Tattoo Removal

The Modern Guide to Tattoo Removal and Fading

By: Pete Peterson

Copyright TATTOO REMOVAL: A MODERN GUIDE TO TATTOO REMOVAL AND FADING. Copyright by Pete Peterson. All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the non-exclusive, non-transferable right to access and read the text of this e-book on screen. No part of this text may be reproduced, transmitted, downloaded, decompiled, reverse engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, no known or hereinafter invented, without the express written permission of the author.

Nobody can go back and start a new beginning, but anyone can start and make a new ending. - Maria Robinson

The information we explore together in this book is the latest and most up to date available. It is my sincere hope that it will help you to make informed decisions about changing things or improving your life - right now! Lets get started.

Pete Peterson

Disclaimer

The author and publisher of this book have used their best efforts to obtain and provide the best possible and latest information available. The author makes no representation or warranties of any kind with regard to the completeness and accuracy of the contents of this book. All product names, logos, and artwork are copyrights of their respective owners. None of these owners has authorized, sponsored, endorsed, or approved this publication. This book is not intended to be a substitute for qualified professional medical advice nor does the information found in this book constitute medical advice. You should always seek and follow qualified professional medical advice before beginning any tattoo removal strategy. Never disregard qualified professional medical advice even if it is in contradiction to the information presented in this book. No part of this book is to be taken as medical advice. The author and publisher accept no liability of any kind for any losses or damages caused, or alleged to be caused, either directly or indirectly, from using the information contained in this book.

Table of Contents

Part One

Why This Book Will Save You Money Inked and Repentant? A Little Bit of History Free Tattoo Removal Top 10 Reasons for Getting a Tattoo Top 10 Reasons for Getting a Tattoo Removed Religion and Tattoos How Tattooing Works

Part Two

Tattoo Removal: Laser Treatment 10 Questions to Ask a Laser Clinic Infrared Coagulators (IRC) Intense Pulsed Light Treatment (IPL) Chemical Extraction: Rejuvi

Tattoo Erase Surgical Excision Salabrasion Dermabrasion Cryosurgery

Part Three

Home Tattoo Removal and Fading Products: The Acids Inkbusters Nuviderm RX-Tattoo Glycolic Acid Wrecking Balm The Creams Tat B Gone Tattoo-OFF Dermasal Profade Tat-Med Fadeplex

Tattoo Fading

Part Four

Tattoo Alternatives 5 Ways to Identify Dangerous Black Henna 5 Tattoo Removal Tips Covering Up

Glossary

Part One

Air Image credit: deviantart.com

Why This Book Will Save You Money

I wrote this book because there is so much misinformation out there regarding the important subjects of tattoo removal and tattoo fading. Everyone makes a decision in his or her life, usually when younger, that they may now, with the hindsight of years, regret in some fashion. People grow and their tastes and views change and that tat you got on spring break after a few too many beers may not be representative of who you are today. Its time to move on. Aside from making a lifestyle change, maybe you need to get de-inked in order to achieve that promotion or find a better job. You dont want a tattoo holding you back from a better life. Your Boss Hates Your Tattoo Everybody complains about work but the reality is that to survive you pretty much need a job. That means most of us fall into one of two groups: those currently without a job and who want one, and those with a job who want a better one. In todays economy and hypercompetitive job market you need every edge you can get. One thing you dont want holding you back is ink. In all surveys one message rings loud and clear: employers hate tats! You may love your tattooI mean, you chose to get it done and you chose the design so, yeah, that makes sense. But that doesnt mean your boss feels the same way. This is especially true of tattoos in highly visible places, like forearms, hands, ankles, or necks. God forbid you have any tats higher than your neck. If you do, you can forget about meaningful

employment in most cases. So you want a job or you want a better job but youve got ink thats holding you back. What do you do? That is the main question. You need to do something about it. Here are your two choices: cover it up with clothing or get it removed permanently. Doing nothing is an expensive choice. Think about all the money you arent making right now because you are being held back. Add that up over a lifetime and you could buy a house somewhere. The sooner you take action the better off you will feel and the better off you will be financially too. Where Can You Get the Full Story? Fine. You have made the decision or are considering making the decision to have that tattoo removed. Where do you start? For tat removal, any product you find online will only tell you how great that product is and how all the other ones suck. If you talk to a laser clinic, they have an agenda too. It shouldnt surprise you that they will strongly recommend laser treatment at their clinic. A plastic surgeon is likely as not to recommend surgical excision or cryotherapy. And so on. Some of these methods are good ways to change or remove an unwanted tattoo but they can be expensive. In this book we will look at and review all of them, and more. What About Fading? Perhaps you want a cover up tattoo and need to fade the original. Tattoo fading is another option for changing or hiding a design you no longer want. In many situations, you dont need to remove the entire tattoo in order to replace it. Lightening a tattoo is relatively easy to do and we will look at all the latest options for this that are on the market today. Fading a tat before getting a cover up or before starting other treatments for complete removal can also be a good strategy. Although laser treatment is becoming more and more popular, it is expensive. What are the more budget-friendly products or ideas available on the market? If you search the internet for tattoo removal products you will be flooded with promotions for this cream and that acid and this solution with all natural ingredients, blah, blah, blah. Do any of these things work? How do they work? Everyone wants to sell you something. Many of the so-called informational sites on the internet which call themselves foundations or institutes that research and review tattoo removal products are just fronts for the promotion of a single producttheir own. Who do you believe? Who can you believe? This book features full and unbiased reviews of the major products on the market today in order to help you make the right choice.

Whats My Agenda?

I wrote this book to provide an independent voice. This is an agenda-free and totally up to date modern guide for tattoo removal and fading. There are many tattoo removal and fading choices out there and you should review ALL of whats available and make the right decision that best fits your wallet and your skin. Whats my agenda? Full disclosure: I have no connection whatsoever to any service or product provider. I will not sell you anythingexcept this book. After reading Tattoo Removal The Modern Guide to Tattoo Removal and Fading you will see that there is no one-size-fits-all solution. Depending on variables such as your skin type and your budget, some strategies will work well for you while others wont work at all. Removing a tattoo or even fading one can be an expensive proposition, especially if you dont have all the facts. This is where my book will save you money. You can literally spend $10,000 or more on laser treatment in order to remove a large tattoo and still have less than satisfactory results. Or you can spend $1,000 on a cream that doesnt do anything at all. Before committing a large amount of your hard won cash on something like that, read this book. The Guarantee I hope this book answers your questions about tattoo removal and fading and clears things up for you. It took a long time to write and to sort through all the bullshit floating around in the marketplace. I honestly believe you wont find anything else like it. However, if after reading my book you are unsatisfied or think it was a total waste of your time, I will be happy to refund your money. Thanks again for reading.

Pete Peterson Seattle, WA April 2012

Inked and Repentant?

Tattoos are a very personal expression of who we are and how we see ourselves. Getting a tattoo often marks an important point in our lives, and the design we choose may represent special people or memories we dont want to forget. But sometimes we change and what was cool or awesome when we were twenty isnt so great when we are older. That is part of life: we grow, stuff happens, and we have to change with it. Tattoo regret is a very common phenomenon. According to recent polls almost 50% of people who have ink have thought about getting it removed; a recent survey of 163 men and women with ink showed that a full one-third regretted getting ink done. Look no further than the following celebrities: Angeline Jolie. After her divorce from Billy Bob, she removed the dragon tat and his name from her shoulder (left image) and replaced them with a list of latitudes and longitudes of where her children were born (right image).

Image credit: alteredidentity.com Eva Longoria. After her divorce from Tony Parker she had his number nine tat removed. His initials were also removed from an undisclosed part of her anatomy. Megan Fox is removing the Marilyn Monroe tat on her right forearm. Britney Spears and Pamela Anderson are two other celebrities who have had success in removing tattoos they no longer wanted. Johnny Depp has over a dozen tattoos. His most famous was the Wynona Forever tat on his right bicep. When they split up, he had it changed to Wino Forever! Other famous people who have successfully moved beyond the tattoos they no longer wanted include 50 Cent, Billy Idol, Eminem, Charlie Sheen, and Kobe Bryant. Mark Wahlberg decided that he would teach his kids a lesson and brought in two of his four children, Ella Rae, eight, and Michael, five, to watch more than twenty of his painful laser treatments. His tats are gone and his kids are scared straight! As he says, I dont want my kids getting tattoos. If I fail as a father, then its all been for nothing. Thats by far, the most important role that Ill ever play in my life ... being a parent and a husband.

Image Credit: Marty Katz photography One-third of all people in the UK under the age of 44 have at least one tattoo. The Brits are the most tattooed people in Europeeven the wife of the Prime Minister has one! 33-year-old Knicks point guard Mike Bibby is keen to remove some of his tattoos, but he says that the tattoos of his children on his back will remain. Glen Davis, 26-years-old and a forward for the Orlando Magic like Bibby, plans to get rid of some tattoos on his right arm within the next few years. Reasons? As he says of Bibby, Hes on the last limb of his career as far as basketball. Now he has to go in the world and know to work. And how do you do that? You blend in with the guys who have done itwho come in with a suit and tie with no tattoos. These celebs and hundreds of thousands of other people just like you have made the decision to remove a tattoo and move forward with their lives. A tattoo that no longer represents who you are is worse than annoying; it is a constant reminder of something that holds you back. In some cases, people have sought removal treatment right after getting a tattoo. If this describes your situation, experts caution that it is best to wait four months or more after the tattoo is finished in order to allow for proper healing before beginning the removal process. The good news is that tattoos are no longer permanent. Tattoos often mark a phase in your life but they shouldnt become an obstacle to your happiness. You dont have to live with a choice you made years ago that now makes you unhappy. You can free yourself. This book will show you the many ways it is now possible to safely remove or fade unwanted tattoos from your skin. Do Something About It Just like getting inked in the first place, the removal of a tattoo should require thought. You didnt think much before you got that tattoo you now hate? Join the club! Many people in that situation have successfully de-inked and are happier for it. They did

something about it and you can too.

Keep in mind, your health insurance will almost never pay for tattoo removal. It is considered elective surgery or cosmetic treatment not required for your physical health. Since you have to pay for tat removal completely out of your own pocket, you need to pick the right treatment for you. Reading this book is the first big step in that direction. You cant make the right move without all the facts. Whats the fastest and cheapest method of tattoo removal? Photoshop! If you look anywhere on the internet you can find lots of examples of promoters that use Photoshop instead of whatever product they want you to buy for perfect 100% tattoo removal. Dont fall for this. It is highly unlikely that you can remove 100% of your tattoo without some residual colors or slight scarring (from the original tattoo needle) being visible. Anyone who promises perfection regarding tattoo removal should be viewed with a healthy dose of suspicion. Tattoo removal, or just the idea of tattoo removal, can arouse strong negative emotions and sometimes outright hostility from the tattoo community. But getting a tattoo is a personal choice and so is removing one. A lot of people have more than one tat, some have dozens. They may decide to remove all of them or just one they dont like any more. Either way, it is their decision and others shouldnt judge them for it. The information presented here in this book will answer most if not all of your questions regarding tattoo removal and allow you to choose the method that best suits you. Like the tattoo itself, there is no one size fits all removal method. There is no perfect answer and there are no guarantees. Again, if anyone guarantees that they can remove 100% of your tattoo, you should walk away. Successful treatment depends on a lot of factors, including the chemical composition of the ink and your skin type. Some treatments work

well on some people but wont work so well on others. Today, the difficulty facing people with an unwanted tattoo is the sheer number of removal choices out there. Recent Advances in Science In the last five years great advancements have been made in the science of tattoo removal. Until this book, however, there was no unbiased single source to help you determine the treatment that fits you best. Everyone assumes that laser treatment is the only way to go. Laser treatment for tattoo removal is the fastest growing area of dermatology, with clinics sprouting up all across the country. Yes, those clinics provide a service, but they are there to make money and they cant make money unless they sell you that service. Thats great if you are rich and have lighter colored skin with a black ink tattoo, or if the tattoo is not on your ankle. But what if that isnt you? What about the various creams on the market? Some do what they say and some dont. Some are downright dangerous. Each marketer will give you a song and dance about why their cream is the only way to go. Again, their basic motivation is to sell you their cream. What about surgery, or tattoo excision? After talking to a surgeon, you may walk away (probably after paying several hundred dollars for a consultation fee) thinking that surgery is the only way to go. Remember, that nice surgeon needs patients like you; he has a mortgage and car payments too. I am not criticizing the many different hard-working service providers and product marketers in the business of tattoo removal, but remember, it is a business. It is hard, if not impossible, to get unbiased advice. This is why I wrote this book. I am not going to sell you anything, and I am completely disinterested about whether, after reading this book, you choose laser, Tat B Gone, surgery, or a cover up. Most importantly, after digesting the latest information found within these covers you will have the information to make a much better and more informed decision than if you just speak with one product guy or one service provider. Read on and get the information you need to make the right choice for you. Note: Please re-read the Disclaimer section. You should always seek and follow qualified professional medical advice before beginning any tattoo removal strategy. No part of this book is to be taken as medical advice. The author and publisher accept no liability of any kind for any losses or damages caused, or alleged to be caused, either directly or indirectly, from using the information contained in this book.

A Little Bit of History

How many of us have tattoos and how common are they? According to the Pew Research Center, about one-third of Americans between the ages of 18 and 40 have at least one tattoo. The highest rate of ink among the population is found within people between the ages of 1829, 38% of whom have at least one tattoo. The Pew Research Center indicates that 23% of all Americans have tattoosthat is almost one in four people! We can see that tattoos are very popular in the US today but where did the practice begin? The Very First Tattoos Tattoos have been with us for at least 10,000 years. Some speculate that the very first tattoos were actually war wounds from rough wooden spears. Ancient peoples used to fire harden their wooden arrows and spears, leaving the end of the implement covered in carbon or ash. Getting stuck like a pig with one of these weapons would not only hurt but, if you survived, the wound would most likely retain some of the black residue that had penetrated your skin. Recovering from something like that back in the days before antibiotics would demonstrate an almost supernatural healing and survival ability. Plus, showing off scars and wounds is a pretty cool way to pass time around the campfire and impress the ladies as well. This is easy to believe because in todays world just getting stabbed accidentally by a pencil will leave a permanent black mark. I have one of those on my hand but it doesnt impress women that much. As many people know, the word tattoo comes from the Polynesian language of Samoa. It was introduced into the English language after Captain Cooks early voyage there on the HMS Endeavor in 1769. Samoan tattoos, called Pea, are famous. Getting a tattoo isnt something Samoans do when drunk, or visiting Coney Island. Tattooing is a sacred rite filled with many taboos (another word we get from that language), and the whole elaborate process takes months. Traditional Samoan tattoos are only in black, and they start at the waist and finish at the knees. Men who have undergone the tattoo ritual are highly respected in the community. Men who havent undergone the very painful process of getting inked by means of handmade bone tools and wooden mallets are considered naked. Unlike in our culture, the tattoo artist himself occupies a prestigious place in Polynesian society and the hereditary title master tattooist, passed down through the generations in Samoa, is held by only two families. Other famous tattoo designs from Polynesia come from New Zealand. The Maori people underwent the tattoo ritual on their faces in order to create the feared ta moko.

Image credit: Wikipedia But despite the importance of tattoos in Polynesia, we know that tattoos were in use all around the world long before Cook stumbled across Samoa. The Romans were heavily into tats: all soldiers had tattoos on their handsa place you cant hideto prevent them from deserting. If you think that is a bit harsh, consider their poor slaves (Romans were big on slaves too). A common practice of early Roman times was the tattooing of the words Stop me, Im a runaway! on the FOREHEADS of slaves! As the Roman Empire began to embrace Christianity, tattooing was first frowned upon and then outlawed. Interestingly, the ancient Greek word for this type of marking on the body is stigma, and this is where we get the negative term in English to stigmatize.

Image credit: superfuture.com Ancient Japanese tattooing, or horimono, is an art form that employs bamboo needles. It dates back to prehistory, or what we call the Stone Age. Tattoos were widespread throughout the Pacific Islands as well as in ancient India, Europe, and Africa. Although tattoos were also common in ancient Egypt, today in Egypt and Ethiopia, people who belong to the minority Christian Copt community often sport a Coptic cross tattoo on the inside of their right arms or right wrists. Native Americans Early on in American history, trappers and adventurers came across the Native American art of tattooing. Indian tribes often practiced tattooing in order to commemorate successful battles. A wandering trapper would find friends amongst Indians of a certain tribe if he too had one of their tattoos. Of course, if he ran into the wrong tribe his future might not have been so bright. At the same time, American whalers from New England were roaming far and wide into the Pacific and beyond, coming into constant contact with tattooed Polynesians and Melanesians. When they returned from their long voyages, they brought this art form back to the ports that were scattered along the east coast. The invention of the electric tattoo machine in 1891 sped up the process of getting a tattoo. In a single day an artist could ink many more customers than ever before. Business for tattoo artists boomed during World War I, and it was reported that a good artist could make up to $100 a day, which was a lot of money back in 1918. How much is that now? About $1,500 in todays money! Sam OReilly Today, instead of using bone needles and wooden mallets for tattooing, artists use an electric tattoo machine that moves a solid needle up and down like a sewing machine. The needle can penetrate the skin up to 3,000 times a minute but it only goes in a little bitabout one eighth of an inchand deposits a tiny drop of pigment (ink) into the dermis. This machine hasnt changed very much since Irish immigrant Sam OReilly invented it in 1891 in New York. His machine, modeled on Thomas Edisons rotary electric engraving device, attracted a lot of attention not only for its increased speed but also for its accuracy. He was a success at painting people but poor OReilly died in 1908 from a fall when he was painting his house. Most of us are familiar with the idea of gang tats, especially teardrop tattoos, which can mean that the person who wears this tattoo is a murderer, with the number of teardrops indicating the number of his victims. Each tattoo carries a message and marks an experience in a mans life. A spider or spider web signifies drug addiction, while a cat

denotes a thief. Tombstones represent time behind bars.

Image credit: russiancriminaltattoo.com Gang tats are common not only among criminals in the US but in Russia too. Russian mafia tattoos are just now being studied. They have a long history going back to the gulag, or Soviet forced labor camps of the 1930s. Surprisingly, for a country that banned religion, religious symbols are quite common. Churches and cathedrals are popular, with the number of spires indicating how many times the convict has been to prison. Captains in the Russian mafia often have a star tattooed on their knees, meaning they bow to no one. These things are taken very seriously: if someone gets a tattoo to bolster his credentials without having earned it, the punishment is death! Tattooing became even more popular in the US during World War II when soldiers and sailors went on active duty in the Pacific. At that time, tattooing was associated with the military, and you could usually find a tattoo artist anywhere there was a military base. After the war and with the beginning of the ultra-conservative 1950s, tattooing entered a quiet phase. This changed with womens liberation in the 1960s, which opened up a whole new market to an activity previously restricted to men. Janis Joplins famous rose and vine tattoo, inked on her wrist by Lyle Tuttle in San Francisco, became a potent symbol of that liberation. She followed that up with a few more small tats, including a small heart tattoo on her left breast, or as Janis put it:

Image credit: Rolling Stone Magazine I wanted some decoration. See, the one on my wrist is for everybody; the one on my tit is for me and my friends. Tuttle went on to tattoo other celebrities of the time, including Peter Fonda. He also did one on Chers posterior (since removed).

Free Tattoo Removal

If you have gang tattoos and are determined to leave a dark past behind, you should know that you can get them removed. You are probably aware that you will find getting a job almost impossible with a gangland tattoo, doubly so in a tough economy. Many church organizations offer free tattoo removal to those who are turning over a new leaf in their lives. Clean Slate LA is one such organization. It is located in Los Angeles and offers low-cost or free tattoo removal for ex-gang members who want to turn their lives around. See their website at www.cleanstlatela.org.

Image credit: erasethepast.org

Dr. Bryna Kane is a practicing dermatologist and professor of dermatology at both UCLA and UC Irvine. Her grandparents died in Nazi concentration camps, but her parents survived. Growing up, she remembered stories of the branding of camp victims and the negative effects that tattoos can have on peoples lives. With her partner, Dr. Glassberg, Dr. Kane founded the charity Erase the Past in 1997. Young people at risk are able to get unwanted tattoos removed at Kane and Glassbergs laser clinic for free. Well, not exactly free: for every visit to the clinic the patient is required to perform five hours of community service. This does not mean picking up trash on the side of the road but involves service that teaches. Examples given by the organization include working at the health department to learn more about sexually transmitted diseases or how to become a better parent. More than 4,000 people have been treated by Erase the Past and the program boasts a less than 20% dropout rate. Dr. Kane comments that 80% of the young people she treats in the program are people of color. She tells us that the good news is many gang tattoos are homemade, and homemade tattoos are usually easier to remove than professional tattoos. She also says that those with homemade tats are getting complete eradication with minimal scarring. This is a great program that young people who are serious about turning their lives around should consider. You can check out this organization at www.erasethepast.org.

The Top 10 Reasons for Getting a Tattoo

The word chickenshit has probably caused more people to get tattooed than any other reason. - Lyle Tuttle

Image credit: Prick Magazine Lyle Tuttle 1) To Look Cool: This is me and Im awesome. 2) Memories: Auntie Em, RIP 3) A tribute: Heavy Metal Rocks! 4) To rebel: Screw you. Im going my own way. 5) Peer pressure: All my friends are getting them! 6) Boredom: Why not? 7) To identify with a group:

Just joined a gang, so 8) To express individuality: I need to be me. 9) Liked the design: I love butterflies. 10) To make a statement: I just had to Tattoos are a personal choice and the reasons for getting them are equally personal. There are probably as many reasons for getting tattoos as people who have them.

Top 10 Reasons for Getting a Tattoo Removed

Change your thoughts and you change your world. - Norman Vincent Peale

Image credit: Wikipedia Norman Vincent Peale

1)

Broken Relationship: Cursive names of a past boyfriend or girlfriend are among the most commonly removed tattoos. Many see the old flames name branded on their body as unfair to the new partner. Job: Employers hate tattoos! If you want a better, higher paying job it can help to lose the tat. Both the police and the military have severe restrictions on tattoos. A tattoo cannot be visible during a military salute. Change in Lifestyle: What interested us years ago feels a little foolish now. Band names are a good example of common tattoo removal requests. Frankie Goes to Hollywood, anyone? Bad Artwork: Lets face it, nothing is worse than a bad tattoo. Did you know that David Beckham has his wifes name misspelled in Hindi tattooed on his left arm? Wedding: Many women feel that unmarked skin looks best in a white wedding dress. Fashion Issues: This is for women in particular. Choosing clothes to either hide or flaunt the tattoo

2)

3)

4)

5)

6)

on a daily basis becomes a pain. 7) Role Model: Many people regret having tattoos once they have children. See the Mark Wahlberg example I mentioned earlier. Leaving a Criminal Past: Whether it is no longer true or not, visible gang tats shout to everyone that you are a gang member. Being Judged: Being judged by others every day gets tiring. New Religion: Some religions permit tattoos and others expressly forbid them.

8)

9)

10)

Religion and Tattoos

Image credit: Wikipedia Since Roman times wherever Christianity has entered the picture tattooing has been frowned upon and discouraged. Devout Christians point to Leviticus 19:28: Do not cut your bodies for the dead or put tattoo marks on yourselves. I am the LORD. Thats pretty clear, I guess. Tattooing is forbidden to followers of the Jewish faith. Orthodox Jews also look to Leviticus 19:28 for their reasoning. More recent Jewish law, however, permits tattooing if the tattoo has been forced upon someone. An example of this is the number with which each victim was branded when they entered a concentration camp during the Holocaust. The two main sects of Islam, Sunni and Shia, disagree on many things and tattoos are no exception. Sunni Muslims believe that tattoos, as well as other permanent physical alterations not connected with surgery or health, are forbidden. The Sunni Hadith do not permit any disfiguring of the body, as these are haram. The Shias, on the other hand, are more ambivalent about the subject. In Hinduism there are no religious police or any strict religious law. Hindus believe that all rivers flow to the ocean and they take pains to point out how inclusive and tolerant their beliefs are. There is no prohibition against tattoos or tattooing Hindu gods or goddesses in Hinduism. However, if the design appears in one the wrong areas of the body, they can cause offence, particularly if the image of a Hindu god or goddess is used. Buddhism, like Hinduism, is non-discriminatory when it comes to body ink. Tattoos are not forbidden as long as the tattoos are not racist or do not incite hatred.

Sikhs are not supposed to change their bodies, which is why some men avoid shaving and let their hair grow. However, browsing the various online forums about Sikhism, it appears that there are no restrictions regarding tattoos. Some symbols may cause offence, but there is no blanket ban. If one converts to another religion, or a sect of a religion that does not permit tattooing, then something must be done to correct a tattoo problem. Such converts are often prime candidates for tattoo removal.

How Tattooing Works

Image credit: wholesale-in-china.org A lot of people get tattoos or have had tattoos for years without really knowing how the process works. In order to better understand your choices for tattoo removal it is essential that you learn what a tattoo is and why they can sometimes be so difficult to get rid of. This is really a simple process, so dont be scared off and skip this part. You may not know it, but your skin is your largest organ. Human skin is composed of essentially two main layers that sit on top of a third layer: the epidermis, the dermis, and the hypodermis. The epidermis is the outer layer that we can feel and touch. It protects us from germs, bacteria, and pollutants in our environment and it is our bodys first line of defense. The epidermis contains melanocytes, or cells that produce melanin, which is the pigment in our skin. The epidermis and the dermis sit upon the subcutis, or hypodermis, which is a thin layer of fat. This layer is often referred to as subcutaneous tissue but it really is loose connective tissue and plain fat. We dont need to concern ourselves with the hypodermis here. Our focus is on the middle layer: the dermis. The dermis is the middle layer of skin, and it contains blood vessels, lymph vessels, hair follicles, sweat glands, collagen, fibroblasts, and some nerves. The dermis is where tattoos live.

Image credit: uchospitals.edu A tattoo needle penetrates the epidermis and deposits ink, or pigment, into the dermis. The introduction of foreign material into the body activates our immune system and our white blood cells quickly ride to the rescue. These cells are called phagocytes, which name comes from the Greek word phagein, to eat; the suffix -cyte is used in biology to refer to a cell. (One quart of healthy human blood is estimated to contain six billion phagocytes, and the discovery of these guys led to the 1908 Nobel Prize for Medicine.) Phagocytes basically eat any bacteria or foreign material so as to protect us from infection. Normally, phagocytes eat and move foreign particles to places where they can be washed away internally by our lymph system. However, ink particles are too large for this to happen, which is why the majority of tattoo ink remains stable and in place in the dermis forever. Over decades, the pigment tends to sink deeper into the dermis and becomes less visible when viewed from outside through the epidermis. This explains the fading and fuzziness of old tattoos. After about two months the newly implanted ink pigment lying in the dermis becomes part of the connective tissue in the fibroblasts. (These cells produce collagen, which gives skin its elasticity). Fibroblasts last forever and this is why tattoos do as well. To remove a tattoo we have to go through the outer layer of skin, or epidermis, in order to get at the ink. There are various ways of doing this; none are pain free and some carry serious risks of scarring and infection. Because they have sunk down deep into the dermis, older tattoos can take more time to remove. Why Do Old Tattoos Fade? A tattoo is basically ink pigment embedded into your dermis below your skin. The ink molecules are too large to be carried off by your immune system and unless disturbed, they lie inert in the dermis permanently. However, you havent fooled your body. The immune system knows that something foreign is sitting there and to protect itself the body coats the pigments in cells over a number of years. This coating and covering over

of ink is what causes a tattoo to fade or become blurry with time. Another thing that can happen is that the pigment may have been applied too deeply. The result, again over years, is a leeching of the ink into the fat cells beneath the dermis. No matter what, tattoo fading and blurring will occur over time. One of the variables, or unknowns, in tattoo removal is that the type of ink used for the tattoo determines how easy or difficult the design will be to remove in the future. Tattoo ink is a combination of pigment (coloring) and a carrier (solvent) and, because the ink is injected into the body, in the US this process falls under FDA regulation. According to the FDA, many ink pigments are industrial strength colors suitable for printers ink or automobile paint. That sounds pretty toxic! This is why under Proposition 65 in California, all tattoo artists must warn customers of the inherent toxicity of tattoo ink. An Old Recipe But what is the ink made of? The Romans left us an ancient recipe for tattoo ink: One pound Egyptian pine bark Two ounces of corroded bronze, ground with vinegar Two ounces of gall (insect egg deposits) One ounce of iron sulphate After mixing, the area to be tattooed was washed in leek juice and the ink mixture was then rubbed into pricked and bleeding skin. We dont have to use insect eggs today, but since manufacturers are not obliged to reveal the ingredients of their inks we can only speculate about what is inside. We do know that heavy metals are frequently used, including mercury (for red coloring), lead (yellow, green), nickel (black), copper (blue, green), and iron (black), among others. In fact, some of the metals have reportedly caused problems in MRI scans. At least there arent enough metals there to set off the body scanners at airports. And a New Recipe A recent advance in ink technology is Infinitink. The manufacturer claims that its ink is easier to remove than traditional tattoo inks. This is because of their patented process of encapsulating the pigment in tiny balls that easily break apart under a laser and release the coloring into smaller particles that the lymphatic system can then wash away. Currently, Infinitink is only offered in a small number of tattoo parlors in the US and Australia. Infinitink only comes in black and maybe red. Time will tell whether this stuff is the future, but right now it looks like it is very much a work in progress.

Part Two

Fire Image credit: deviantart.com

Tattoo Removal

Image credit: absolutemakeover.com.au Ok, weve come to the section that you are most interested in: How do I get this thing off? Below we examine all the various choices for tattoo removal that are available today. As I said earlier, there have been advances in the last couple of years, especially in the laser field, that have increased the success rate of the removal process. However, you need to realize that there is no single best way to remove a tat. There is a best way for you, however, and it may be different than that one that worked for your friends. These differences have to do with your skin type, the age of the tattoo, the ink used, and other variables, which is why a thinking consumer should look carefully at all the options on the table. Often a combination of removal methods works best. The Most Important Thing The most important part of the removal method you eventually choose is patience. All satisfying results take time. The reason why there is no best way of tattoo removal is because there are many variables at play. These variables are unique to each case and impact how successful or disastrous a chosen method of removal may be. Not considering budget, the main physical variables that have to be accounted for are the following: Your skin type Your skin color Health of your immune system Age of tattoo Depth of ink

Type of ink Professional or amateur tattoo Early forms of tattoo removal ranged from the ridiculous (injecting pigeon poopreally!) to the sadistic (sanding it off). Today with advances in science there are many more effective and less painful choices on the market. One of the most important factors is your skin type. The US Food and Drug Administration and the American Academy of Dermatology use the Fitzpatrick Scale to classify skin color and the tanning behavior of various skin types. Dr. Fitzpatrick was the Chairman of the Department of Dermatology at Harvard Medical School. In the Fitzpatrick Scale there are six skin-types:

The Fitzpatrick Scale

Skin Type

Sun History

Example

Always burns easily, never tans, extremely sensitive skin

Red-headed, freckled, Celtic, Irish-Scots

II haired, eyed Caucasians

Always burns easily, tans Fair-skinned, fairminimally, very sensitive skin blue-

III Sometimes burns, tans gradually Average-skinned Caucasians, to light brown, sun-sensitive light-skinned Asians or skin, skin Hispanics

IV

Burns minimally, always tans to moderate brown, minimally sun-sensitive skin

Mediterranean-type Caucasians, light skinned African Americans

Rarely burns, tans well sun insensitive skin

Middle Easterners, some Hispanics,African-Americans and Asians African Americans, Dravidians

VI

Never burns, deeply pigmented,

sun-insensitive skin

Finally, no matter which treatment you choose, even if you get 100% of your tattoo ink removed you will likely still have a small scar. In the best case scenario, this scar wont be horrific. This is the scar left behind from the original tattoo needle piercing your skin.

Laser Treatment

Image credit: The Washington Post Many people automatically and incorrectly assume that laser treatment is the only sure way to remove a tattoo. Not so. Laser treatment is, however, now the most popular choice. Lets look at the pros and cons of this relatively new method. What does Q-switched Mean? The word laser, like the word scuba, is an acronym for a longer term that doesnt sound as cool: Light Amplification by Stimulated Emission of Radiation and Self Contained Breathing Apparatus arent that easy to say. I like laser and scuba better. There are many different types of lasers which fall into one of two broad categories, continuous wave and pulsed operation. Continuous wave lasers are just thatthe beam is of constant output power, is uninterrupted, and is monochromatic (i.e., it has an unchanging wavelength). Pulsed power lasers are what we are interested in; they work on peak pulse power with short duration. Q-switched lasers are a prime example of pulsed power lasers. What is Nd:YAG? The most common Q-switched lasers are Nd:YAG lasers, which, if you really want to know, stands for neodymium-doped yttrium aluminum garnet. This identifies the crystal used in the solid state laser, YAG. The rare earth neodymium is doped into the crystal to improve its effect. The common wavelength is a frequency-doubled 532 nm, which

creates a greenish light. Other Q-switched lasers used for tat removal are Q-switched ruby and Q-switched alexandrite. Where did lasers come from? Santa Claus didnt bring them down from the pole. Their beginnings can be traced back to Einstein who established the theoretical foundations for this new science almost 100 years ago. Various groups of scientists around the world fooled around with these things after that, but the word laser didnt come along until 1959. Nobody knew what to do with them at the time and they were referred to as a solution looking for a problem. Society in general came into contact with lasers with the invention of the supermarket barcode scanner, which was introduced in the mid-1970s. Now, of course, we find them everywhere, from the ultra low-power laser pointers used at boring conferences to the semiconductor lasers in our DVD players to the laser printers in the office. Lasers Get Cheaper In the 1990s lasers became cheaper and more widespread, which made them a viable method for many medical procedures including eye treatment, kidney stone treatment, and finally, tattoo removal. Lasers used in tattoo removal work by breaking down into small particles the pigment in the ink that is embedded in the dermis. This process is called selective photothermolysis. These particles can then be removed naturally by the bodys lymphatic system. In effect, once small enough, the particles are washed away by the bodys natural immune system. As we just learned, the lasers now preferred in tattoo removal are called Q-switched lasers. This type of laser is most suited to tattoo removal because it works using bursts of energy, or pulses, rather than one steady beam. By bottling up the energy and using an attenuator to suddenly release the charge, the laser transmits much higher watts of energy during the pulse. Just enough energy is used to break down the ink pigment without heating up and destroying the skin around it. This is where operator skill comes into the picture. The more skilled the operator, the less chance scarring will occur from overheating of the surrounding skin. Each color of your tattoo requires a different laser color (or wavelength) to ensure that the ink itself is absorbing the energy and not the surrounding tissue. The pulse duration of the laser is measured in nanoseconds to allow just enough energy to break up the pigment as well as to allow heat dissipation from the surrounding tissue. If not enough energy is released, the pigment will not break up and the tattoo will remain in place. If too much energy is used, the surrounding skin is cooked and scarring is likely to occur. Again, the skill of your practitioner is vital in minimizing the risk of scarring. What Color Ink Is Easiest to Remove?

Lasers work best on black ink. One of the arguments against laser treatment, other than cost, which I will come to later, is they are not as effective in removing certain colors: yellow and green in particular are more difficult to break up. Lasers manufactured after 2006 have a better track record here. The newest lasers can produce four different wavelengths in one machine. Some clinics have lasers with the correct wavelength that target these colors, or they have the correct dye modules. You need to confirm that this is the case with your practitioner before you commit. White ink in particular is very difficult for lasers to break up. Some clinics will only work on white ink if at least five to ten years old. If you have a lot of white ink in your tat you will want to ask about this first. The rest of the tat may eventually disappear with laser treatment but it wont be a complete removal if the white ink is left. The other risk of using lasers on white ink is due to the higher incidence of iron oxide in this ink. Laser treatment can cause this material to turn gray or black, and it will then never come out. If you have pastel colors in your tat there is a high likelihood that white ink is mixed with darker colors in order to obtain that color. This is true with pinks and sky blues in particular. Make sure your clinic or dermatologist of choice uses a scientific predictive method to estimate how many treatments you will need to ensure successful tattoo removal. The most well known method is the Kirby-Desai Scale, which was developed in 2009 by two dermatologists with tattoo extensive removal experience, Dr. Kirby and Dr. Desai.

Image credit: willkirby.com You may recognize Dr. Will Kirby as a media personality with his own fan site. He has appeared on the reality TV shows Big Brother 2 and Big Brother 7: All-Stars, among others. Dr. Kirby is also a part owner of the Dr. Tattoff laser tattoo chain of clinics found in southern California and Dallas, Texas. The Kirby-Desai scale uses numerical measurements for six critical variables:

1) 2) 3) 4) 5) 6)

skin type tattoo location tattoo color amount of ink scarring layering

The resultant score provides an accurate estimate of how many laser treatments, spaced eight weeks apart, will be necessary for complete removal. Without the KD Scale as a guide, your practitioner is just guessing about your treatment, and, given the expense and time commitment you are making here, you deserve better. Laser treatment is also less effective on darker skinned people. This is because dark skin contains more melanin, which diffuses and absorbs the laser radiation and results in the skin becoming cooked and then scarred while at the same time the ink does not receive enough energy to break apart. A Q-switched Nd:YAG 1064 nm laser is often used in this instance. The wavelength of the Nd:YAG is half that of the normal green colored Nd:YAG 532 nm laser, making it infrared and invisible. What is Hypopigmentation? Hypopigmentation, or permanent skin lightening at the area of treatment, is also a higher risk for people with dark skin. In these cases, it is recommended that people undergo treatment intervals of longer than the average six-to-eight weeks to ensure proper healing. Another downside of laser treatment is that it works best on areas of thicker skin. That ankle tattoo you now hate may not respond well to laser treatment and the risk of scarring there is higher. Again, because of all the different variables that are unique to each patient, like age of tattoo, depth of ink, type of ink, color of ink, skin type, etc., laser clinics will not offer a money back guarantee. Practitioners just dont know whether or not their process will work 100% on a specific person. Laser treatment will fade a tat for all the reasons mentioned but complete removal is still a crap shoot. After getting blasted by a laser some bleeding on the skin surface may occur. A white discoloration, which is thought to be caused by steam or gas released within the skin after laser contact, is often observed. Afterward, a crust or scab forms over the treatment area; this will fall off about two weeks after treatment. Some ink pigment may be seen in the scab itself. In order to avoid the possibility of scarring, it is very important that you dont pick a the scab. Let it go, baby, let it go.

How Long Does It Take? Unfortunately, laser treatment requires multiple visits and is quite expensive. After each treatment, time is needed for the lymphatic system to remove the now shattered pigment molecules from the dermis. On average, at least eight visits are needed with a healing period of up to eight weeks between each visit. Anecdotal evidence suggests that treatment at four-to-six-week intervals results in a much higher percentage of scarring. Depending on the color, complexity, and size of a tattoo, up to twenty visits may be needed. Complete removal of a tattoo using a laser will therefore take between eight to twelve months for smaller tats and maybe two years or more for full trunk tattoos. Does It Hurt? Like all tattoo removal options, laser treatment is not pain free. It is often described as being like having your skin stunned by a big rubber band, or being splattered with hot grease. Fun. Topical anesthetic gels are often applied for pain management purposes. Scarring from Q-switched laser treatment is reported in about 5% of all cases. Allergic reactions have been known to be triggered with the breakup of the ink pigment and its release into the immune system. These can be controlled through the use of oral antihistamines and corticosteroids that are administered before treatment. Another potential drawback is the release of carcinogenic amines into the blood stream, which may occur when a laser breaks up certain azo dyes. Azo dyes and colorants have been banned in the EU since 2003 but tattoos that predate this may be at risk, particularly if colors such as reds, oranges, and yellows are present. People with diabetes may need to exercise caution when considering laser treatment as diabetes can impede the healing process. The Stats: Cost: Each session will range from $250$850 depending on where you live, the size of the tattoo and other complications. According to the ASPS (American Society of Plastic Surgeons), a 2007 study found that the average cost of laser tattoo removal was around $2,500. This depends again on the colors and size of the tattoo, how deep the ink was applied, the kind and amount of ink used, and the type of skin of the patient in question. Also, there were wide regional differences in cost, with the lowest average cost of $2,250 found in the mid-Atlantic states and the highest costs on the west coast of around $2,900. For large, multicolored tattoos, the costs could reach up to $10,000. A rough rule of thumb for laser treatment is to budget about ten to twenty times what the tattoo originally cost.

Time: This depends on the number of treatments required. For anything but the tiniest tattoos, it is best to budget on at least eight treatments each spaced six to eight weeks apart. Pain: More painful than other methods. It hurts! Pros: Second highest rate of success for complete removal. Cons: Expensive, painful, and takes eight to twelve months for full treatment. Guarantee: None. Effectiveness: Second highest rate of success for complete removal. Where: Reputable laser clinic or dermatologists office.

10 Questions to Ask a Laser Clinic

Nothing in life is guaranteed and there is no guarantee that laser treatment will be the best choice for your skin and your tattoo. This is why it is very important to have a consultation with a trained and experienced laser technician or dermatologist in order to get the answers you need before you commit to a lengthy and expensive treatment process. These questions are examples of the major areas that you should cover in this consultation and they should be asked in person. The doctor or technician will only be able to give you an accurate assessment and estimate of effectiveness and cost after seeing you and your tattoo. 1) Can you completely remove this tattoo using lasers? 2) How many visits will it take? 3) How long between now and total removal in your estimation? 4) What will the treatment cost? 5) Do you have payment plans or treatment package plans? 6) Would you recommend that I fade the tattoo using a tattoo fading acid or cream before I begin laser treatment? 7) Will the lasers in your clinic be able to treat all the colors in my tattooincluding the whites, yellows and greens? 8) I have dark skin. What are the risks of permanent pigment change to my skin? 9) What do you recommend in terms of aftercare? 10) Will my insurance cover this? (The answer is likely to disappoint you. Tattoo removal is considered a cosmetic or elective medical treatment and is not covered by most insurance policies.)

Infrared Coagulator (IRC)

Image credit: greathairtransplants.com Like a laser, an infrared coagulator (IRC) uses light to attack the ink pigment lying inert in the dermis. However, an IRC is not a laser as it uses infrared light to heat the tissue that holds the pigment. A laser attacks the pigment directly by matching the laser wavelength with that of the ink color. Because it uses infrared light, the incidence of collateral tissue damage using an IRC is likely to be higher than that of a true laser. The treatment procedure is similar to that of lasers. The area to be treated is cleaned and a topical anesthetic is applied to numb the skin. Very short pulses of infrared light are shot at the tattoo. A grid-like approach is used to target the tattoo with untreated spaces left between treated spaces. After treatment a scab will form and eventually fall off. With the scab some of the ink will be removed. At least three treatments are necessary for small tattoos. The advantage of IRC treatment is that it attacks all ink colors. It usually requires fewer visits than laser treatment as well. IRC treatment should be cheaper than laser treatment because the equipment costs much less. But there are also downsides to keep in mind. The chance of scarring using an IRC is higher than that of laser treatment, depending on whom you talk to. This is because of the heating of the surrounding tissue rather than just the ink during treatment.

The Stats:

Cost: Several hundred dollars per visit. Three visits are likely to cost up to $1,500. Time: One-month intervals for healing between visits. Three visits, or three months for a small tattoo. Pain: Similar to laser treatment. Pros: Possibly cheaper than laser and faster as well. Cons: Higher risk of scarring. Guarantee: Unlikely. Effectiveness: Can be effective for total removal. Where: Any qualified clinic or dermatologists office.

Intense Pulsed Light treatment (IPL)

Image credit: Daily Mail Intense pulsed light therapy is another type of light treatment. IPL uses filtered xenon flash lamps, not lasers. The tattoo is covered in a special anesthetic gel, a prism is placed on it, and a light-emitting wand is passed over the area to be treated. IPL is less painful than laser treatment but more expensive, costing around $10 per pulse. If you have a large tattoo you would need a lot of $10 shots and these can add up. IPL is sometimes incorrectly referred to as laser treatment. It is not. However, like a Qswitched laser, IPL is light transmitted in short bursts at high intensity. It is frequently used in hair removal. The debate about the relative effectiveness of IPL and Nd:YAG laser treatment is ongoing. The consensus is that IPL is as effective as laser treatment but may require more treatments. One thing everyone can agree on is that IPL is less painful than laser treatment. It described as feeling something like a light sunburn. Aside from hair removal, IPL is often employed in the treatment of acne, spider veins, and birth mark removal. IPL skin treatment is also called photorejuvenation and is used to remove wrinkles and reverse some aging effect. This is achieved by causing controlled wounds to the skin, which then stimulates new skin production. How Does IPL Work? For tattoo removal, IPL works by sending light through a prism that is put on the skin. When this light hits dark areas such as the tattoo pigment, it breaks these areas apart and allows the lymphatic system to clear away the now-shattered and smaller pigment particles. The closer the tattoo is to your heart the quicker the clearing process occurs, meaning that ankle and wrist tattoos take longer.

As with laser removal, IPL works through the absorption of heat energy by the ink pigment. This is wavelength-dependent. Different wavelengths of IPL are also needed to target and break up different tattoo ink colors. IPL works best on people with light colored skin and has a lower success rate on dark skin. This is because IPL targets the dark color in the dermis. The greater the color discrepancy between the tattoo ink and the surrounding skin, the more effective it is. As with lasers, those with darker skin who undergo IPL treatment are at risk of hypopigmentation, or localized permanent loss of skin color. The risk of this occurring is less with IPL than with lasers. People with diabetes will need to exercise caution here as diabetes may impede the healing process. How Long Does It Take? Practitioners claim that on average amateur tattoos require three to five treatments while professional tattoos require five to eight treatments. Scarring is reported to occur in around 2% of patients undergoing IPL treatment. After treatment the skin will turn red and swell a little. Blisters may form but the skin should return to normal in one to two weeks after treatment. The reason IPL hurts less than laser treatment has to do with the main difference between them. IPL directs light to the dark areas of the skin, which in this case is the tattoo ink sitting in the dermis. It does not damage the epidermis, or outer layer of skin, in order to do this. Lasers, on the other hand, have to pierce the epidermis to reach the ink in the dermis. This superheats and damages the outer layer of skin, causing more pain and more damage. Another advantage of IPL compared with lasers is that there is less down time between visits. With IPL, treatments are usually performed every three to four weeks. Laser treatments are more invasive and require a six-to-eight-week gap between treatments. IPL can cost anywhere from $250 to $600 per treatment depending on the variables discussed earlier. Packages for treatment are often available and this can help lower the per treatment cost. All terms should be discussed thoroughly and fully understood before you commit to treatment. IPL at Home

Image credit: hairlaserremoval.co.uk Black Magic IPL, or Neodymium Magnetic Light as the product is also called, is marketed on the internet as an at home IPL solution. Details can be found at www.neomaglight.com. The promoters, backed by venture capital firm Vydrogen, caution that the device is effective for small tattoos around the size of business cards only and will not be effective on large body tats or full sleeve tats. Dark inks lighten the easiest. Despite the information publicly available, the website itself is poorly constructed and there are a lot of spam comments. The before and after pictures are hardly convincing. The other issue with home IPL treatment is that the customers lack of training and experience will probably result in less-than-optimal results. IPL bursts need to be adjusted in order to deal with different ink colors and the depth of the ink in the dermis. Only a skilled medical professional will be able to do this accurately. However, you are paying this professional a lot of money for each visit. Keep in mind that most home-use IPL units are for hair removal purposes only.

The Stats:

Cost: Anywhere from $750 to $4,800 depending on the size of the tattoo. Time: Three to eight treatments at one month intervals. Pain: Less than laser.

Pros: Less painful and less invasive than laser treatment. Cons: Expensive but can cost less than laser treatment. Guarantee: No. Effectiveness: There is some dispute as to how effective IPL is compared to laser treatment. Where: Spas and qualified clinics.

Chemical Extraction

Chemical extraction is a method of tattoo removal that requires using a tattoo machine to actually tattoo over the existing ink. However, this time a chemical compound that bonds with the inert ink lying in the dermis is tattooed into the design. After bonding with the ink the combined mixture is pushed up naturally to the epidermis and forms a scab. A couple of weeks later the scab falls off, taking a large part of the ink with it.

Image credit: allposters.com Over a hundred years ago in 1888, a physician in France, one Dr. Variot G. Nouveau, discovered that tattooing over an unwanted tattoo with an acid solution was an effective removal technique. His process, the Variot Method, or the French Method, caused a large scab to form which, when it fell off, removed ink with it. Dr. Nouveaus formula contained a mixture of tannic acid, glycerin, and water. Tannic acid was found in the mid-20th century to cause cancer and is no longer used in medicine.

Rejuvi

Image credit: Rejuvi.com Rejuvi is a chemical extraction substance that is applied with a coil tattoo machine or a rotary cosmetic tattoo machine and works by bonding with the ink pigment lying inert in the dermis. Known as E-raze in Europe, the ingredients in the Rejuvi Tattoo Removal Suspension Solution chemically bond with the inorganic metal oxides in tattoo ink, like iron oxides, carbon black, chromium oxide and titanium oxide. Once the ink pigment bonds with the suspension solution, the body pushes it to the surface. A scab, or crust, is formed and some of the original ink is removed when the scab falls off. The treatment cant be done at home and requires a professional technician trained in Rejuvi application in order to minimize risk of scarring. The four step process involves: 1) 2) 3) 4) application of topical anesthetic, the tattooing of Rejuvi into the skin, the formation of a crust over one to three weeks, and the falling off of the crust in fifteen to twenty-five days.

Once the crust falls off the skin will be red and raised. The skin should return to a normal color over a period of a minimum of three to six months.

How Long Does It Take? Due to the fact that professional tattoos lie just beneath the surface of the skin, one treatment of Rejuvi usually results in an up to 60% removal of the unwanted tattoo. Older tattoos will require more work than newer ones. While one visit may result in a big

difference, the preferred method is the multiple session approach. The maximum recommended area to treat at one time is two square inches. Large tattoos will be treated in separate sections and separate visits. Follow up treatments can be made only after eight to ten weeks have elapsed in order to allow for sufficient skin recovery. A single treatment will take up to one hour for a two-square inch area (five-square centimeters). The company behind Rejuvi, Rejuvi Laboratory Inc., is based in California, and the product is the result of research collaboration between founders Dr. Wade Cheng, who holds a Ph.D. in biochemistry from University of California, Davis, and Dr. Arthur Furst, who holds a Ph.D. in chemistry from Stanford University. The company has a whole range of cosmetic and skincare products with the tattoo removal system being just one of their offerings. Aftercare Is Vital The company claims that there is a 92% success rate in removing tattoos with a scarring rate of 6%. Some users rave about their success while others have experienced severe scarring, usually due to improper aftercare. The drawback of Rejuvi, other than its expense, is that aftercare is absolutely critical. Users complain that after treatment the scab, or crust, is itchy, and scratching it dramatically increases the risk of scarring. The crust must remain absolutely dry for the first seventy-two hours after treatment. Once it forms, users report skin tightness, which is uncomfortable. Ingredients: water, zinc oxide, magnesium, oxide, calcium oxide, n-propanol, Triethlaomine, and benzoic acid. Rejuvi treatments are performed at qualified clinics and spas. The treatment itself mimics that of getting a tattoo and the pain experienced should be similar. Much of the pain and discomfort involved comes in the period of aftercare. However, patients report that it is a lot less painful than having laser treatment. Three to seven treatments for tattoo removal are required, with three to four being enough on average. Treatments can be performed only after complete healing of the previous visit, or around every two to three months. The average cost per treatment will depend on where you live and whether you are treated at a clinic, a dermatologists office, or by a trained tattoo artist. It is safe to figure on $125$150 per square inch.

Rejuvi Banned in Europe?

According to the Times of Malta, in 2010 the Malta Standards Authority ordered the withdrawal of Rejuvi from the market. The reasons cited were that the product posed a health risk to consumers due to its pH-value of 13.8 and its highly corrosive potential. I contacted Rejuvi about this and they denied it. According to the email I received from one Jeanie Munich: Why Rejuvi Tattoo Removal technique is popular in many European countries but is banned in certain part (sic) of Europe? Does this make sense? I wasnt able to find any more information about a partial European ban of the product. I did learn, however, that Rejuvi at least responds to inquiries.

The Stats:

Cost: At $125 to $150 per visit with up to four visits are required, budget on $600 to remove a one-inch square tattoo. Time: Up to 60% of the tattoo is removed with first treatment. On average, three to four treatments required for complete removal with each treatment interval being two to three months. Pain: Same as getting the original tattoo. Skin tightness and itchiness a problem during aftercare. Pros: Faster and cheaper than laser. More effective than creams. Cons: Complex aftercare required. Risk of scarring or ulcer development if infection occurs during aftercare. Guarantee: No. Effectiveness: Reportedly effective in most people. 100% removal is difficult. Where to buy: Only sold wholesale to qualified technicians.

Tattoo Erase

Image credit: tattooerase.com Developed by researchers in Germany, Tattoo Erase uses a very similar treatment process to Rejuvi. The company behind the product claims that the ingredients used in the Kataderm Fluid solution are all natural. However, the company does not provide any details about what those natural ingredients are. Similar to Rejuvi, the Kataderm Fluid is applied via a tattoo machine, placing the compound beneath the outer skin layer so that it can bond with the ink pigment that rests in the dermis. The bodys immune system then expels the newly bonded molecules to the surface of the skin where they are removed when the scab falls off. Currently, the procedure is only offered in Europe and the UK. Costs will depend on the clinic you visit and the results of your consultation with the technician. One clinic in the UK was advertising this treatment for $100 for each fifteen-minute session. On average, one session will not be enough to remove all the tattoo ink. Treatments are done in fifteen-minute intervals, which is enough time for smaller tattoos. Up to one hour is needed for larger tattoos. At least eight weeks healing time is necessary between visits. Aftercare is absolutely vital to avoid scarring. As the company soberly notes, It is possible you may be scarred by this treatment.

The Stats:

Cost: Expensive: up to $400 per one hour session. Time: Four months for two treatments with two month intervals needed between future treatments. Pain: Similar to getting the original tattoo. Itchiness for several weeks as scab heals. Pros: More effective than creams.

Cons: Expensive. Only available in Europe. Ingredients unknown. Risk of scarring. Guarantee: No. Effectiveness: Can be effective. Where: Currently available at select clinics in Europe only.

Surgical Excision

Image credit: no1footdoc.com Tattoo excision is the surgical removal of a tattoo by a qualified surgeon. This is the most effective way to completely remove an unwanted tattoo. Excision, while invasive, is most suitable for smaller tattoos, which can be removed in one session. It is also the method of choice for people whose tattoos are too deeply embedded to be removed effectively by any other means. Deeply embedded tattoos can be amateur tattoos or just old tattoos where the ink pigment has sunk into the lower dermis. Its Fast After a consultation with your surgeon the procedure works like this. First, the area of the tattoo to be removed is shaved and cleaned. Local anesthetics are given. This numbs the area in question only. You will be awake for the procedure so if you dont like blood, especially your own, you will definitely want to look away. Actually, bleeding is reportedly very light as blood vessels are cauterized during the procedure. For a small tattoo, a full thickness removal occurs, which consists of removing the epidermis and the dermis. The skin on either side is then stretched to close over the wound and held together with sutures. You are given antibiotics and are usually out the door in one hour. Stitches are normally removed in a week to ten days. For larger tattoos this process is far more complicated. The center of the tattoo is removed first and the wound allowed to heal. Several visits and operations may be necessary with skin graftsthe taking skin from another area of your bodybeing necessary to close the wound. The pain, expense, and risk of infection are obviously higher the larger the tattoo to be removed.

Scars? A slight linear scar is likely to result where the skin is sutured. The size and permanence of the scar depends on the skill of the surgeon and how rigorous the aftercare is. Often these small scars fade away with time; over a six-to-eight-month period. However, Asians and other darker skinned people who are susceptible to keloid formation (heavy scarring) should carefully consider the risks involved in excision.

The Stats:

Cost: Around $1,000 for a small tattoo. Time: One hour for a small tattoo. Excision is also the fastest way to remove a tattoo. Pain: Minimal. Pros: Fastest and most effective method for complete tattoo removal. Cons: Invasive, expensive, and a small risk of a linear scar. Guarantee: Not likely. Effectiveness: 95% success rate. The most effective method of complete tattoo removal. Where: Any qualified surgeon or cosmetic surgeons office.

Salabrasion

Image credit: izismile.com Salabrasion is the oldest form of tattoo removal known to man. Looking at the word will tell you all you need to know: sal (salt) + abrasion (rubbing). This can be a DIY procedure but all you will end up doing is replacing that unwanted tattoo with an unwanted scar. Here is how it works: 1) 2) 3) 4) 5) The area to be treated is shaved and cleaned; A topical or local anesthetic is applied (if done by a medical professional); A gritty paste of salt and water is made; The paste is applied to a wood block wrapped in gauze; The tattoo is rubbed hard for 30 to 40 minutes. Enjoy.

Intense bleeding will result. Healing time will be many weeks and the procedure almost always requires repeat treatment (ouch!) to get all the ink out. The rubbing has to be deep enough to reach into the dermis where the ink lies. This method may be the oldest and cheapest method of tattoo removal but it is probably the worst of all your choices. Heavy scarring is almost guaranteed and the risk of infection is high. Salabrasion should not be considered by people who are prone to keloid formation. Salabrasion is not a DIY procedure. Not recommended.

The Stats: Cost: Less than $5 if you do it yourself (not recommended). Otherwise it depends on the practitioner, if you can find one.

Time: Less than an hour for each treatment. At least two treatments are likely to be necessary. Pain: Painful aftercare if anesthetic used. Painful during procedure and after if not. Pros: Cheap. Fast. Cons: Highest risk of scarring (almost certain) and infection. Guarantee: Unlikely. Effectiveness: Effective. Where: May be difficult to find a clinic that still practices this.

Dermabrasion

Image credit: Squidoo.com Dermabrasion is the rubbing away of skin to encourage new skin growth. For tattoo removal, this is usually accomplished by using a mechanical spinning brush that is designed to peel human skin. Yes, it is unpleasant and frequently the last ditch choice for those who have tried everything else. Dermabrasion usually only works on tattoos that are not very deep. Your doctor, or plastic surgeon, cleans the area to be treated and administers a local anesthetic such as lidocaine. Next, the skin is sprayed with liquid nitrogen to freeze the top layer making it stiffer and easier to work on. Then the spinning abrasion brush is brought out in order to grind away the epidermis and reach the dermis where the ink pigment is located. (Time to look away!) The process will take anywhere from a few minutes to two hours depending on the size of the tattoo. Vasoconstrictors, such as ephinidrine, are also used to control blood flow to the treated area. Without these you will bleed a lot. They work by causing the veins that carry blood to narrow and therefore reduce blood flow. Proper aftercare is critical and takes up to two months. More than one treatment is necessary. The chances of scarring are very high, and this treatment should not be considered by people who are keloid-prone. Permanent change in skin pigmentation of the treated area is also a risk for people with darker skin. Dermabrasion is not a DIY procedure. If all that doesnt turn you off, consider this: the cost is high. Each treatment session will cost several hundred dollars with repeat visits necessary. Some estimates put the

average cost of dermabrasion tattoo removal at around $1,500.

The Stats:

Cost: High. Around $1,500 on average. Time: Six months or more of treatment. Pain: Painful, expensive, and involves lengthy aftercare. Pros: Effective on shallow tattoos when nothing else works. Cons: High risk of scarring (almost certain) and infection. Guarantee: Unlikely. Effectiveness: Effective in most cases. Where: Qualified plastic surgeon or dermatologists office.

Cryosurgery

Image credit: uchospitals.edu Despite the name, cryosurgery isnt really surgery at all. It is also known as cryotherapy. Cryosurgery works by using a super cooled gas, such as liquid nitrogen, to freeze the skin above the tattoo. This procedure has been around for over 100 years but is still a relatively uncommon way of removing a tattoo. Freezing the skin destroys the cells inside resulting in the peeling away of the skin. It is similar to getting frostbite. The frozen tissue below the skin where the tattoo pigment lies is also destroyed and then slowly replaced by the bodys healing process. The procedure is not as painful as laser treatment but it is also not pain free. Chances of scarring are minimal but there is a risk of damage to nearby tissue and nerve cells. Some patients have experienced pigmentation changes in their skin after treatment and healing. The risk here, as ever, will be greater for patients with darker skin. Several treatments will be necessary but the number and depth of treatments will depend on the size, location, age, and depth of the tattoo. Cryotherapy treatment on areas of very thin skin and no fat, such as the ankle, may be very painful and are not advisable.

The Stats:

Cost: Less than laser treatment but not cheap. Cost is similar to dermabrasion. Time: Several months as more than one treatment will be necessary. Pain: Minor compared to laser or salabrasion. Pros: Less invasive, less chance of scarring. Cons: Risk of tissue and nerve damage. Some pigment change reported. Guarantee: Unlikely. Effectiveness: Reviews are mixed. Where: Qualified plastic surgeon or dermatologists office.

Part Three

Earth

Image credit: deviantart.com

Home Tattoo Removal Products

Image credit: the bolditalic.com What about removing a tattoo at home? There are many options out there, most of which are cheaper than those which require expensive visits to clinics. Please Note: Used improperly, some of these treatments are dangerous. This is especially true of the acids. Improper usage of acid on the skin will burn and cause scarring. If you do not feel confident trying this on your own then dont do it! Also, please re-read the disclaimer page at the beginning of the book. I am not advocating any at home treatment without you first discussing it with a qualified medical professional. So what are the choices for at home tattoo removal products? Generally, there are two types, peeling agents (acids) and creams. The internet is full of products that are guaranteed to completely remove your tattoo without pain and in the privacy of your own home. The ads scream, No waiting in the doctors office! Etcetera. Take these claims with a large grain of salt, or even a few spoonfuls. There is no conclusive proof that these creams actually work in removing tattoos. Some of these solutions may work on some people and others may give you cancer. Used properly, however, these methods are less painful than laser treatment and very much cheaper. UV protection is an important part of the healing process. After treatment bandages should cover affected areas and later a good sunscreen applied daily until healing is complete and normal skin color has returned. Recent medical research indicates that the use of glycolic acid makes people more susceptible to UV damage and sunburn.

Lets look at what these acids and creams do and how they differ.

The Acids

TCA The Poor Mans Laser

Image credit: ioffer.com TCA, or trichloroacetic acid, is a non-prescription skin peeling agent. Often called the poor mans laser, TCA is also used for genital wart removal and comes in liquid form. TCA is the main active ingredient in the products Inkbusters and Nuviderm. It works by causing a controlled inflammation to the surface of the skin above the tattoo, according to Inkbusters. New skin replaces the old skin, gradually covering the tattoo and resulting in tattoo fade. There is a chance of scarring using TCA products and they are not recommended for facial cosmetic tattoo work. TCA may also cause hypopigmentation (white spots) on darker skinned (Type V, V I) people, among whom the results are more unpredictable. What is Hypopigmentation and Hyperpigmentation? Hypopigmentation is the permanent loss of your natural skin color, which results in the skin becoming lighter in appearance. This is caused by lack of, or depletion of, melanin in the skin. It is more common in people with darker skin (Type V, VI). Melanin is the pigment that determines skin, hair, and even eye color. Albinos, for example, have little or no melanin. Melanin has special photochemical properties that absorb harmful UV rays from the sun and dissipates them as heat. This prevents direct and indirect DNA damage to the skin that results in melanomas and other malignant

skin cancers. Hyperpigmentation is the darkening of skin and sometimes nails caused by an increased amount of melanin. This can be caused in darker skinned people with excess sun exposure. Laser treatment can be a cause of hyperpigmentation as well.

Diluted TCA is also frequently used in dermatology clinics as a medium-depth chemical peel. It works, like other chemical peels such as glycolic acid, by burning off the top layer of skin allowing healthier newer skin to come through. TCA is often used at skin clinics or spas in this fashion to remove fine wrinkles, acne scars, and other slight imperfections in the skin. TCA is less a cream and more a gel or a liquid. TCA is normally applied every six weeks; the skin should begin to peel about two weeks after its application. The dead outer layer of skin will peel off, and this process takes another two to three weeks. Further treatment cannot be undertaken until this happens. Unlike laser treatment, acids and peeling agents are color insensitive (i.e., it does not matter what color your tattoo is). It will take more than two treatments to start to see any fading of the tattoo under normal circumstances. The Most Common Method Before Lasers Before lasers, TCA was the most common method of tattoo removal and tattoo fading. Complete success with this method is rare and depends on the tattoo and the other variables discussed earlier. The real problem with TCA and other chemical peels is that they do not reach down into the dermis where the ink resides. They only attack the epidermis, or outer skin layer. But they are effective in causing new skin to grow and gradually cover the tattoo. This rarely results in complete tattoo removal and usually results in tattoo fade. Some of the ink in the dermis is disrupted and removed during the skin healing process, however. Remember that the A in TCA stands for acid and if used at full strength it will burn your skin. Recommended dilution is at least 50% to 75%. In fact, most TCA is shipped at only 50% strength that is then further diluted to a 15% to 30% concentration using water prior to application. Patch testing should be tried at different concentrations in order to find the optimal balance between pain and effectiveness for your individual skin. TCA Treatment: First, patch test different dilutions. Use water to dilute. Start with a mild 10% strength to see how your particular skin reacts. Higher concentrations (25% and above) raise the risk of hypopigmentation occurring in darker skinned people.

Clean tattoo area with alcohol pad. (This often comes in TCA removal kits). Apply TCA with a Q-tip in properly diluted form and fan dry. Wait two to three minutes. Apply one to two more coats with same procedure. Treated skin should frost over. Full frosting usually occurs with 25% - 30% concentrations. Leave application on for about five minutes after this point. This is the controlled burn of the epidermis. Wash off with water and dry gently. Baking soda mixed with water can also be used to neutralize the acid. Peeling of the skin will happen within a week. Scabbing follows. Do not pick at peeling or scabbing skin. This will only stimulate the development of scar tissue and raise the risk of infection. Apply anti-bacterial ointment every day for one to two weeks after treatment. Emu oil is also used as a post-treatment salve in order to enhance healing.

Image credit: Wikipedia Emus and Oil As you would guess, emu oil comes from the fat of emus, the largest bird native to Australia, and the second largest bird in the world after the ostrich. As the bald eagle is for Americans, the emu is a national symbol for Australians and is found on Australian coins and the national coat of arms. Emu fat was used by early European settlers as lamp fuel. It was used much earlier by

Aborigines for medicinal purposes including the treatment of joint pain as well as cuts and sores. Emu fat is mainly oleic acid (42%). It contains antioxidants and has antiinflammatory properties as well. The oil has been scientifically proven to stimulate healing through a process that is not yet fully understood. Patience Is Key As with all tattoo removal strategies, patience is the key to good results. Proper healing of the burned skin by means of correct intervals between treatments (four to six weeks) is necessary. Inkbusters recommends one treatment every six weeks. Also, dont feel hurried and increase the concentration to more than 50%. The real risk of private TCA use in the home is just that: you may feel like doing too much too soon. This is an acid and it will burn and scar you if you are not careful. At higher concentrations the risk of permanent hypopigmentation or hyperpigmentation in darker skinned people is greater as well. Some users report a greater concentration tolerance after repeated uses, i.e., they can gradually increase the concentration of the acid after they are several months into the process. Post-treatment care is essential to ensure proper healing and scar avoidance. Itching is also a common complaint after TCA treatment. This should go away in time. TCA treatments work well on areas of very thin skin, such as the ankle. Ankle tattoos are notoriously painful and difficult to remove by laser. This has to do with the lack of blood flow and the very thin tissue found in the area. One mother of three commented that laser treatments on her ankle tattoo were more painful than childbirth. It is believed that TCA is safe to use during pregnancy because it only works on the local cells to which it is applied but this is not recommended. TCA is not easily absorbed by the body and doesnt enter the bloodstream. However, if you are pregnant it is best not to take any risks and to refrain from using such products unless first consulting a doctor. How Much Does It Cost? TCA kits come with the acid, applicators, emu oil for healing, and sometimes a small fan for cooling the affected area. Kits come in various sizes with the smallest containing 10 ml of TCA. This can be purchased on eBay for as little as $10 and will reportedly take care of a one-inch square tattoo. A one-ounce bottle of TCA Chemical Peel for Home Use at 25% strength can be purchased online through Amazon.com for $26. (At the other end of the scale you can also buy a YAG laser machine, made in China for just $6,000. Only for the very brave.)

Inkbusters

Image credit: inkbusters.com Inkbusters is a TCA solution sold by a California company based in San Diego. Application occurs once every six weeks, and the company claims that their one-ounce bottle of medical grade 50% TCA will be enough to radically fade or remove a three-inch square tattoo. The company is unique in that it offers two guarantees: one 30-day and one six-month guarantee. The 30-day guarantee applies if you change your mind about removing the tat and havent yet opened the bottle. The six-month guarantee applies if you follow their directions explicitly and are then not 100% satisfied with your results. This appears to be the best guarantee in the market. Their customer service is pretty good; I sent them an email inquiry and was answered right away.

The Stats:

Cost: A one-ounce bottle sold on the website costs $49.95. Inkbusters will also sell you two ounces for just $10 more. And they have free shipping. Time: Will take several treatments to see progress over a period of six to nine months. Pain: Yes, but less than laser treatment. Pros: Inexpensive. Two guarantees. Good customer service. Cons: Risk of scarring. This is an acid. Be careful. Guarantee: Yes. Effectiveness: Effective on some people if instructions are carefully followed.

Where to Buy: www.inkbusters.com

Nuviderm

Image credit: besttattooremovalcream.com Established in 2007, Nuviderm the company produces Nuviderm the product which, like Inkbusters, is a TCA solution. Nuviderm also offers a six-month money back guarantee. The six-month guarantee is needed because it takes about six months of proper use in order to see if a removal method is actually working. Nuviderm claims that it only has an 8% return rate from customers. Nuviderm sells one-ounce bottles at 50% concentration for $39.95 and it claims that this should be enough to remove a three-inch square tattoo. They also offer a free customer service hotline for questions. I will have more to say about this later. A Warning Nuviderm was selected by the US Commerce Association and won an award for Best Business in the tattoo removal category for 2009. The full text of the award is here: Press Release FOR IMMEDIATE RELEASE NUVIDERM.COM Receives 2009 U.S. Commerce Association Award U.S. Commerce Association Honors the Achievement WASHINGTON D.C., August 26, 2009 NUVIDERM.COM has been selected for the 2009 Tattoo Removal category by the U.S. Commerce Association (USCA). The USCA Best Business Award Program recognizes outstanding businesses throughout the country. Each year, the USCA identifies companies that they believe have achieved exceptional marketing success in their local community and business category. These are companies that enhance the positive image of small business through service to their customers and community. Various sources of information were gathered and analyzed to choose the winners in each category. The 2009 USCA Award Program focused on quality, not quantity. Winners are determined based on the information gathered both internally by the USCA and data provided by third parties.

About U.S. Commerce Association (USCA) U.S. Commerce Association (USCA) is a Washington D.C. based organization funded by businesses operating in towns, large and small, across America. The purpose of USCA is to promote business through public relations, marketing and advertising. The USCA was established to recognize the best businesses in their category. Our organization works exclusively with business owners, trade groups, professional associations, chambers of commerce and other business advertising and marketing groups. Our mission is to be an advocate for small and medium size businesses and business entrepreneurs across America. SOURCE: U.S. Commerce Association CONTACT: U.S. Commerce Association Email: PublicRelations@us-ca.org URL: http://www.us-ca.org I had never heard of the US Commerce Association and so I did some research. It turns out that this is a group that targets award-winners and then charges them to receive their plaque or award. In fact, the Better Business Bureau, which is real, published a warning about the USCA on their website here: http://spokane.bbb.org/article/all-that-glitters-us-commerce-association-awards-to-bizmay-not-be-what-they-seem-11397 In the warning the BBB says, among other things: The Better Business Bureau (BBB) urges that local area businesses exercise caution when dealing with this group or a related organization called the U.S. Local Business Association. Apparently both groups are headed by the same person and no information or phone number is available on their respective websites. The BBB continues: The Washington, D.C.-area BBB office gives U.S. Local Business Association an F grade So this award that Nuviderm.com received may be much less that it seems. In fact, Nuviderm the company may also now be much less than they seem. The website is inactive and as I write this the company is apparently bust.

The Stats:

Cost: Unknown. Time: Six to nine months. Pain: Similar to other TCA products. Pros: N/A. Cons: Company out of business? Guarantee: N/A. Effectiveness: Similar to other TCA products. Where to Buy: Unknown.

RX-Tattoo

Rx-Tattoo is another TCA-based chemical peel. It appears that this company is also now out of business. Their former website, www.rx-tatto.com, no longer works and it seems that you cannot buy this product any more. However, if you have some RX-Tattoo, the stats are below

The Stats:

Cost: Expensive. A half-ounce bottle sold for $38. Since concentration is unknown, we assume that this is good for the usual one month of treatment. TCA peels take, on average, six to nine months to see results and up to twelve months or more for removal. A full years course would run you $380. Time: Six to nine months needed to see results. Pain: Similar to other TCA products. Pros: N/A. Cons: Company is out of business. Little known information on product. Guarantee: No. Effectiveness: Similar to other TCA products.

Where to Buy: Unknown.

Glycolic Acid

Image credit: fromcairo.com Also known as Alpha Hydroxyl Acid (AHA), glycolic acid is a milder alternative to TCA, depending on its concentration. While TCA is used in dermatology clinics as a medium peel, AHA is considered a light peel. AHA is found in natural sources such as sugar cane and pineapples but it is manufactured chemically. It works in the same way as TCA by burning off the top layer of skin and stimulating new skin growth that covers the tattoo. Glycolic acid is often marketed as an anti-aging or anti-wrinkle chemical peel. Maximum strength is 70% for glycolic acid, but this is usually only found in doctors offices. Commercially available home tattoo removal kits usually contain concentrations of 30% or less. Bathing in Goats Milk Originally discovered from fruit acid and dairy products, AHA was supposedly used by Cleopatra 2,000 years ago in ancient Egypt. She was fond of bathing in goats milk, which reportedly kept her skin soft and supple. Women have been using natural acids in various forms ever since in order to keep their skin young and glowing. AHA, or glycolic acid, works as a deep exfoliant, stimulating new skin growth. AHA is commonly found in a variety of skin care products sold over the counter including, anti-aging creams, moisturizers, and cleansers. It works as an exfoliant, removing old and

dead skin cells by dissolving the lipids that hold them together. Like TCA, AHA can be neutralized with sodium bicarbonate (baking soda) mixed with water. Due to its natural origins, glycolic acid can also be marketed as lactic acid (which comes from milk), malic acid, citric acid, and even as sugarcane extract. AHA usage increases your sun sensitivitysome studies indicate up to 50% greater sensitivity. UV protection is very important for the new skin that grows to replace the sloughed off epidermis. Glycolic acid is less irritating to the skin than TCA and can be a good choice for people whose skin cannot tolerate a stronger acid treatment. The procedure is similar to TCA but because glycolic acid is milder, intervals between treatments can be much shorter--about once every week or two. However, glycolic acid treatments take longer to achieve the same results. If your skin cannot tolerate either TCA or glycolic acid, or you have very dark skin, mandelic acid is another similar choice. Mandelic acid is a member of the AHA family and comes from the extract of bitter almonds. In fact, the word mandel is German for almond. Treatment: As with TCA and other peels, patch test on your own skin at various strengths in order to determine your tolerance level. The area to be treated should be cleaned with a mild cleanser. Do not shave the area before treatment. Pat dry. Apply glycolic acid with a Q-tip or cotton ball and let it sit for two to three minutes. Thoroughly rinse off with cold water and pat dry. Apply an approved moisturizer, such as emu oil, to help the healing process. Keep the treated area out of the sun and protect from UV radiation.

The Stats:

Cost: You can buy a one-ounce (30 ml) bottle of glycolic acid at 35% concentration on Amazon.com for as low as $17. Ebay.com has a seller that will send you an ounce of glycolic acid at the full medicinal strength of 70% for $25.95.

Time: Six to twelve months for full effectiveness. Pain: Mild burning sensation but less than TCA or laser treatment. Pros: Less pain involved, inexpensive. Cons: Lengthy treatment period required if using glycolic acid alone. Guarantee: No. Effectiveness: May be effective on some people. Where: Can be purchased on the internet from various sources.

Wrecking Balm

Image credit: wreckingbalm.com This brand of tattoo removal product has an odd website to go with its odd name. The name is hard to figure out: I guess it wrecks the tattoo. Many people get it wrong and think it is called Wrecking Bomb, or Wrecking Ball. This is confusing. Wrecking Balm is a botanical chemical peel and therefore works on the same principles as TCA and glycolic acid. The company behind it, Preval Health, promotes other skin care and health products as well. Does It Work? On this question internet forums and complaint websites are equally divided. Some say, Hooray, my tat is almost gone! Others say, Dont waste your money! Its a scam! Again, it comes down to the variables we talked about earlier involving your skin type, tattoo ink amount, and depth all being important. In short, Wrecking Balm appears to work on some people but not on others. There is a 30-day guarantee with the twelve applications system and a 60-day money back guarantee with the twenty-four application system. Remember, it will take at least two to four months to see any progress. Patience is required. Also, it may be the case that the money back guarantee is not available if you buy the product at Walmart. Another thing to keep in mind at the beginning of your treatment is that as old skin is sloughed off the tattoo may actually even begin to appear brighter than before. Of course, this is the opposite of what you want but the tat should then begin to fade as new skin layers grow over the design. Doc Wilson, the reported character behind the product, has a humorous warning hidden on the companys website:

May cause user to become overjoyed by results of product. Choosing this method over others may lead to more money saved, which may be spent on another tattoo youll regret. To me, Wrecking Balm sounds like an AHA (it is a botanic chemical peel) that is combined with some dermabrasion (the hand-held skin exfoliator). They dont warn about scarring so it must be a relatively mild concentration of acid. So I thought. Upon further investigation I found on their website under the heading Tattoo Removal Study a Clinical Breakdown that was poorly written with typos and bad grammar by one Dr. Thomas Latino. Dr. Latino just so happens to be a Preval Health employee. His conclusion is unsurprisingly very positive. He writes that Wrecking Balm is both effective and safe for the consumer. More relevant is the breakdown of the major components in the Wrecking Balm system, which makes for interesting reading. Wrecking Balm treatment is a three part process that includes: 1) Demomaticthe handheld microdermabrasion device 2) Suffusion Gelthe tattoo fading compound 3) Hydravescent Creamthe post-treatment moisturizer Microdermabrasion is the sanding of your skin. This removes the stratum corneum, or the outer layer, which contains a lot of dead skin cells and debris. The major components of the Suffusion Gel are the following: 1) 2) 3) 4) 5) Peppermint Oilhas anti-inflammatory and anti-bacterial properties Walnut Shell Powdera detergent to help cleanse the skin Tea Tree Leaf Oilminimizes inflammation Lemon Oilhas anti-bacterial and anti-microbial properties Lavender Oilhas anti-fungal properties

Image credit: club.cciproject.org Reportedly, the active ingredient in Wrecking Balm is salicylic acid. The name of this acid comes from the Latin word for willow, or salix, as the acid used to be derived from bitter willow tree bark. Its medicinal properties, particularly that of fever relief, were well known by the ancient Greeks as well as Native American tribes. Today, salicylic acid is produced using a high-temperature chemical process and it is frequently found in skincare products. Salicylic acid is used to treat warts, corns, and acne as well as other skin conditions. It is even used to treat dandruff in some shampoos. Salicylic acid chemically is often called a beta-hydroxy acid (BHA), which is different from alpha-hydroxy acids (AHAs) and is used at lower strengths. (Some chemists dispute the BHA nomenclature but for our purposes that is irrelevant.) For wart removal, a concentration of just 17% is recommended, which would be too strong for facial use. Some people are hypersensitive to salicylic acid and even small doses may cause them hives, nausea, diarrhea, memory loss, and other undesirable side effects. As a similar compound is used in regular aspirin, if you are unable to tolerate aspirin you may find that you have similar problems with salicylic acid. Since the gel contains walnuts, Wrecking Balm is also not suitable for people with nut allergies. Obviously, if you cant take nuts or aspirin then dont go near this product! The Hydravescent Cream is a skin moisturizer containing cocoa butter and shea butter, which are both commonly found in over-the-counter cosmetics.

The Stats:

Cost: I found that for Internet Explorer users cannot purchase Wrecking Balm on the website anymore as all the purchase links are disabled. The online store works using a different browser, like Firefox. Wrecking Balm feeder sites, such as www.tattooremovalcreaminfo.com, will take you to Preval Healths online store where they sell the product for $59.95. Walmart sells the Wrecking Balm Tattoo Fade System in its first aid section for $49.97. Check Ebay.com for random deals. Amazon.com is selling the same product for $58.58. However, it appears that the guarantee is only available if you buy directly from Preval Health. One kit contains a Demomatic Mircrodermabrasion Applicator, two ounces of Suffusion Gel, 0.2 ounces of Branding Butter, and 2 AA batteries. This is enough for twelve applications over an area the size of the palm of your hand. Refill kits cost $24.97. If you do the math, twelve applications would only last a short while, or about a month. For small tats you will most likely need four to six months of treatment to see any fading and your total cost would be between $100$175thats if you follow directions well and if the product works for you. By comparison, this is less than one average trip to the laser clinic. Time: Six to twelve months. Pain: Minimal. Pros: Easy to buy. Some guarantee. Cons: May not work on some people. Guarantee: Limited with conditions. Effectiveness: May or may not work on some people. Where: Available at Walmart, Amazon.com, or the Preval Health website.

The Creams These products promise everything to everyone. Consensus opinion is they just dont work as well as acids or laser treatment. The difference between the creams and the acids is that creams only bleach the skin using skin whitenersoften with hydroquinone, which is dangerous and a known carcinogen. The claims by tattoo removal cream companies that these products will not scar the skin are likely true since strong acids are not found in the ingredients. It is unlikely that they will burn the skin, nor do they penetrate the skin like an acid does.

What Is Hydroquinone and Will It Kill Me?

Image credit: www.skinlighteningtreatment.com Hydroquinone (HQ) is a toxic chemical that was discovered in the 1800s and was originally used to develop photographs on film and paper. Commonly used as a skin whitener in the Asian and African American cosmetic market, hydroquinone has been banned in Japan, Australia, and in Europe under European Union Directive 76/768 EEC:1976. The chemical was approved for use in the United States until it was revoked by the FDA in 2006. The agency even went as far as to propose a ban on all over-thecounter cosmetics that might have HQ as an ingredient because of the risk that it is a carcinogen. Although there are as yet no proven cases of human malignancies due to HQ exposure, rats exposed to HQ experienced an increase rate of tumors and mononuclear cell leukemia. This is why the FDA is currently conducting a review of HQ and is considering banning it in the United States.

Not only is there a risk of cancer with prolonged use of HQ, it has also been proven to cause exogenous ochronosis. A bluish black discoloration of certain tissues, exogenous ochronosis is more commonly found in darker skinned people. The skin discoloration caused by this malady can be permanent. There is some argument in the medical community over HQ, with many dermatologists claiming that the 2% HQ concentration in most over-the-counter topical solutions is safe. Prescription creams may contain up to 4% HQ. However, I would be leery about using this on my skin: it is already banned in Europe as well as several other advanced countries and it is now under review by the FDA. Avoid. New research is being conducted into the use of retinoids and retinoid combinations as a substitute for HQ. These materials are gaining more recognition in the medical community.

Tat B Gone

Image credit: tatbegone.com Also known as Tat-b-gone and Tatbgone, this product is heavily promoted by the selfproclaimed Tattoo Removal Institute, which is a website that, as far as I can tell, pretends to be a non-biased institution. There is no history, record, or address of this august body and, according to their research, Tat B Gone and Tattoo-Off always come out on top of every tattoo removal study. If you disagree, try sending them an email by using their Give Your Opinion! button. It doesnt work. As Tat B Gone is a cream that does not contain acids it can be considered a tattoo-fading cream. In fact, the company behind the product promotes it as The Original Tattoo Fade Away System. TBG is a three-step process. It is claimed that the system helps to fade a tattoo in an average of three to nine months. The three-cream system requires application twice a day, once in the morning and again at night. Note: the claim is that it fades not removes the tattoo. This is because its ingredients do not burn and peel the skin like the acids do. Total effectiveness of TBG for complete removal will likely be less than that of other treatments. TBG Ingredients: Water, glyceryl, polymethacrylates, olymethacrylates, propylene glycol, prunus armenicaca (apricot) seed powder, DMDM hydantion, lodopropynl butylcarbamate, polysorbate, carbomer, sodium hydroxide, aloe barbadensis gel, benzophenone-4, disodium edta, phyodine (vitamin K), chamomile extract, rosemary

extract, calendula extract, orange peel extract, lemongrass extract, basil extract, sage extract, horsetail extract, eucalyptus extract, honey extract, black walnut, benzyl alcohol, fragrance, hydroquinone. This product contains hydroquinone, a known carcinogen banned in many countries. Hydroquinone, as we wrote earlier, is a skin-whitening, or skin-bleaching agent. It has not been proven to penetrate the epidermis and to reach the dermis where tattoo ink lies buried. Therefore, using a skin-bleaching cream for complete tattoo removal is likely to not be very effective. This conclusion is borne out by complaints found online from dissatisfied users. Again, there are also some people out there who are satisfied with the results they got from TBG (remember those variables we talked about earlier?). However, nobody claimed 100% removal of their tattoo. TBG can be purchased off the Tat B Gone website where a two-month supply costs $129.99. Amazon.com sells the same thing for $119.99. A four-month supply will set you back $189.99. That wont be enough to fade anything but the smallest and shallowest of tattoos. Most users require around six months of application to see real results, and there is no guarantee that you will be one of those who do see results after that time period. Six months will set you back $390. Lack of response is a common theme with this company. They dont seem to respond to phone calls or emails that quickly, according to many online reports. However, to test this I sent them an email and got a response the same day. That seems like good customer service.

The Stats:

Cost: Not especially cheap: $390 for a six month supply. Time: Six months for fading of tattoo. Pain: None. Pros: No pain and less risk of scarring. Cons: This is for tattoo fading not removal. Contains hydroquinone, a known carcinogen. Guarantee: No.

Effectiveness: May only fade the tattoo, not for complete removal. Where: Available on Amazon.com or company website.

Tattoo-off

Tattoo-off is a product from a company based in Florida. Another cream with many natural ingredients, what sets Tattoo-off apart is their claim that the cream contains No Chinese Ingredients. However, since they put hydroquinone (2%), a known carcinogen, in there, the safety implied by their No Chinese Ingredients goes right out the window. Tattoo-off has about the longest list of ingredients of any cream on the market. What is most interesting is that the first one-third of the ingredients list is EXACTLY the same as Tat B Gone. Water, glyceryl, polymethacrylates, olymethacrylates, propylene glycol, prunus armenicaca (apricot) seed powder, DMDM hydantion, lodopropynl butylcarbamate, polysorbate, carbomer, sodium hydroxide, aloe barbadensis gel, benzophenone-4, disodium edta, phyodine (vitamin K), chamomile extract, rosemary extract, calendula extract, orange peel extract, lemongrass extract, basil extract, sage extract, horsetail extract, eucalyptus extract, honey extract, black walnut, benzyl alcohol, isohexadecane, glycerin, trimethylpentanediol/adipic acid copolymer, steareth-21, cetyl alcohol, stearyl alcohol, polyacrylamide (A) C13-141soparafhn (&) lalketo 7, behenyl alcohol, dimethicone copolyol, sucrose cocoate, steareth-2, dea-oketh-3 phosphate, Hydroquinone 2, dmdm hydantoin (A) iodopropynl butylcarbamate, polysorbatc, salicylic acid, sodium metabisulfite, ascorbic acid (vitamin C), propylene glycol, stearic acid, glyceryl stearate, butylene glycol, sopropyl palmitate, propylene glycol, triethanolamine, sweet almond oil, dimethicone copolyol, diazoltdinyl urea, methylparaben, propylparaben, aloe vera gel, tocophoeryl acetate (vitamin E), disodiumedta, dimenthicone, fragrance. Other than that, there is almost no information available on the company website, nor is there a contact number or email address. One thing that makes me suspicious is the obviously Photoshopped image on their home page. It is the typical before-and-after shot of the back of a woman with a HUGE green dragon tattoo:

Tattoo-off is a two step process, using a Primer and an Initiator.

The Stats:

Cost: You can buy a three-month supply on the Tattoo-off website for $99.95. Amazon.com has a seller that pushes a one-month supply for $55, but you can get that on the company website for $39.95. Time: Six months for tattoo fading. Pain: Little to none. Pros: Very little likelihood of scarring. Cons: Contains hydroquinone, a known carcinogen. Takes a long time to work. Guarantee: No. Effectiveness: May only fade the tattoo, not for complete removal. Where to Buy: Available on Amazon.com and company website.

Dermasal

Image credit: tattooremovalassociation.com Dermasal is a tattoo removal kit produced by a company in Baton Rouge, Louisiana called New Tech Healthcare. (Dermasal, the tattoo removal product, should not be confused with Dermisil, a product used for removing genital warts!) The company makes bold claims on their website, http://dermasal.com. These include: Proven in three double blind research studies to work. Worlds only proven way to remove tattoos without surgery! Lets examine these claims before we make a purchase. First, there is no detail given about these double blind research studies. There is no information whatsoever on the website nor a link to the studies. Second, we know that lasers can remove tattoos without surgery so the second claim is patently false. The website also claims that they have a customer service hotline and an 800 number because, as they say, It doesnt matter what time it is we have operators standing by 24 hours per day seven days per week, even on holidays. I called both numbers several times. Neither one works. So much for their excellent customer service. I also emailed the company about my major concernthe fact that there is no list of

ingredients. If this is another cosmetic cream that contains the known carcinogen hydroquinone, then buyer beware. Another concern is that the company behind Dermasal, New Tech Healthcare, claims that they are, One of the most respected names in the nutraceutical world with over 50 years of experience. No other company even comes close. If this is true, why does New Tech Healthcare appears not even have a company website? Why is the only information available on the company from the Better Business Bureau note that their grade is an F on a scale of A+ to F?: http://www.bbb.org/baton-rouge/business-reviews/mail-order-and-catalogshopping/new-tech-healthcare-in-baton-rouge-la-90001334#reasonrating At the bottom of the Dermasal website is yet another company name, www.newtechvitamins.com. There is nothing publicly available about this company either and again I could find no corporate website. Given the above and the complete lack of detail concerning a list of ingredients, my skepticism toward Dermasal is very high. Wait, More Bad News Further research on Dermasal was conducted by the newsmagazine TV series, Street Cents, which aired for a seventeen-year period on the Canadian Broadcasting Corporation (CBC). During their investigation, which also concluded that Dermasal was a highly suspect enterprise, they spoke to a dermatologist regarding tattoo removal creams. Here is what Dr. Kevin Smith had to say about creams such as Dermasal: Dont waste your money. They dont work and its a rip off. An Associate Professor of Dermatology, Harvey Lui, also weighed in on Dermasal: If you accept what the pictures show, they would appear to be impressive, but even with the best techniques that we have from a medical perspective, we would be hard pressed to reproduce those kind of results in many cases, you know, even with the most sophisticated lasers. So, I am somewhat skeptical. Finally, here is the opinion of a well known tattoo artist in Toronto, Gary LaRochee: You see all of these kinds of things all the time, but none of them work.

By the way, I sent emails to both addresses provided for Dermasal and New Tech Health. Both emails bounced back as undeliverable. Obviously, the company is out of business or they have discontinued the customer service part of their offering! Beware.

The Stats:

Cost: Dermasal is expensive with a one-month supply costing $82.95 on the company website. A six-month supply will set you back $292. Time: Unknown. Dermasal is also a three-step process that is applied every day or every three days depending on skin sensitivity. Pain: Claims are it is pain free. Pros: None. Cons: Clearly explained above. Ingredients unknown. Guarantee: No. Effectiveness: Unknown; we dont have a list of ingredients. Where to Buy: Dermasal website. Note: When I tried to buy this product, all of the shopping links were broken. It is possible that this product is no longer available.

Profade

Image credit: profade.com Profade is another tattoo removal cream that uses a three-step process. The website uses strange English, and they claim to offer a four-month guarantee if you arent completely satisfied with the results. This is offered with some restrictions. (Profade the tattoo removal cream should not be confused with another product with the same name made by PRO2H Skinware, also called Profade. That Profade does contain hydroquinone and is a skin-bleaching cream.) The company also provides an extensive list of ingredients for each cream: Step 1: Water, Glycerine, Polymeth-Acrylates (&) Propylene Glycol, Prunus Armeniaca (Apricot), Seed Powder, DMDM Hydantion (&) Lodopropynyl Butylcarbamate, Lavendula Angustifolia (Lavender )Extract, Polysorbate, Carbomer, Aloe Barbadensis Gel, Disodium Edta, Melaleuca Alternifolia (Tea Tree) Leaf oil, Chamomile Extract, Rosemary Extract, Orange Peel Extract, Sodium Hyaluronate, Sage Extract, Horsetail Extract, Honey Extract, Tocopheryl Acetate, Benzyl Alcohol, Fragrance. Step 2: Water, Cetil Alcohol, Isopropyl Myristate, Steareth-2, Sucrose Cocoate, Butanediol, Niacinamide, Stearyl Alcohol, Salicylic Acid, Aloe Barbadensis Leaf Juice, Rosmarinus Officinalis (Rosemary) Leaf Extract, Sweet Almond (Prunus Amygdalus Dulcis) Extract,

Vitis Vinifera (Grape) Seed oil, Salvia Officinalis (Sage) Leaf Extract, Sodium Citrate, Citrus Medica Limonum (Lemon) Extract, Sodium Hyaluronate, Honey, Sodium Metabisulfite, Dipotassium Glycyrrhizate, Dimethicone, Phenoxyethanol, Bisabolol, Methylparaben, Butylparaben, Ethylparaben, Propylparaben, Fragrance. Step 3: Water, Stearic Acid, Alcohol Cetyl, Alcohol, Gliceryl Stearate, Butylene Glycol, Propylene Glyicol, Triethanolamine, Glycerin, Sweet Almond Oil, Methylparaben, Jojoba Oil, Propylparaben, Aloe Vera Gel, Fragrance, Witch Hazel Distillate (Hamamelis Virginiana) Extract, Castor Oil, Tocopheryl Acetate (Vitamin E), Butycropermum Paklii (Shea Butter) Extract, Glycine Soja (Soybean) oil, Dimethicone. As can be seen from the above, the ingredients mostly include moisturizers and exfoliant plant extracts. In the second cream, the activation, we see a little salicylic acid. However, it is diluted. Other skin-bleaching agents in the product include sodium metabisulfite, which is also found in over-the-counter body wash and hair treatments. Note: According to the publicly available list of ingredients, Profade does not contain the harmful carcinogen hydroquinone. The conclusion is that Profade is a mild solution that will not cause pain or scarring. You have to ask, is it strong enough to penetrate the epidermis and disrupt the ink lying beneath it? Another thing that sets Profade apart is a testimonial from a medical doctor, one Dr. Pedro J. Salguero, who states, Profade definitely works, and very well. Here is his interesting testimonial:

Image credit: profade.com My experiences as a medical professional has permitted me to treat patients who dont feel happy with a tattoo and want to get rid of it, or lessen its appearance at any costs. Normally this is because the tattoo patients recall a certain memory, or old relationship or simply that it was done when they were young and now they dont like to see it everyday. Until just a little while ago, the only alternatives for eliminating tattoos were surgical operations and laser treatments.

However, since Ive found Profade, it is the treatment I always recommend. In my opinion, keeping in mind that the research that I have done, Profade is made-up of an extremely effective method for eliminating tattoos when it is used daily and consistently. I recommend Profade to anyone who doesnt want to undergo the risks of an operation or is unwilling to spend the necessary money for laser treatment. Profade definitely works, and very well. Dr. Pedro J. Salguero So far, so good. However, according to my research, it turns out Dr. Salguero, while he is in fact a real doctor, is actually a urologist in Buenos Aires, Argentina who specializes in treating premature ejaculation! While I am sure the good doctor is qualified within his specialty of penile dysfunction, I do wonder how that translates into being an authority on tattoo removal products. In short, the Dr. Salguero pictured above is not a dermatologist. If Profade works as well as he claims, surely the company would have been able to find a skin specialist closer to home who could stand behind it. Usage is twice a day, in a three-step process. That is six applications a day, something that is not easy for busy people. The average tattoo reportedly will need a minimum of between three and nine months of treatment for adequate results.

The Stats:

Cost: Expensive. A one month treatment package is $69.95. Reportedly, up to nine months is needed to fade the tattoo. A ten-month treatment package costs $479. Time: Three to nine months. Pain: None reported. This is a milder form of treatment than acids. Pros: Mild and pain free. Little to no chance of scarring. Safe ingredients. Cons: Effectiveness is questionable. Guarantee: No. Effectiveness: May only fade the tattoo, not for complete removal. Where to Buy: www.profade.com.

Tat-Med

Image credit: tatmed.com Tat-Med likes to call itself a serum, not a cream. This is because the product is a gel. The company claims that gels penetrate the skin better than creams. Similar to other topical products, Tat-Med is an alternative to laser and other invasive and possibly expensive treatments. But will it work? Again, lets look at the list of ingredients: Alpha Arbutin, Kojic Acid, Marine Algea, Water Cress Ext., Bearberry Ext., Hyaluronic Acid, Sea Buckthorn Ext., Caprylyl Glycol, Plankteen Ext., Hexlene Glyco, Seaweed Ext., Phenoxyethanol, Potassium, Sorbate, Distilled water. The active ingredients here are the first two, alpha arbutin and kojic acid. Alpha arbutin, originally an extract from plant leaves, especially those of the bearberry shrub, cranberry, blueberry, or some types of pears, is now made synthetically. Alpha arbutin is found in many skin lightening creams and cosmetics. It works by inhibiting enzyme production of tyrosinase, which is the enzyme that makes melanin in the skin. Melanin is what gives skin color. By halting melanin production in a certain area of the skin, a lightening of color is achieved. Kojic acid is originally derived from mushrooms in Japan. It works in a similar fashion to alpha arbutin by inhibiting melanin production. Note: According to the publicly available list of ingredients, Tat-Med does not contain the harmful carcinogen hydroquinone. Usage is a twice daily application of the cream. This is done after mild exfoliation using an exfoliating pad such as a loofah. The company claims that Tat-Med will help fade small to medium tattoos. Note: they do not claim tattoo removal, just fading.

No guarantees are offered. Honest Approach The company behind Tat-Med recommends daily usage for at least 12-24 weeks, or three to six months. At this point, if results are noticed then the application should be continued. No bold claims here of being the best way or the only proven way of removing tattoos. They dont even claim total effectiveness but couch their phrases by saying that if you notice something, continue treating it! Its an honest approach to advertising.

The Stats:

Cost: A one-ounce bottle is enough to treat a one-inch by three-inch tattoo for one month. That will cost $49.95. The company offers a buy two and get one free plan for $99. That will only last you three months, and you may need twice that long to see whether it is actually working for you. But still, as Tat-Med doesnt contain a lot of unnecessary moisturizers and extracts the cost here is much less than other topical tattoo removal products. Time: Three to six months are needed to see any results. Pain: None reported. Pros: Safe ingredients and inexpensive. Cons: Up to six months are needed just to see if it works. Guarantee: No. Effectiveness: May only fade the tattoo, not for complete removal. Where to buy: www.tatmed.com.

Fadeplex

Image credit: fadeplex.com Another serum or gel, Fadeplex is different than other products available for tattoo removal as it contains a newer proprietary and patented skin-whitening agent called chromabright. Produced by Lipotec, a Spanish cosmetics firm based in Barcelona, chromabrights chemical name is dimethylmethoxy chromanyl palmitate. The compound, or synthetic peptide, works in the same fashion as alpha arbutin and kojic acid in that it inhibits the production of the enzyme tyrosinase that is needed to produce melanin. Melanin is the pigment that gives skin color. By halting melanin production in a certain area of the skin a lightening of color is achieved. In recent laboratory testing, in very low doses chromabright demonstrated greater skin lightening effectiveness than kojic acid, to which it was directly compared. Tests also showed that chromabright has mild UV-protection qualities as well. This is very important as eliminating melanin production in an area of the skin leaves it vulnerable to damage from harmful UV radiation from the sun. This is why all the tattoo creams and serums recommend using a sunblock with an SPF of 30 or greater on the treated area if it will be exposed to sunlight. Tested in vivo, or on live human volunteers, chromabright has also shown no cytotoxicity, a property of things that are toxic to living cells. Therefore, it appears to be safe with little to no side effects. Lets look at the ingredients, which are posted on the Fadeplex website: Deionized Water, Chondrus Crispus (Carrageenan), Malva Sylvestris (Mallow) Extract, Mentha Piperita (Peppermint) Leaf Extract, Primula Veris Extract, Alchemilla Vulgaris Extract, Veronica Officinalis Extract, Melissa Officinalis Leaf Extract, Achillea

Millefolium Extract, Dimethylmethoxy Chromanyl Palmitate (chromabright), Propylene Glycol, Sodium Hyaluronate, Licorice Extract, Glycerin, Alcohol, Citric Acid, Phenoxyethanol, Caprylyl Glycol, Potassium Sorbate, Hexylene Glycol. Note: According to the publicly available list of ingredients, Fadeplex does not contain the harmful carcinogen hydroquinone. Fadeplex treatment is similar to Tat-Med. It is used twice daily after rubbing the area to be treated with a common exfoliating pad, such as a loofah. Does It Work? Again, this is a tattoo fading gel, not a tattoo removal product. The company offers no guarantees that it will work and says that you need to use it for a minimum of ninety days to see any results. Fadeplex is pitched as a Tattoo Fading System, not a tattoo removal product. If you are interested in only de-emphasizing or fading a tattoo so that you can do a cover up, rather than total removal, Fadeplex could be worth a try. If you are looking for complete tattoo removal, this product is not likely for you.

The Stats:

Cost: A one-ounce bottle costs $47.50. The company offers a buy 2, get 1 free offer for $95. Each one-ounce bottle will last four to six weeks, depending on the size of your tattoo. Since the company itself says that you need three months to see whether anything is happening, the entry cost will be $95. Time: Minimum ninety days to see results. More fading will require more time. Pain: None reported. Pros: Safe ingredients, no hydroquinone. Inexpensive compared to alternatives. Cons: Only fades the tattoo, probably ineffective for complete removal. Guarantee: No. Effectiveness: May only fade the tattoo, not for complete removal. Where to buy: www.fadeplex.com.

Tattoo Fading

Image credit: tattoofading.com Tattoo Fading is unique in that the company claims that its ingredients are natural. They also say that they do not mix any product until it is ordered. Note that they dont claim that all of its ingredients are natural because some are not. In fact, the fine print in the warnings and terms and conditions spells out that if your family has a history of cancer you must tell the company. Once notified, Tattoo Fading will substitute that ingredient for you. Somehow, that doesnt sound so natural to me. Here is a list of ingredients supplied: (Note: this is not necessarily a complete list but it is all that is provided). Almond Extract, Arbutin (natural alternative to hydroquinone), Ascorbic Acid, Avocado Oil, Bearberry (UVA-UVSI), Butylene Glycol, Carbomer, Cetyl Alcohol, Citric Acid, Diazolidinyl, Urea, Dimethicone, Ferulic Acid, Glyceryl Stearate, Horsetail Powder, Hydroxymethylglycinate, Jojoba Seed Oil, Kojic Acid, Licorice Extract, Melatonin The potentially dangerous ingredient here could be sodium hydroxymethylglycinate, which is a chemical preservative that can turn into formaldehyde in the body. The skin-bleaching properties revealed here are alpha arbutin and bearberry extract. Alpha arbutin is originally an extract from plant leaves, especially those of the bearberry shrub, cranberry, blueberry or some types of pears, and it is now made synthetically. Alpha arbutin is found in many skin lightening creams and cosmetics. It works by inhibiting enzyme production of tyrosinase, which is the enzyme that makes melanin in the skin. Melanin is what gives skin color and by halting melanin production in a certain

area of the skin a lightening of color is achieved. Kojic acid was originally derived from mushrooms in Japan. It works in a similar fashion to alpha arbutin by inhibiting melanin production. Note: According to the publicly available list of ingredients, Tattoo Fading does not contain the harmful carcinogen hydroquinone. Treatment is a three-step process once a day. It is relatively confusing as you need to use the Fade-Away Cleanser, then the Fade-Away Skin Scrub, and finally, the FadeAway Cream. The company says that its testimonials are real, unlike other product websites, yet they dont list any. This I find strange. Some Questions Tattoo Fading offers a 30-day money back guarantee, which is encouraging. However, you will need more than thirty days to see if the product is actually working. You will begin to see results.4-6 weeks on average. That makes it kind of hard to get your 30day guarantee. The company also states it will take 6-18 months before your tattoo is completely removed. This brings up another interesting question: if they are talking about complete tattoo removal, why is the company called Tattoo Fading? And another question, why is the guarantee only for thirty days when it will take six to eighteen times that to remove your tat?

The Stats: Cost: The basic Tattoo Removal System sells for $65 and includes a one-month supply of the three-product course. The one-month supply is based on use, as recommended, for the removal of a two-inch by four-inch tattoo. The product should be used daily. Again, you need to multiply that number six to eighteen times in order to see whether the result is complete tattoo removal. This would cost you between $390 and $1,170 for the full time period. Tattoo Fading sells other additional products for increased effectiveness, including a Pumpkin Enzyme Peel for $90 and a Lemon Peel Bioferment Tattoo Lightening Accelerator for $40. Your costs could add up quickly if you decide you need these extras to get the system to work on your skin. Time: Minimum four to six weeks to see results. Up to eighteen months for total supposed removal. Pain: Redness and skin irritation a possibility. No pain reported.

Pros: 30-day guarantee. Cons: 30-day guarantee. Complicated and lengthy procedure required. Guarantee: 30-days. Effectiveness: May only fade the tattoo, not for complete removal. Where to buy: www.tattoofading.com.

Part Four

Water Image credit: deviantart.com

Tattoo Alternatives

Henna

Image credit: Wikipedia Aside from temporary adhesive tattoos found in many stores, one semi-permanent tattoo or body art has been around for thousands of years. This is henna. Referred to in the Bible as camphire, henna is a natural dye derived from the crushed leaves of the henna shrub, which grows in hot, arid areas throughout the Middle East, North Africa, India, and Pakistan. In use for over 6,000 years as a hair dye, henna was also used to dye wool and leather. Cleopatra, probably the most famous frequent user of beauty products in the ancient world, dyed her hair with henna. So far, Queen Cleopatra has entered this book twice, bathing in glycolic acid-rich goats milk and now using henna, but I havent been able to determine whether she had any tattoos! A versatile shrub, henna blossoms are also very pungent and frequently used in perfumes. Ancient Roman soldiers often preferred to wait until henna blossoming time to patrol the poorer areas of large cities, which, due to bad or nonexistent sanitation, smelled pretty badly! The dye itself, lawsone, is found in the henna leaf and is usually mixed with lemon juice or tea to turn it into a paste. The stain works by binding to keratin in the skin. Areas of

thicker skin, such as the palms and soles of the feet, absorb more lawsone resulting in a darker and longer lasting stain. The paste is painted on the skin using very intricate designs and then wrapped in tissue or tape sometimes overnight. The longer henna paste sits on the skin the better the results. At first, henna design appears orange or dark orange in color but because of oxidation the colors will continue to darken to a reddish brown. Henna stains can last from one to three weeks depending on exposure time and quality of henna used. Painting the hands and feet of women with henna was and continues to be a very popular tradition in India, North Africa, and the Middle East. This is particularly true at weddings where even the guests receive henna tattoos. Although these are not real tattoos because the skin is not pierced, the phrase henna tattoo has entered the popular lexicon. Mehndi

Image credit: mehndidesignsgallery.blogspot.com Popular in India, the word mehndi comes from Sanskrit and signifies the ritual painting of skin using henna and turmeric. This practice has been around from Vedic times and is an important part of Vedic ritual. Traditional mehndi designs on the palm represent different ideas and concepts. A ritualistic drawing of the sun represents the mind, for example. Now popular at Hindu weddings, mehndi has followed the Indian diaspora around the globe. Mehndi is not just for the bride; sometimes the groom gets hennaed as well.

Black Henna

Image credit: naturalexpressions.org Black henna is bad, even deadly. Formally known as p-phenylenediamine, or PPD, this chemical substance very quickly stains the skin black. However, it can cause severe allergies and blistering several days after application. Found in black henna tattoos, PPD is not henna at all. Getting a black henna tattoo can give you a lifelong sensitization to coal tar derivatives, and future exposure to things such as hair dye can result in a lifethreatening reaction. People with this sensitivity have later been found to be allergic to sunscreen, perfumes, and some medication as well as printer ink and other dyes. Black henna is to be avoided at all costs, and its use is strictly forbidden for skin applications by the FDA. Mild concentrations of PPD are legal in hair dye (less than 6%), as it is not to touch the scalp but to be quickly washed away. Black henna tattoos have much higher concentrationssome up to 80%and are left on the skin for up to thirty minutes. Black henna is found in tourist spots, places where you might buy a temporary tattoo. Not all temporary tattoos have PPD, or black henna, but a lot do. Do not fall for the temptation of getting a temporary black henna tattoo. You are putting your health at risk.

5 Ways to Identify Dangerous Black Henna

1) Is it black and does it stain quickly? Henna is green or brownish green and takes hours to enter the skin.

2) Does it smell nasty? Henna smells like spinach or tea and is natural.

3) Ask the guy whats in his mix. If he wont tell you or doesnt know, run. True henna paste is mixed with lemon juice and natural oils.

4) Ask the guy what color the stain will be. If it is black and stays black, its PPD. Henna is an orange stain that darkens over a two-to-three-day period.

5) Ask how long the stain will last. If the stain is black and only lasts three days it is safe. PPD stains black and lasts more than a week without changing color.

5 Tattoo Removal Tips

1)

Regardless of which tattoo removal strategy you are considering, start in the fall, not summer. Cooler weather will allow you to keep the treated area covered with less sweating and discomfort. Try the cheaper method first: TCA. This can be combined with laser for maximum effect. By first fading the tat using an acid, fewer expensive trips to the laser clinic will be needed. If you just got your tattoo and then decide the same day that you dont want it, tough luck. No matter which method of tattoo removal you choose, you will still have to wait until your brand new tattoo is completely healed. On average, complete healing of a new tattoo will take up to four months. Only then will you be able to safely embark on a removal action plan. Trying to remove a new tattoo before the skin has properly healed will lead to scarring. When using at home products, always patch test! Every person is different and your reaction to a specific product may be very different, whether good or bad, than that of your friends. Before treating an entire tattoo with the new acid or cream that you just purchased, try a little sample on your skin and elsewhere on your body, preferably out of sight and not on an overly sensitive area. Only then will you know if the concentration is too strong or if you will suffer from hypopigmentation or hyperpigmentation (white or dark spots). You can adjust the dosage accordingly. Be patient. Remember, you are trying to remove something that was supposed to be permanent. Trying to hurry up the process will as likely as not only result in permanent scarring, the ultimate downside of unsuccessful tattoo removal.

2)

3)

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5)

Covering Up

Image credit: tattoodonkey.com A cover-up is getting another tattoo over the one you dont like. This can be a solution, but you do end up with an even bigger tattoo, which may not be what you want, especially if the tattoo location is very public. Successful cover-ups are dependent on the skill of the tattoo artist. Ask to see his or her cover-up portfolio, not the regular portfolio, to be sure he or she has the artistic ability to accomplish what you want. Fading the old tattoo first before getting a cover-up can also be a good solution. Depending on the design, it may make it easier to have the cover-up done. At the very least, less ink will be deposited into your body for the cover up if the original tat is faded. There are various strategies you can use to minimize or obscure your tattoos from the unwanted stares and equally unwanted judgment from the general public without going through lengthy, painful, and expensive removal processes.

Image credit: kryolan.com The easiest is to use some make-up or foundation that is the same color as your skin. There are various tattoo cosmetic kits on the market. Celebrities such as Angeline Jolie prefer concealers such as Kryolan Dermacolor Camouflage. This product isnt cheap but it has been around for three decades and that alone should tell you that it works. Kryolan is applied by rubbing a small amount on your palms to warm it up. Use a finger to apply the now warmed mixture to the tattoo you want to hide. The product comes in a huge range of colors. You might need to mix a color or two to exactly match your skin tone. Camouflage combination kits are available so that you can achieve perfect skin color matching (see image above). Kryolan Dermacolor Camouflage is popular for covering up birthmarks and melasma (dark skin blotches) as well. It can be purchased for around $25 for one ounce (25 ml).

TatJacket

Image credit: tatjacket.com

TatJacket is another temporary tattoo covering strategy. This is great if you want to keep your tattoos but are not allowed to show them at work. Or as TatJacket puts it, Because you love your ink but your boss doesnt. Created by a Californian police officer, the company makes synthetic sleeves that can be worn on the arms or the lower legs. The coverings come in three colors, black and two shades of light brown. Made of 90% nylon and 10% spandex, the sleeves are machine washable and cost $19.95 for one pair. TatJacket can be purchased on Amazon.com or off the company website. See www.tatjacket.com.

Glossary

Alpha Arbutin A natural form of skin lightener derived from the leaves of bearberry, cranberry, mulberry, or blueberry bushes. Commonly referred to as bearberry extract. Alpha Hydroxl Acid (AHA) Also known as glycolic acid or lactic acid, AHA has been used for centuries as a natural skin-lightening agent. It works by inhibiting melanin production. Anesthetic A drug that causes a loss of sensation and is applied as a gel, injected as a liquid, or inhaled as a gas. Used for all surgeries where pain minimization is required. Azo Dye Industrial dyes that are found in some tattoo ink. Currently regulated or prohibited for use in consumer goods in many countries. Azo dyes may be released in the body after laser treatments break up ink pigment. Black Henna A dangerous dye for coloring skin black using temporary tattoos. Black henna often contains p-phenylenediamine (PPD), which can cause scarring and severe and often permanent allergic reactions in its victims. Avoid at all costs. Camphire The archaic name for henna, as it is found in the Bible. Carcinogenic Properties of a chemical or compound that cause cancer. Chromabright Chemical name dimethylmethoxy chromanyl palmitate. Chromabright is a patented skin-whitening agent produced by the Spanish cosmetics firm, Lipotec. Chromabright works by inhibiting melanin production in the same fashion as alpha arbutin or kojic acid. Collagen An abundant protein in animals that is found in connective tissue. Collagen is what gives skin its elasticity. Cryosurgery

A type of therapy that uses liquid nitrogen to freeze skin in order to destroy moles, tumors, and other imperfections. Can be used to for tattoo removal as well. Cytotoxicity The quality of being toxic to cells. Dermis The layer of skin underneath the epidermis that sits on the subcutis or hypodermis. The dermis is where tattoo ink pigment lies inert after its application. Emu Oil A natural oil rendered from the fat of the Australian bird, the emu. Emu oil has been used by Aborigines for thousands of years for its curative and anti-inflammatory properties. Enzyme Proteins found in the body that are necessary to catalyze chemical reactions. Epidermis The outermost layer of skin that is also the bodys first line of defense against infection and other threats. Exogenous Ochronosis A bluish black discoloration of certain tissues more commonly found in darker skinned people. Skin discoloration caused by this malady can be permanent. Fibroblasts Cells which are found in connective tissue and that produce collagen. Fitzpatrick Scale A widely used classification method devised by Dr. Thomas B. Fitzpatrick in 1975 for categorizing human skin color. Glycolic Acid A naturally occurring acid formerly derived from milk and fruit that has been used for centuries as a mild chemical peel. Glycolic acid is a type of alpha hydrocl acid (AHA). Henna A natural skin dye derived from the crushed leaves of the henna plant. Horimono An ancient form of Japanese tattoo art. Hydroquinone (HQ)

An aromatic organic compound that is most frequently used in cosmetics as a skin lightener. Banned in Europe, Japan, and Australia after being recognized as carcinogenic, hydroquinone should be avoided for long-term topical skin use. Hyperpigmentation Permanent skin darkening caused by increased melanin production. Hypodermis The innermost layer of skin, also known as the subcutis. Hypopigmentation A loss of skin color caused by depletion of melanin. In Vivo Medical testing on live human volunteers. Irezumi Modern term for Japanese tattooing. Infrared Coagulator (IRC) A tattoo removal method that uses light to attack the ink pigment lying inert in the dermis. IRC is different from laser treatment in that it uses infrared light to heat the tissue holding the pigment. Intense Pulsed Light treatment (IPL) A tattoo removal treatment that uses filtered xenon flash lamps via a light-emitting wand to transmit light in short bursts at high intensity in order to break up tattoo ink. IPL is most frequently used for hair removal purposes. Kojic Acid Originally derived from Japanese mushrooms, kojic acid is a natural skin lightener than inhibits melanin production. Laser An acronym for light amplification by stimulated emission of radiation, lasers used for tattoo removal work by matching the color wavelength of a particular ink. Energy is used to break down the pigment without heating up and destroying the skin around it. Lymphatic System The system that connects the lymph nodes and that plays an extremely important part of the immune system. The lymphatic system washes away foreign particles such as tattoo ink once that ink has been broken up by invasive treatments such as

lasers. Melanin The natural pigment produced by the body that gives skin, hair, and nails its color. Melasma Dark skin blotches common in pregnant women. Microdermabrasion The controlled abrasion of the epidermis that stimulates new skin production. Nanosecond One billionth of a second. Nd:YAG Laser The most common Q-switched lasers. Nd:YAG stands for neodymium-doped yttrium aluminum garnet. Pea Traditional Samoan tattoo. Phagocytes White blood cells that eat foreign material that has entered the body. Phagocytes are an important part of the immune system. Photorejuvenation The process, or treatment, that results from intense pulsed light and that uses light energy bursts to wound the skin and stimulate new skin growth. Photothermolysis The process of using light heat to target the destruction of certain cells. This is what laser treatment is all about. P-Phenylenediamine (PPD) Also known as black henna, PPD is a dangerous compound that should never be applied directly to the skin. Q-switched Laser A type of laser that uses short bursts of light energy, rather than a continuous beam, for surgical and tattoo removal procedures. Retinoids Chemically related to vitamin A, retinoids are used in a number of dermatological

treatments. Salicylic Acid Formerly derived from the bark of the willow tree and now produced synthetically, salicylic acid is used to treat warts, corns, acne, and other skin conditions. It is commonly found in many cosmetics and dandruff shampoos. Sam OReilly An Irish immigrant to New York who invented the tattoo machine in 1891 and who died from a fall while painting his house. Sodium Metabisulfite A common food additive, sodium metabisulfite is also used in cosmetics for its skinbleaching properties. Stigma The original Greek word for tattoo. Tattoo excision Surgical removal of a tattoo. Ta moko Traditional Maori facial tattoos found in New Zealand. Trichloroacetic Acid (TCA) TCA is a non-prescription skin peeling agent. Often called the poor mans laser, TCA is the active ingredient in many over-the-counter, acid-based tattoo removal products. Tyrosinase The enzyme that catalyzes the production of melanin in the body.