Category Archives: Skincare

Tattoo Removal

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: 

From “We’re the Millers”

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.

Dermabrasion

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 surgery

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

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.

References and sources to learn more

Layers of the skin

Classifications of burns

Science of tattooing

Healing

Removal

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Tattoo Healing

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.

Getting the Tattoo

What’s happening to your skin when you’re getting a tattoo?

Getting a tattoo is like getting multiple injections of ink in a concentrated location on the skin – of course usually in a meaningful pattern according to the tattoo design. Tattoo needles take the ink through the epidermis (outer layer) into the dermis (second layer).

  • The epidermis is responsible for new skin cell production. Think about your skin peeling after a sunburn and scabs forming when you get a cut. This layer of the skin also produces melanin, dictating what color your skin is. Additionally, protective immune cells live in the epidermis. Think about how much nasty stuff your skin is exposed to on a regular basis. These immune cells are hard at work 24/7. First-degree burns are those that affect the epidermis.
  • The dermis has its own set of duties, including sweat production, sensation, hair growing, oil-making, and ferrying blood to and from the epidermis. Second-degree burns are those that affect the epidermis and part of the dermis.

The immune cells living in the epidermis don’t know that the needle piercing the skin is something you’ve voluntarily agreed to do (actually paying someone to do). They react as if the body is under attack, triggering the inflammatory response. You’re familiar with the immune response if you’ve ever cut yourself, scratched a bug bite, or gotten a sunburn. I’m going to go out on a not-to-flimsy limb here and say you’ve definitely experienced the inflammatory response during your lifetime.

When immune cells in the epidermis trigger the inflammatory response, the immune system goes on high alert, sending troops of specialized immune cells to the wound site. This is also why you feel pain during a tattoo (and other wounds) – your body is telling you that you’re under attack and you need to GTFO.

The ink delivered by the tattoo is taken up by immune cells called macrophages, which specialize in engulfing particles and digesting them to “clean up debris” at a wound site. Skin cells called fibroblasts also take up ink. Whichever way the ink goes, those cells stay in the dermis permanently, providing the “a tattoo is forever” quality that makes grandmothers everywhere furrow the brows and purse their lips in disapproval.

The Truth About Sunscreen and SPF

The CDC lists increasing exposure to UV light as “the most preventable cause” of skin cancer, the most common cancer in the United States. This includes natural sunlight or artificial sunlight from tanning beds. Since we can’t wear full-body protective suits every day to prevent unwanted sun exposure, we use sunscreen to protect our skin from harmful rays of sun. I have studied a series of videos produced by Huffington Post where Dr. Neal Schultz discusses various elements of sun protection. He debunks several sunscreen misconceptions of which you should be informed! Luckily for you, I have compiled the most important information here. Read on!

Image Source: ClipartPanda
Image Source: ClipartPanda
“SPF,” the acronym you see on all sunscreen products, means Sunburn Protection Factor. It’s a relative measurement that describes how much sun is required to cause a burn considering the current amount of sun protection on your skin, compared to the amount of sun required to cause a burn on skin without any protection at all (FDA).

The important thing to realize about SPF is that it’s directly related to the amount of sun you are exposed to, not the time you are in the sun (FDA). Time and amount are not always interchangeable; the sun is more powerful at noon than it is at 10AM. For example, you can ingest the same amount of alcohol by taking a shot of liquor that you can by drinking one whole beer. SPF is relative in the same way. The FDA lists other factors affecting the relationship between SPF and the power of the sun including skin type, the amount of sunscreen applied, frequency of reapplication, and the fact that “greater solar intensity occurs at lower altitudes.” All of these things must be taken in to consideration when using sunscreen.

Another important question we ask when picking out a sunscreen to use is this: what SPF should I use? It’s vital to understand how protective each SPF number is, and first you must understand that SPF values are not linear. Get this: a sunscreen labeled 15 SPF gives you 88% protection from the sun. Moving up to 30 SPF, you increase your sun protection to 95%. However, when you move up to 60 SPF, you are only getting four more percent protection from the sun.

“Part of this numbers game is drive by consumer demand,” Dr. Schultz points out.

Our advice: save some money and use 15 or 30 SPF sunscreen, and reapply often to account for sweating and rubbing off in the water when swimming. You are wasting your money on sunscreens labeled 60, 70, and 100 SPF. Plus, when using such high value SPF sunscreen, people may incorrectly assume that applying enough sunscreen and reapplying later are less important. If you don’t use enough sunscreen, the SPF value greatly decreases, and you leave yourself very vulnerable to harmful rays of sun.

Another issue I looked into was that of spray vs. lotion. I am personally guilty of taking the easy way out, choosing a spray sunscreen over lotion to cut down on time spent applying sunscreen and to prevent my hands from getting sticky/sandy/etc. FutureDerm.com tested it and concluded that spray sunscreen is less effective than lotion. This result is derived from the fact that SPF is only as powerful as the amount of sunscreen that you use on your skin. What I mean by that is this: FutureDerm discovered that when people apply spray sunscreen, they end up using much less than if they applied using a lotion. Like I discussed earlier, not using enough sunscreen drastically decreases the value of SPF protection. So, if you’re going to try and save some time by using spray sunscreen, make sure to spray a generous amount on your skin, or you’ll be making up the time saved by rubbing aloe on your burnt skin 8 hours later.

Lastly, keep in mind that UV-A rays, the dangerous rays of sun that cause skin cancer and premature aging, don’t diminish in the winter. It’s always important to wear sunscreen on a daily basis. Also, sunscreen SPF is not additive. If you wear moisturizer that provides 15 SPF protection and foundation makeup that also has 15 SPF protection, you don’t get a combined protection of 30 SPF. You get the SPF protection of the first thing that you put on your skin. If you can, make sure that the first layer is sunscreen, not foundation.

My hope from doing this research and from writing this blog post is that you’ll change your habits based on learning the facts. Take care of your skin!

Check out Dr. Schultz’s videos for yourself here:

http://videos.huffingtonpost.com/tech/how-to-choose-the-right-sunscreen-266799626