMLA cream, a mixture of two local anesthetics absorbed extremely well into the skin.  EMLA is very safe and is tolerated well by just about everyone.

Does it work?  To answer that question, let's back up a bit to how laser tattoo removal works.  In tattooing, colored mineral crystals are injected 1 to 2 millimeters into the skin's live layer, or dermis.  Most of the crystals are too large for the body to deal with, so there they stay, permanently embedded.  Laser tattoo removal shatters these crystals into fragments small enough to be cleared safely and naturally by the body.  Our PicoSure laser accomplishes this very efficiently and without an excess of heat.  No skin is ever broken in the process, and there's never a burn.

So, if there's no breaking of skin and no burning, why does it hurt?

It's the explosion of ink crystals.  Even though it happens on an extremely tiny scale, there's a lot of it happening at once.  The brisk snap! heard when a tattoo is lasered is literally this summation of minuscule explosions.  That sound--and the sensation associated with it--is proof positive that ink is being destroyed and the tattoo is not long for this world.

The good news is that we can greatly reduce the pain.  With proper application of EMLA and the addition of ice-pack cooling, most patients report anything from trivial to moderate pain.  That's a lot better than "ten times worse than getting a tattoo," and having to stop and take frequent breaks.  With EMLA on board, patients only rarely ask for a break, and the procedure is over before they know it.  They leave smiling every time.

Score another point for EMLA!

Dr. Richard Rosol owns TattooMedics and personally performs all procedures.

Ask the Doctor: What is hypopigmentation?

Sometimes when we remove a tattoo, the underlying skin lightens in a phenomenon called post-inflammatory hypopigmentation. More common in people with darker complexions, the skin can react to even the mildest inflammation with a temporary dormancy of the cellular machinery responsible for production of melanin, the skin's natural pigment.

The photograph above is a textbook example of the hypopigmentation sometimes seen in laser tattoo removal. The process is completely unrelated to that of scarring, which is extremely rare with the PicoSure laser in experienced hands. The affected skin is supple and smooth--only lighter in color. This can actually be beneficial in laser tattoo removal, which works even better when there is less melanin in the treatment area.

Hypopigmentation of this kind does resolve on its own once treatments are completed, but the restoration of natural skin color can take an average of one year. During the wait, a touch-up with the right foundation can make it nearly unnoticeable. For military qualification hypopigmentation is a non-issue: The only thing that matters to recruiters is that all tattoo pigment be gone.

Follow our blog for more answers to frequently asked questions. If you have a question of your own you'd like to see us address, please contact us!

Our story begins in the Italian Alps...

Over five thousand years ago, a Neolithic man, shot through the shoulder by an arrow, apparently escaped his attackers only to die alone on a frozen mountaintop in the Italian Alps.  This man, affectionately named Ötzi, bears on his naturally mummified skin the earliest known symbolic tattoos.  No anchors or mermaids, these tattoos, but bizarre and arcane markings.

The practice caught fire and sprang up on all corners of the globe.  Whether tribal or spiritual ritual, or mere decoration, tattooing has left an indelible mark on human history.  A tattoo became a snapshot of a moment in the life of its host, writ permanent, and taken to the grave.

For most of the tattoo’s history, one can speculate that the same human ingenuity has been working on the problem of removal.  All kinds of frightening and almost unmentionable methods have been attempted to remove tattoos.  To succeed, it seemed, one had to remove the very skin into which the tattoo was embedded.  Most methods were variations on that simple and painful theme.

Then came the laser.

In the 1990s the first lasers developed for laser tattoo removal became commercially available.  Their aim was to fragment tattoo pigment crystals, leaving skin as undisturbed as possible.  Those Q-switched lasers reigned as the first–and only–laser solution to tattoo removal.  Still, the pulse was long, pumping a lot of heat into the pigment and surrounding tissues.  In the wrong hands, burns and scars are easily inflicted.

Enter the PicoSure.

In 2012 technology took its first giant leap forward in decades.  The PicoSure laser, with a pulse 100 times shorter than its Q-switched ancestors, could target tattoo pigment more specifically while drastically reducing the amount of heat released into surrounding tissues.  The PicoSure is especially strong in the black/blue/green and can remove these colors in significantly fewer treatments.

In 2016 tattoos can be removed completely, without scarring or “ghosting.”  Skin is left clear and with normal texture to be displayed proudly–or re-tattooed!  When laser tattoo removal is performed by a physician, comfort becomes a major priority (thanks Hippocratic Oath!), so there is no need to experience the pain so commonly associated with the procedure.

After over 5 millennia of tattooing, we are fortunate to live in the age of complete tattoo removal, where no tattoo is truly an irreversible mistake.