Laser tattoo removal works, but it is slow, it is rarely cheap, and the number of sessions depends on the tattoo more than on the clinic. The American Academy of Dermatology says lasers have largely replaced every other removal method, and the FDA has not approved any removal cream. We pulled the session counts, side effects and aftercare from the AAD, the FDA and a published study of 100 laser removal patients, so you can set realistic expectations before a consultation.
Tattoo removal: the short answer
See a board-certified dermatologist for laser removal, and plan for a series of sessions spaced weeks apart. In a study of 100 patients, satisfactory removal took about ten sessions on average, with a range from three to twenty. Expect some redness, swelling and blistering after each session, keep the area out of the sun, and do not expect a guarantee of completely clear skin.
How laser tattoo removal works
Tattoo ink sits in the dermis, where immune cells called macrophages take it up, which is why a tattoo does not wash away. The AAD explains that the laser’s light shatters the ink into tiny particles, and the body, not the laser, then flushes those particles out. After each treatment the tattoo should lighten.
That is also why it takes several visits. Tattoo ink is layered, and the AAD says a laser cannot safely break down all the layers in one session. The skin needs time to heal between treatments, and the body needs time to clear the ink that was broken up.
The FDA describes laser treatment as the most common removal method, and says it should be performed by, or under the supervision of, a health care professional.
How many sessions tattoo removal takes
There is no fixed number, but there is useful data. In the study that proposed the Kirby-Desai scale, a chart review of 100 laser removal patients published in the Journal of Clinical and Aesthetic Dermatology, the average number of treatments needed for satisfactory removal was about 10, with a range of 3 to 20, and treatments were spaced 6 to 8 weeks apart.
The scale scores a tattoo on six factors that predict how many sessions it will need:
- Skin type. Scored by the Fitzpatrick scale, which rates how skin responds to sun.
- Location. Tattoos on the head and neck did better than those far out on the arms and legs, which the authors link to lymphatic supply.
- Color. Black ink was the easiest to remove, and green, yellow and orange were more difficult.
- Amount of ink. From amateur tattoos to heavily saturated professional work.
- Scarring. Existing scar tissue in the tattoo adds to the count.
- Layering. A tattoo that has already been covered with another adds more.
The AAD’s list of what a dermatologist considers at a consultation overlaps closely: how long you have had the tattoo, how deep the ink goes, its colors, where it is, your health, the medicines you take and any history of raised scars.
How much tattoo removal costs
The American Society of Plastic Surgeons gives $697 as the average cost of laser skin treatments such as laser tattoo removal, and notes that the figure does not include related expenses. It adds that large, colorful and elaborate tattoos are likely to need more sessions and so cost more, and that most health insurance does not cover cosmetic procedures.
Because the total is the per-session price multiplied by a number of sessions nobody can promise in advance, ask for a per-session price and an estimated range of sessions at the consultation. The Kirby-Desai authors proposed their scale partly so that patients could get a more certain cost estimate.
Does laser tattoo removal hurt
It can. The AAD describes laser tattoo removal as uncomfortable or painful, and says a dermatologist can give you a numbing cream or an injection to prevent discomfort. That is numbing under medical supervision, which is a different thing from buying a numbing product yourself, and our page on tattoo numbing creams covers the FDA’s warnings about those.
Side effects and risks
The AAD says the most common side effect is light or dark spots on the treated skin, which tend to disappear within 6 to 12 months, and that other side effects are rare when a dermatologist performs the treatment. Among the side effects the FDA lists are lightening of the skin, scarring, infection, pinpoint bleeding, redness and soreness.
- Training matters. The AAD says scarring, changes to skin texture, burns and other wounds are more common when the person treating you lacks medical training.
- Some ink may stay. The AAD notes that one laser cannot remove all ink colors, and clinics that use only one laser may leave some color behind. The FDA says some procedures can fail to remove a tattoo completely and can leave permanent scarring.
- Not everyone should be treated. The AAD says you need a healthy immune system for removal to work, and that pregnant or breastfeeding women should not be treated.
- Some things are unknown. What happens over the years to the pigment fragments the laser creates has not been worked out, and the FDA’s tattoo safety page says as much.
Aftercare between sessions
After a session you may see redness, swelling and some blistering, according to the AAD. Its advice for getting the best results is short:
- Follow your dermatologist’s home-care instructions. That may mean washing the area and applying an antibiotic ointment for a few days, moisturizing well and keeping the area covered until the skin heals.
- Protect the treated skin from the sun for 3 months. The AAD says clothing is the best protection, and it has to block light completely: a thin white or yellow shirt lets light through.
- Keep every appointment. The AAD says people too often stop treatment before they see optimal results, and each treatment removes more ink.
Removal methods to avoid
Removal creams and home kits do not work. The FDA has not approved any, and the AAD warns that they often contain strong acids that can cause a rash, a burn or a permanent scar. Our page on tattoo removal creams goes through the ingredients, including a published case of acid burns that needed skin grafts.
Salabrasion, rubbing salt into skin that has been scraped raw, is the other home method that circulates online. The AAD calls it extremely painful and warns it can cause a serious infection and a scar.
Before you book
- Book a consultation with a board-certified dermatologist, and ask to see before-and-after photos of their laser removal patients.
- Ask which lasers they use, especially if your tattoo has more than one color.
- Ask for a per-session price and a range of sessions, and whether the goal is full removal or fading for a cover-up.
- If the tattoo is over a scar, or you have had raised scars before, say so. Our page on tattoos and scars covers keloids, one of the reasons the AAD asks about raised scars.
The verdict on tattoo removal
Laser removal by a board-certified dermatologist is the method that works. Plan for several sessions spaced weeks apart, about ten on average in the one published scale study, with black ink clearing most easily. Expect temporary light or dark spots, protect the area from the sun for three months, and keep every appointment.
FAQ
How many sessions does it take to remove a tattoo?
It varies with the tattoo. In a published study of 100 laser removal patients, satisfactory removal took about 10 sessions on average, with a range of 3 to 20, spaced 6 to 8 weeks apart. Skin type, location, colors, amount of ink, scarring and layering all change the number.
How much does laser tattoo removal cost?
The American Society of Plastic Surgeons gives $697 as the average cost of a laser skin treatment such as tattoo removal, not including related expenses. The total depends on how many sessions the tattoo needs, and health insurance usually does not cover it.
Does tattoo removal hurt more than getting a tattoo?
People describe it differently, and there is no good comparative data. The AAD calls laser removal uncomfortable or painful and says a dermatologist can numb the area with a cream or an injection before treatment.
Can a tattoo be completely removed?
Often, but not always. The FDA says some removal procedures may fail to remove a tattoo completely and can leave permanent scarring, and the AAD notes that a single laser cannot remove all ink colors.
What colors are hardest to remove?
In the Kirby-Desai study, black was the easiest color to remove, while green, yellow and orange were more difficult. Multicolored tattoos may need more than one type of laser.
How long should I wait between tattoo removal sessions?
The patients in the Kirby-Desai study were treated 6 to 8 weeks apart. The AAD explains that the gap lets the skin heal and gives the body time to flush out the ink the laser has broken up.
What should I do after a laser tattoo removal session?
Follow your dermatologist’s instructions, which may include washing the area, applying an antibiotic ointment for a few days, moisturizing and keeping it covered while it heals. The AAD also advises protecting the treated skin from the sun for three months with clothing that blocks light completely.