13 VITAL QUESTIONS TO ASK WHEN YOU SHOP FOR LASER TATTOO REMOVAL

You're interested in removing a tattoo. You've heard lasers are best (it's true!). Maybe you've heard about different lasers. You've heard it hurts. You've never done any of this before. Help!

I've prepared this little SHOPPING LIST for anyone looking for local laser tattoo removal. These are the questions you want to ask, the questions you NEED to ask.

You might not find anyone who scores perfectly on all 13 of them, but at least you know what you're getting yourself into if forced to compromise.

Here goes...

1. How long has the business been removing tattoos?
A business' long track record means you can trust them to be around for the 1-2 years you might be going there, and it's even better if you're prepaying for treatments. It's a tough industry, and it's common for laser tattoo joints to go out of business, due to high overhead costs.

2. How long has any given practitioner been removing tattoos?
A business' knowledge is only as good as the knowledge of their technician(s). Think of it this way, if their only practitioner has 2 months of experience, then so does the business. "Institutional experience" is not helpful, because bricks and mortar don't know how to remove tattoos. The goal is to find the person with the most experience.

3. What does the practitioner do besides laser tattoo removal?
Dermatology offices may boast physicians and other medical professionals, but they're spending most of their time doing the vast specialty of dermatology and maybe not lasering so many tattoos. This is a good thing, because they're detecting cancers and saving lives. Still, you might want to move on if tattoo removal is something merely occasional for them. The dream scenario is someone who lasers tattoos all day, every day.

4. What are the practitioner's medical credentials?
Many states allow non-medical people to handle lasers and remove tattoos, but that doesn't make it a good idea. Find someone with as much medical education as possible (measured in years, not hours), and be prepared to pay the difference. Funny thing is that there isn't always a difference, and the professional can cost the same or even less than the person with the weekend course certificate and laser bought off eBay.

5. Does the practitioner carry malpractice insurance?
Anyone going near your skin with a laser must have special liability insurance. It's a cruel irony that the ones who really need insurance usually don't have it. Your licensed medical professional will be insured against unforeseen problems that may never arise, thanks to their skills and education. Regular business insurance doesn't cut it, although it's helpful if you slip on their wet floor and hurt yourself. Don't feel shy about asking for proof of insurance.

6. Do they take pain control very seriously and offer numbing?
This one is easy. If they say they don't numb, move on. If they say it's supposed to hurt, move on. If they say numbing "doesn't work," move on. They're jerks, when you consider that anesthetics have been cheap and available since the early 1940s.

7. What kind of laser technology do they have?
I consider this to be less important than all of the above questions. Finding a best practitioner means you'll find someone you can trust to employ effective technology. Sure, picosecond lasers are newer and better than older nanosecond (Nd YAG, Q-Switched, etc.) lasers, but never let it be the dealbreaker. I'd much rather see a physician with an old nanosecond laser than a non-medical person flinging a picosecond beam around, without insurance.

8. Will they be there if you have problems? Will they even be there the next day?
Some outfits operate out of vans. The mobile idea may seem great for them, but imagine getting a medical procedure somewhere that's going to be a patch of empty parking lot by nightfall.

9. What can and can't they promise?
Be wary of anyone who promises a tattoo will be gone in X treatments, or that any tattoo or color will respond perfectly. There are physical limitations at play that no one is immune to, no matter what laser they're using or how much experience they have. Do they suddenly get noncommittal when you try to pin them down? Good! THEY'RE the ones to trust. There are no promises with laser tattoo removal. Beware of promisers.

10. Do they manage their own medical complications?
Say you have bad, deep blistering, maybe a non-healing burn, or perhaps an infection (these are possible issues with older, nanosecond lasers and their inadequately-trained handlers). You call, asking for help. A medical professional will see you without hesitation and treat the complication appropriately. Anyone else will probably shrug and suggest the ER, and that's a good thing, because you don't want them suddenly playing doctor when a problem arises.

11. Can you get a live person on the phone easily?
If you can, that's someone who cares about clients and respects their time.

12. Do they have Before & After pictures?
Yes? Good, now ignore them. Good practitioners with good equipment make tattoos go away, end of story. Before & After photos are cherry picked, anyway. Everyone does it. I promise you there won't be photos of the stubborn ones. Before & After photos are kind of like a ripped, muscular guy telling you that one gym works better than another.

13. Are they respectful?
You don't need anyone making you feel bad about your choices. If you get a judgmental vibe, take it seriously and consider moving along. Saying goodbye to an unwanted tattoo should be a positive thing.

I hope you find this list informative, and I wish you the very best of luck in researching this very important decision!

Richard Rosol, MD
Owner, TattooMedics Laser Tattoo Removal
Providence, Rhode Island

DOES LASER TATTOO REMOVAL HURT?

It's the first question to cross people's lips: Does laser tattoo removal hurt?

The short answer is that IT SHOULDN'T. Safe and effective anesthetics have been in wide use since the early 1940s, so there's no excuse for not using them, right?

Maybe you've seen the videos on the Internet of people writhing and screaming as their friends--and even the technician!--tell them to suck it up. Let's face it, pain isn't cute, no matter how much you try to dress it up in a video. We're not talking about getting-a-tattoo pain, either. This pain is on a whole new level.

So why doesn't everybody numb up for laser tattoo removal?

Let's back up a little.

Laser tattoo removal works by shattering trapped ink crystals in the skin's live layer--the dermis--without breaking skin. With the latest picosecond lasers, such as our PicoSure, that explosion is extremely effective, reducing the ink to very fine particles so that the body's immune system can safely remove them. This shattering happens in a veritable "forest" of pain nerves. This would be extremely painful were it not for effective numbing.

The best numbing medicines are available only by prescription, which is probably the main reason non-physicians attempting laser tattoo removal commonly don't provide them. To be truly effective, topical anesthetics must be used properly. Improper application is a common error made by well-meaning practitioners, contributing to the myth that numbing doesn't help.

Also, there is a myth on the street that treatments are less effective with anesthetics. It sounds like something our mother would say ("It has to hurt to work!"), but it's simply not true. In reality, treatments are more effective with numbing, because the pain can be so severe that people will cancel their future appointments over anticipated pain, and tattoos don't get removed that way.

The overwhelming majority of our patients enjoy their treatments and look forward to the next. That's the way to do laser tattoo removal humanely, putting the patient first.

Laser tattoo removal SHOULD NOT HURT. Don't let it. And don't let anyone talk you into it.

Richard Rosol, MD
Owner, TattooMedics