How Does Tattoo Removal Work?

As tattoos have become increasingly popular forms of self-expression, the demand for effective tattoo removal has grown significantly. Whether it's due to evolving personal tastes, changing professional standards, life events, or simply dissatisfaction with original tattoo quality, more individuals than ever before are seeking ways to remove or alter their tattoos.

In the past, tattoo removal methods such as dermabrasion, surgical excision, and chemical peels were common, but they were often painful, invasive, and carried significant risks of scarring. Thankfully, advancements in laser technology have transformed this area of cosmetic dermatology. Picosecond laser technology, such as in devices like the PicoWay laser, has revolutionized tattoo removal by offering safer, quicker, and more effective treatment outcomes.

Today, patients have access to cutting-edge, non-invasive laser solutions for tattoo removal that deliver impressive results without significant discomfort or downtime. This innovative technology ensures that tattoo removal is not just possible, but practical and efficient for virtually anyone seeking to remove unwanted ink.

Understanding Picosecond Laser Technology

Picosecond lasers, such as the PicoWay, represent a significant leap forward in tattoo removal technology, primarily due to their ultra-short pulse durations measured in picoseconds (one trillionth of a second). This revolutionary method achieves superior results through a unique photomechanical effect that distinguishes it from older laser technologies.

Ultra-Short Pulse Delivery: The PicoWay laser emits incredibly brief, intense pulses of laser energy, significantly shorter than traditional lasers. This rapid delivery prevents excessive heat from spreading to surrounding tissues, greatly reducing the risk of thermal damage to normal skin.
Photomechanical Impact: Rather than relying on thermal energy alone, the PicoWay laser uses mechanical stress waves generated by rapid energy pulses. These stress waves specifically target and fracture the tattoo pigment particles beneath the skin without causing significant damage to surrounding tissue.
Breaking Down Tattoo Ink: When the laser energy is delivered, the targeted ink particles absorb it, creating microscopic pressure waves. This rapid absorption shatters the tattoo pigment into much smaller, dust-like particles compared to traditional laser methods.
Ink Fragmentation and Immune Response: After the tattoo ink is fragmented, the body's immune system plays an essential role in the removal process. Immune cells known as macrophages identify these tiny ink particles as foreign materials, engulf them, and gradually remove them from the body through natural metabolic processes.
Improved Results and Efficiency: Because of its efficient fragmentation process, picosecond lasers typically require fewer treatment sessions compared to older laser technologies, providing quicker, more complete tattoo removal with minimal downtime.

This advanced mechanism of action makes picosecond lasers like PicoWay highly effective at safely removing a wide range of tattoo inks, colors, and skin types.

Our tattoo removal process is meticulously designed to prioritize patient safety, comfort, and excellent results.

Step 1: Preparation and Numbing

We begin by preparing the area to ensure the treatment is as comfortable as possible:

Prescription-Strength Numbing Cream: Initially, we apply a prescription strength numbing cream to the tattooed area to significantly improve comfort.
Local Anesthetic Injections: For maximum comfort during treatment, we often administer numbing injections to completely numb the area to be treated with laser. The only times we can't numb with injections is if a large area is being treated with the laser, in which case injecting with lidocaine could lead to toxicity. A cooling device, called a Zimmer Cooler, is used during the numbing procedure to decrease discomfort with the numbing injections.

Step 2: Customized Laser Treatment

After the area is numbed:

Selection of Laser Settings: Dr. Arash Akhavan will select laser parameters tailored specifically to each tattoo, considering ink colors, tattoo depth, skin type, and previous treatments.
Laser Application: During treatment, the PicoWay laser delivers precise pulses to shatter the tattoo pigment. Our fully numb patients do not feel any discomfort during the procedure.

Step 3: Immediate Aftercare

Post-treatment care is crucial:

Dressing Application: Immediately following treatment, we apply a protective dressing and topical antibiotics to the area.

Step 4: Post-Procedure Instructions

To optimize healing and ensure the best results, we provide clear post-treatment guidelines, including:

Gentle Cleansing: Wash the treated area gently twice daily using a mild, fragrance-free cleanser.
Antibiotic Ointment: Apply bacitracin ointment twice a day to prevent infection.
Avoid Sun Exposure: Protect the area from direct sunlight with clothing or sunscreen to prevent discoloration.
No Picking or Scratching: Allow scabs or crusts to heal naturally to avoid scarring.

With proper adherence to this structured process and aftercare, laser tattoo removal with PicoWay can provide exceptional results safely and efficiently.

Arash Akhavan, MD, FAAD

Arash Akhavan, MD is founder and owner of The Dermatology and Laser Group, one of the top centers for cosmetic procedures in New York City for over a decade. Arash Akhavan, MD, FAAD is a Board Certified Dermatologist and an Associate Professor at The Mount Sinai School of Medicine. Dr. Akhavan is a Castle Connolly Top Doc, New York Magazine Best Doctor, and Super Doctor featured in The New York Times. Dr. Akhavan is a key opinion leader that has been featured on hundreds of media publications including The New York Times, Allure, Marie Claire, Women’s Health, Cosmopolitan, ABC News, Fox News, Fox 5, NY1, WPIX, and more. He has been featured on nationally syndicated television programs such as The Doctors.

Dr. Akhavan serves as an educator and lecturer for multiple aesthetic device and injectable companies. This allows his office access to newer technologies at an earlier date than other offices, as well as a higher level of expertise in the use of these devices. This, in turn, translates to more effective and safer treatments for our patients.

By Arash Akhavan, MD, FAAD | April 2nd, 2025 | Categories: Body, Tattoo Removal

How Does Laser Tattoo Removal Work?

Medically Reviewed by Arash Akhavan, MD, FAAD

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How Tattoo Removal Works

Understanding Picosecond Laser Technology