Infrared Technology: A New Answer to 'Tattoo Regret'

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Oct. 20, 2000 -- Maybe you feel that 'Winona Forever' doesn't really capture your inner heart anymore. Or perhaps the Rolling Stones' signature mouth with the tongue hanging out plastered over your arm isn't helping you get the respect of your kids. One of the many contradictions of youth seems to be that the young think that they will live forever -- but they don't realize that their tattoos will, too.

And one of the realities of middle age is that a mistake of youth, which may have cost only $10-$50 to get, will now cost $1,000-$5,000 to get rid of. It will also take multiple sessions of laser surgery, different lasers for different colors within the tattoo, and a whole lot of time and effort.

A new infrared device, however, has the potential to make tattoo removal much less expensive and less of a hassle because it can remove all the colors in fewer sessions than is typically required of laser surgery, says Tolbert S. Wilkinson, MD. He presented research on the device recently at the annual meeting of the American Society of Plastic and Reconstructive Surgery. The device, known as a tattoo removal infrared coagulator (TRIC), works by creating a superficial burn on the skin, thus obliterating the pigment from the tattoo ink.

In a rehabilitative program sponsored by the state of Texas, Wilkinson treated 2,000 tattoos with TRIC. The participants were former gang members who had requested tattoo removal for a variety of reasons. For this group of people, the cost and logistics of laser tattoo removal can be prohibitive. While the repeat sessions for the laser process can take up to two years, TRIC can typically remove tattoos in two or three sessions, Wilkinson tells WebMD.

"The problem is that 80-90% of people who need to get rid of a tattoo can't afford it," he says. "The repeat sessions are difficult for young people to manage, and the removal results were often inadequate for their needs. Many of the program participants needed to have a visible tattoo removed because of a job offer that required no visible tattoos. For example, the armed forces will not accept applicants with visible tattoos." For the participants in the program, then, a safe, relatively quick, and inexpensive way to remove a tattoo helped them move toward a more promising future, says Wilkinson, a plastic surgeon in San Antonio.

With TRIC, the patient receives an injection of a local anesthetic prior to infrared treatment. The physician uses infrared light to induce a superficial second-degree burn to the skin with the tattoo. This type of burn causes blisters but involves less loss of the skin's natural pigment than a deeper second-degree burn. Afterward, the burn is treated with antibiotic ointment and a cream to reduce inflammation and is then covered with a pressure dressing. The new skin is free of tattoo ink, but it will typically have a flat scar.

Experts are not certain what the eventual role of a device like TRIC would be in the field of tattoo removal. "Since the ancient Egyptians, the problem in tattoo removal has been that removal induces scarring," says Phillippe Capraro, MD, a plastic and reconstructive surgeon in private practice in Denver, Colo., who commented on the procedure for WebMD.

"I'm always excited by new technology, and Wilkinson deserves a lot of credit for finding an affordable method of tattoo removal for a group of people who need the treatment," says Paul J. Carniol, MD, who also commented on the new technique for WebMD.

Carniol, a clinical associate professor of plastic surgery at the University of Medicine and Dentistry of New Jersey in Newark and the author of two cosmetic surgery books, Facial Rejuvenation and Laser Skin Rejuvenation, still has some questions about the procedure.

He is cautious about TRIC's potential to satisfy more mainstream patients with 'tattoo regret,' such as a man or woman who doesn't want to go through life with a former sweetheart's name on his or her body. "I wouldn't rush to do the infrared procedure on all my patients until I know more about potential problems, such as hypertrophic scarring and pigmentation problems," says Carniol, referring to the risk of a raised scar and the risk that the treated skin would likely be either lighter or darker than the surrounding skin. "A more demanding patient population may be less able to tolerate these effects."

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