I was chilling at a café near the hospital when I saw Shalini waving at me. with a pretty lady next to her.
“Hi, Mrs. Tanya! It’s nice meeting you!” I shook hands with Mrs. Tanya, as she gave me a broad, sweet smile.
Mrs. Tanya and her husband are our new neighbours, living just a street away. Shalini has gotten along quite well with Mrs. Tanya since then.
“I have a question in mind, Juliet. is it true that tattoos can be removed using salt?”
In a way, it's true. That was one of the tattoo removal treatments done in the past (or even these days).
With the developing advanced technology in laser treatments today to remove tattoos with lesser pain and side effects along with fewer treatment sessions, have you ever wondered how it used to be to remove tattoos?
Some people still use these tattoo removal methods, but are they worth the extra pain?
Non-Laser Tattoo Removal Treatments
As tattoos do not only occur on the skin surface (epidermis layer), different methods for tattoo removal have been explored throughout the years.
Before modern technologies were available and with limited scientific knowledge of our skin structure in the past, tattoos were considered to be superficial (on skin surface only).
Like applying strawberry jam on your piece of toasted bread, when you’ve regretted your choice of jam and there are no bread left, what comes to your mind first to remove it?
The easiest way would be scraping it off. This is actually similar to some earliest forms of tattoo removal via the mechanical way.
After scraping off the strawberry jam, you see some jam residues in the little “holes” on your bread. You cut the part away and eat the rest of your bread. This is similar to the surgical excision of your tattoo(s).
Maybe you change your mind and instead of cutting it off, you “wash off” the strawberry jam residues with water. However, that area of the bread gets soaked and even sinks in.
This works like the chemical method to remove tattoos - the usage of corroding chemicals to remove tattoos. This is usually warned against by medical professionals due to the effect of dangerous chemical properties of acids on our skin (like what water does to bread).
Or you can run a lighted match gently across the jam-residues areas, like the thermal method used for tattoo removal. By using heat to burn off tattoo particles on the skin, this is considered as the introduction to using lasers to remove tattoos.
These techniques cause pain during and particularly, after treatments. Take a look at each of them in more detail!
1. Tattoo Removal using a Salt Solution (Salabrasion)
This is what Mrs. Tanya mentioned about, on tattoo removal with salt. Well, the term “salabrasion” is derived from the words “salt” and “dermabrasion”. It is the use of an abrasive “salt scrub” to remove tattoos.
Salabrasion works by vigorously rubbing and gradually peeling off the epidermis layer (top surface layer of skin) until the dermis layer, where the tattoo ink lies.
The earliest report on tattoo removal was dated back in 543 CE, when Aetius, a Greek physician, detailed on salabrasion. A salt solution is first applied on the top layer of a tattooed skin area, and a surgical dressing of a moist, sterile gauze dressing is placed for 24 hours or more. The skin area is then scraped off.
Although this method is sometimes still used as a home remedy to remove tattoos, salabrasion is not reliable. The tattoos do fade off, but the process is considerably painful, and the treated area can be very sore and raw until the skin starts to scab in recovery. Scarring definitely occurs with some ink left without complete removal.
2. Tattoo Removal by "Sanding" (Dermabrasion)
Dermabrasion is another abrasive tattoo removing method where a rapidly spinning abrasive tool (diamond fraise wheel or wire brush) is used to scrape the skin surface with the tattoo. It’s like “sanding” the tattoo off your skin, literally.
In addition, dermabrasion is occasionally used before surgical excision for complex tattoos. These complex tattoos are first abraded at the surface, exposing the deeper section, which is then surgically removed.
Tattoo removal using dermabrasion usually causes bleeding during the tissue-destructive treatment. Some side effects after dermabrasion include possible red and swollen (inflammation) on the treated skin area, changes in skin color (especially for people with darker skin), scarring, or other skin reactions to the abraded top layer of skin.
These days, dermabrasion is more effective in treating acne scars, or fine lines (especially around the mouth). If you are interested to read more about how dermabrasion (microdermabrasion as the newer technology) helps in acne scars, I have covered it here: Juliet, Please Take Me Away From The Moon After That "War On Acnes"!
3. Tattoo Removal by Cutting It Off (Surgical Excision)
Removing tattoo by surgery may completely remove tattoos in a single treatment. Tattoo removal via surgical method is considerable for small tattoos, or tattoos locating at physical parts not commonly being paid attention to.
Skin surface with the tattoo to be surgically removed can be covered by skin flaps, skin grafts, tissue extension, or tissue expansion. Most likely people opt for surgical methods when they don’t have options for laser treatments (especially in rather remote areas), or due to “convenience” where the tattoo can be completely removed with a single treatment.
Nonetheless, surgical excision for tattoo removal is not recommended as it causes scarring (hypertrophic scarring or keloids). Large tattoos are not recommended to undergo this tattoo removal method as they required multiple surgeries, or skin grafts (taking skin from other parts of your body) as well as having greater risks of complications.
4. Tattoo Removal with Chemicals
The use of chemical substances, particularly acids, is another form of physical skin destruction. Chemicals traditionally used for tattoo removal are corroding (caustic) chemicals, (tannic acid, silver nitrate), phenol solution, etc. These chemicals are traditionally done after dermabrasion, or surgical incision.
Phenol solution, or phenol chemical peel for instance, is considered as a deep chemical peel, which is also said to be the strongest chemical peeling. It penetrates straight into the dermis layer, where tattoo pigments lie. The first application itself will penetrate deeply into the skin, causing an intensely painful tattoo removing process. Although by one treatment session itself tattoos can be removed, phenol chemical peel is more for skin lightening purposes, and on people with darker skin tones, the skin lightening effect will be more obvious.
The use of acid as chemical peeling is considered effective to be done alone without combining with other methods. TCA (TriChloroacetic Acid) peel is a medium-depth peeling that burns off the surface layer of tattooed skin area. Despite that, TCA peel is more commonly used to treat sun damage, fine lines, wrinkles, and acne scarring.
Anaesthesia or pain medications are needed as chemical treatments can be very painful for patients, as they cause stinging sensation due to the chemical burning of the surface layer of your skin. Tattoo removing by this method leads to scarring, possible unwanted tattoo pigments, infection, hyperpigmentation, uneven skin tones, etc. Plus, the repeated use of phenol solutions may cause serious skin burns as it is one of the strongest chemical peel.
5. Tattoo Removal with Heat (The Use of Infrared Coagulation)
Thermal (heat) used in the past included injuries made on the unwanted tattoos by fire, hot coals, and cigarettes, among others. Infrared coagulation (IRC) was developed by 38 years ago in 1979. Infrared coagulation, also known as infrared radiation, delivers an infrared (non-consistent, multispectral) light with specific pulses to attack tattoo ink pigments.
Removing tattoos by infrared coagulation is similar to that by lasers. Patients need to put on numb cream (topical anesthetic) before the treatment is done, which aids the treating sessions to be pain-free. So what’s painful with this non-laser tattoo removing method? The scarring that lasers won’t leave you with. This treatment causes heat destruction of skin tissue, thus after this treatment, the tattooed area that has been removed is considered as a burn wound.
Unlike laser treatments, the infrared coagulator used does not allow for selective breakdown of tattoo pigment particles via heat from light. This is disadvantageous compared to what laser treatments can do. While laser can attack tattoo pigment directly by being more specific (matching laser wavelengths to ink colour), Infrared coagulator uses infrared light to burn the skin tissues holding tattoo pigments. Thus, it causes more scarring than lasers, particularly newer Q-switched and picosecond lasers. Other common side effects are deaths of deep collagen tissues (deep collagen necrosis) and unwanted ink pigments.
Infrared coagulation is more commonly used to treat haemorrhoid in recent years, and considered undesirable for tattoo removal as there are more appropriate thermal treatments via laser. You may read further to understand better about laser treatments for tattoo removal on What's New On Tattoo Removing Laser For Malaysia In 2017.
“Wow! I didn’t expect all these! I’ve heard about removing tattoos with salt, but didn’t know there are people who use more abrasive methods for tattoo removal! It seems so desperate for them to remove tattoos!” Mrs. Tanya looked confused.
“It was more of those old days, when laser treatments are yet to be properly developed and used like now. But some people opt for these options as they are deemed to be much cheaper methods than laser treatments. Little did they know, these methods are so much more damaging to their skin! ”
Juliet's Reminder: In fact, tattoos can only be ‘faded’, without any methods that promise complete removal, except by surgical removal that leaves scars. However, newer technologies are thriving to aim at fading tattoos close to no inks left anymore. No matter what it is, it is best for you to consult medical professionals to get to know about your tattoos and best diagnosis for your tattoo removal – so find your preferred tattoo removal service here today! Do share this with your friends if you find this helpful!