When I think of tattoo removal, I think of Ted Mosby from How I Met Your Mother getting his lower-back butterfly tattoo removed and meeting the infamous Stella in the process. Also this:
I think a lot of us have heard that getting a tattoo removed is even more painful than getting the tattoo in the first place. Other than that, it’s likely you don’t know that much about how a dermatologist actually removes a tattoo.
Tattoo removal specialists are more likely be able to remove a tattoo – and remove the entire design – if:
The tattoo was professionally done (not homemade – yikes)
The tattoo includes less of the deep black/blue inks
More time has passed since getting the tattoo
Even under the most perfect circumstances, scarring, skin color variation, and incomplete removal of the tattoo often result. As it is considered a “aesthetic” or “cosmetic” procedure, tattoo removals are usually not covered by medical insurance. The cost of a tattoo removal procedure will depend on the type of procedure and the type/size/location/age of the tattoo.
There are three main types of tattoo removal according to the American Society for Dermatologic Surgery.
Like I explained in a past blog, tattoo ink only permeates into the epidermis and dermis. The idea behind dermabrasion is to remove these layers of the skin affected by tattoo ink in order to remove the tattoo. This approach is lauded for its low costs, outpatient experience, and well-tested assurance. Like other approaches to tattoo removal, dermabrasion is accompanied by a risk of skin color changes and potential scarring. Patients receiving dermabrasion for tattoo removal should expect to experience a two-three week healing time and a feeling of being “wind-burned.” During recovery, patients should avoid exposure to the sun.
Laser therapy (also called laser surgery or laser rejuvenation) is the preferred treatment for tattoo removal (low-risk, minimal side effects). This treatment option involves targeting a tattoo’s pigment with high-intensity laser beams. Based on what type and how many lasers used as well as various laser settings, this approach can work for different color and size tattoos. Laser therapy limits the amount of scarring that results from tattoo removal because of the laser’s ability to selectively target the tattooed skin without damaging un-tattooed skin.
Surgical excision is as invasive as it sounds. The dermatologists uses a scalpel to surgically remove the tattoo (this option is rarely used and usually only for small tattoos in special cases). The wound is closed with stitches.
30 states require tattoo artists to provide aftercare instructions, and rightly so. Proper aftercare is super important for maintaining the integrity of the design and preventing infections.
Saniderm Tattoo Healing
Every tattoo artist has their own preference for tattoo healing, and the shop I went to – Canvas Tattoo & Art Gallery in Charlotte – prefers tattoo aftercare via Saniderm, an adhesive bandage that lets the tattoo “breathe” while protecting the healing skin from environmental exposure at the same time. Interestingly, similar bandages are used for burn victims.
The folks at Saniderm explain that because recently tattooed skin is indeed an “open wound,” appropriate aftercare is essential to not only make sure the quality of your new ink stays intact, but also to prevent unwanted infections that could ruin your tattoo and be really dangerous. The Saniderm bandage keeps newly tattooed skin moist and clean during the first few days after the initial tattooing when the skin is the most vulnerable.
After completing the tattoo, the fabulous Grace Jang at Canvas (who also designed my tattoo, check out her insta) put a Saniderm bandage on my arm and gave me these instructions:
Remove Saniderm bandage after 12-24 hours, gently clean tattoo with antibiotic soap, and pat dry with a paper towel.
Put another Saniderm bandage on and leave it on for five days.
No scratching or soaking my arm (no baths, but showers okay) for 3 weeks.
After removing Saniderm, keep tattoo moist with moisturizing lotion to prevent scarring, which could affect the tattoo design.
I followed her instructions meticulously, and three weeks later, my tattoo looks fabulous. There was a bit of (expected) peeling and it was a little itchy, but I kept it clean and moisturized and everything was fine.
So why is it imperative to keep a new tattoo moisturized? The healing wound will dry up and form a scab (like wounds tend to do) if you don’t keep it moist. While scab formation is a normal part of topical wound healing, excessive scabbing can warp the design of a tattoo as the body gets rid of “damaged” skin cells (in this case, tattooed skin cells likely important to the integrity of your design) and replaces them with new skin cells. Together, using Saniderm immediately after getting a tattoo and relying on moisturizing lotion in days after that is a great way to compromise with your immune system – protecting skin cells without ruining your new tattoo.
Other types of tattoo healing
General advice from MedlinePlus recommends covering a fresh tattoo with petroleum ointment followed with plastic wrap/bandage for at least a few hours. After removing the bandage, wash the tattoo with soap and water and apply more petroleum ointment. After this point, you’re essentially letting the wound heal naturally, keeping it moisturized and protected from the sun. Most experts will advise not scratching the tattoo while it heals and not soaking it in water.
One of my passions surrounding “biological awareness” so-to-speak is proper hand-washing behavior (see my BuzzFeed article – http://tinyurl.com/BacterialResistance). The perspective I want to take today, however, is actually the practice of drying hands after washing them. What is the best way to dry your hands post-cleansing? *My perspective of “best” = most sanitary*
Let’s look at some common options:
Let’s go ahead and knock out that last option. Cloth towels are infamous for quickly becoming cesspools of germs like Coliform bacteria and Escherichia coli (1). E. coli is an infamous pathogen known for playing a role in cases of food-poisoning. Coliform bacteria are a group of bacteria commonly transferred by fecal contamination. These bacteria alone are not highly pathogenic, but their presence indicates a high incidence of other more dangerous germs that are similarly transmitted.
Poor hand-washing techniques exacerbate the colonization of these microorganisms. When microorganisms colonize, they are growing into communities of germs that are derived from a common ancestor and are increasingly resilient as they grow into larger numbers. If one person does not adequately scrub their hands with soap and remove all dangerous infectious agents while washing, these leftover germs are transferred to the cloth towel. Also, since hand towels will realistically remain moist during the majority of their existence, essentially the perfect environment is created for many bacteria to grow and thrive until the next person comes along to dry their hands. Little does this person know, all progress made moments ago at the sink are erased (and potentially made worse) by re-infecting your hands with the germs harbored by the towel.
Our next option: utilizing hot air and friction (by rubbing your hands together) under an automatic hand dryer. This may seem like the best option because often you do not have to press a button or touch anything else after cleaning your hands. The preferred hand dryer is motion-activated and effectively dries your hands in 45 seconds. UNC Chapel Hill pharmacy student and science enthusiast Tim Angle is convinced that the warm air from these dryers is generated from a place swarming with bacteria. “Air dryers distribute bacteria due to their moist, warm environment that is prime for growing bacteria,” Angle explains. However, back in 2000, scientists showed that the air emitted from hand dryers is in fact just as sanitary as paper towels (2). In addition, in 2012, a group of researchers found that the air leaving a hand dryer actually had fewer microorganisms than the air entering it (3).
Nevertheless, Angle is still correct about the capability of warm air hand dryers to spread bacteria. This seemingly flawless method of using air to dry just-washed hands is still, in some ways, faulty. According to an article by three scientists comparing the hand-drying efficacy of various methods, warm air dryers and jet air dryers are more likely than drying hands with paper towels to spread potentially infectious droplets to the environment (4).
Dr. Christy Esmahan, a molecular biologist, brings up another flaw of warm air hand dryers. “It takes so long that people tend to leave with their hands still moist — a magnet for fresh germs.” Just like a wet cloth towel provides a fruitful breeding ground for germs, still-wet hands provide the same environment, especially when people leaving a restroom are highly likely to touch door handles and cell phones within seconds.
Considering my strictly sanitation focus, paper towels could very well be the best method for hand drying. One-time use greatly decreases risk of contamination in comparison to cloth towels. In addition, using paper towels includes the same benefit of frictional removal of bacteria as rubbing hands under a warm air dryer, while eliminating the high incidence of spreading potentially contaminated droplets to the environment.
Indeed, in a study of 47 random participants, a large majority preferred paper towels to warm air hand dryers (Image 1). However, the evidence for the sanitation of paper towels may not be enough to convince the large number of environmentally-concerned citizens to abandon warm air hand dryers and cloth towels. 63% of people preferring hand-drying methods other than paper towels mentioned reduction of waste as the main motivation for their choice. In addition, although the large majority of the surveyed participants did choose paper towels as their hand-drying method of choice, only 25% of those participants mentioned cleanliness and sanitation as their reasoning. 25% rationalized their choice with speed and efficiency.
Therefore, the concluding question seems to be not only “Which method is the most sanitary?” but also “How should the most appropriate method be communicated?” and, thinking holistically, “Should we be more concerned about sanitation or waste reduction?” Those who are biologically biased will likely continue to clash with the environmentally-minded. However, potential future projects that could bring the two fields together could revolve around biodegradable paper towels, for example. Ultimately, the question you should be asking yourself after reading this article is this:
What will it take to change YOUR daily hand-drying habits?
Gerba, Charles P., Tamimi, Akrum H., Maxwell, Sherri, Sifuentes, Laura Y., Hoffman, Douglas R., Koenig, David W. 2014. Bacterial Occurrence in Kitchen Hand Towels. Food Protection Trends. 34(5): 312-317.
Best, E.L., Parnell, P, Wilcox, M.H. December 2014. Microbiological comparison of hand-drying methods: the potential for contamination of the environment, user, and bystander. Journal of Hospital Infection. 88(4): 199-206.
Huang, C., Ma, Wenjun, Stack, Susan. 2012. The Hygienic Efficacy of Different Hand-Drying Methods: A Review of the Evidence. Mayo Clinic Proceedings. 87(8): 791-798.
Tayler, J.H., Brown, K.L., Toivenen, J, Holah J.T. December 2000. A microbiological evaluation of warm air hand driers with respect to hand hygiene and the washroom environment. Journal of Applied Microbiology. 89(6): 910-919.