How we remove tattoos with a laser

Who might need tattoo removal?

Today a tattoo is a common form of self-expression. Life circumstances, a profession, aesthetic preferences or poor execution can make a design unwanted. The share of patients who wish to remove a tattoo is steadily growing worldwide and this is directly tied to quality of life: a visible unwanted design can interfere with work, sports, and personal life, and cause psychological discomfort. Our priority is safe, predictable treatment with maximum improvement in the skin’s appearance.

How a laser “sees” and breaks down ink

Modern lasers work by selective photothermolysis. Ultrashort light pulses with carefully chosen wavelengths are absorbed by pigment particles and fragment them into smaller pieces that are then cleared by the immune system. This concept has been the foundation of laser dermatology since the 1980s.

Wavelengths and associated colors:

• 1064 nm (Nd:YAG, nanosecond or picosecond): black and dark blue inks, including on darker skin due to low melanin absorption, which lowers the risk of dyschromia

• 532 nm: red and orange inks

• 755 nm (alexandrite, especially picosecond): green and blue pigments

• 694 nm (ruby): an alternative option for blue and green in selected cases

Picosecond vs nanosecond (Q-switched) lasers

Picosecond pulses create a stronger photoacoustic effect and often provide faster lightening of a tattoo compared with classic nanosecond systems, especially for difficult colors such as blue, green, and red. At the same time, nanosecond lasers can be more effective at the start of treatment when there is a large amount of pigment.

Here you can see the laser removal process in real time. Pigment granules in the skin break into smaller particles and this high-energy process causes visible whitening. The whitening will fade in about 30 minutes.

Why Uskov Kliinik

Modern, safe technologies. Our clinic uses medical-grade laser systems with all key wavelengths used worldwide for tattoo removal (1064, 532, 755, 694 nm), including picosecond platforms. This lets us adapt the protocol for complex, multilayer, and colored tattoos.

Combined proprietary protocols by Dr. Uskov. In challenging cases we use multipass sessions, optical aids, and adjunct techniques to speed and even out results. Selection is strictly individual and aimed at minimizing risks.

Full diagnostic workup. In-person examination, and when needed digital dermatoscopy, Wood’s lamp, infrared assessment, ultrasound, and other tests. This improves prognostic accuracy and safety.

Experience with tattoos of any age. From fresh to long-standing and previously treated.

How many sessions are needed

Removal is a series of sessions, not a single procedure. The number depends on ink color and composition, pigment depth and density, tattoo age, location, skin type (Fitzpatrick), layering, professional or amateur technique, immune and behavioral factors such as smoking, and the patient’s age and overall health. The Kirby-Desai scale is used internationally for orientation, but it still provides only an approximate forecast.

In our clinical experience:

• Amateur tattoos usually clear faster than professional ones.

• Intervals between sessions are typically 6 to 8 weeks or longer; extending the interval can sometimes improve response.

• Smoking statistically lowers the chance of complete clearance by the tenth session. We strongly recommend stopping smoking during the course.

Here you can see the result after three sessions

Why intensive techniques and expensive equipment are sometimes needed

Dense, multilayer, professional tattoos contain a lot of pigment that lies deep. Their fragmentation requires high peak power and short pulses (nano or picosecond), precise selection of wavelength and spot parameters, effective cooling, and experienced staff. This belongs to medical laser dermatology, not basic cosmetology.

Combined protocols: how we speed up results and improve safety

Sometimes we use a multipass technique with a PFD patch (perfluorodecalin). The transparent PFD patch reduces the temporary whitening effect, which allows several safe passes in one visit and often accelerates clearance with a comparable safety profile.

Picosecond plus Q-switched. We alternate or target them by colors or layers to optimize the response.

Choice of wavelength by a color map: 1064 nm for black and blue, 532 nm for red and orange, 755 nm for green and blue, 694 nm as an additional option.

Important: even with intensive protocols our main goal is safety, minimizing scarring and persistent dyschromia. Every additional pass and every pulse is used only when indicated.

A difficult and very sensitive area: the tattoo was located on the inner surface of the index finger.

Preparation and procedure

1. In-person consultation with Dr. Uskov: history taking, examination and when indicated digital dermatoscopy, Wood’s lamp, infrared assessment, ultrasound, and other studies to clarify pigment depth, location and risks.

2. Test pulse if needed on the least noticeable area.

3. Procedure: cleansing, cooling or anesthesia when indicated, a series of pulses by zones with monitoring of clinical indicators such as whitening and micro-petechiae. If chosen, multipass technique with a PFD patch.

4. Finish: cooling, skin protection if needed, post-procedure care instructions.Session length depends on area size, color, parameters and chosen tactic.

Aftercare

Care and restrictions are specified at the in-person visit. Typically they include keeping the area clean and dry for the first 8 to 48 hours, then gentle washing. Do not pick scabs and do not traumatize the area. Apply cold locally in the first hours if there is swelling. Use antiseptic or healing care as prescribed. Strict photoprotection with SPF 50 plus and no tanning for the entire course. Intervals between sessions are at least 6 to 8 weeks, sometimes longer.

Contraindications assessed at the in-person consultation

Pregnancy or breastfeeding, active dermatoses and infections in the area, decompensated systemic diseases, recent tan, photosensitizing medications, tendency to keloids and others. Borderline cases are discussed individually.

Important conclusion and next step

Tattoo removal is a clinically studied and safe procedure when medical lasers are used and protocols are followed by an experienced team. The impact on a patients quality of life is significant and expectations and outcomes depend on many factors. Book a consultation at Uskov Kliinik. At the visit the doctor will perform an examination and if needed a digital dermatoscopy, Wood’s lamp assessment, infrared imaging, ultrasound and other tests. This will allow selection of the optimal and safe removal strategy tailored to you.

Frequently asked questions (FAQ)

How many sessions will I need?

Usually several. Amateur tattoos need fewer, professional tattoos more. We provide an exact estimate after in-person diagnostics, using the Kirby–Desai scale for orientation.

Can it be removed completely?

In many cases yes, but sometimes faint traces remain such as a shadowy veil, residual dots, or areas of hypo or hyperpigmentation. Risk is minimized by correct parameter selection and intervals.

Is it dangerous?

The method has been studied for many decades. With a medical approach, risks are low and predictable. We explain possible reactions in detail and monitor the patient at every stage.

What about permanent makeup?

There is a risk of paradoxical darkening due to iron or titanium oxides. We discuss alternative strategies, including ablative fractional methods, and we always start with a test.

Why might you be advised to stop smoking for tattoo removal?

Smoking significantly reduces the chance of complete clearance by the tenth session. It is a factor that worsens the prognosis.