Dr. TATTOFF was featured in a laser tattoo removal article in Inc. magazine this past Wednesday. From the article:

Regret that Tattoo? No Problem
More entrepreneurs are making money on removing unwanted body art.

When Dr. Will Kirby and his partner decided in 2004 to open a business that would specialize in removing tattoos, they were eyeing a growing market. “Fifty years ago sailors had 90 percent of tattoos. Now, lawyers and doctors and everyone else had tattoos,” says Ian Kirby, Will’s brother and current business partner. The year before, a Harris Interactive Poll had estimated that about 17 percent of Americans had a tattoo.

Dr. Kirby noticed studios etching tattoos everywhere he looked, but he couldn’t find a clinic that specialized in serving the inevitable proportion of these studios’ customers who would regret their permanent body art. He opened the first Dr. Tattoff in Beverly Hills to fill this need. On Dr. Tattoff’s first day of business, 90 people inquired about the process of removing a tattoo. Six years, 50,000 treatments, and two more locations later, the environment for the unusual franchise concept has only improved. In an economy when start-up capital is hard to come by, Dr. Tattoff has plans to open an additional location in Texas later this year, and, if all goes well, to expand to nearly every state within five years.

“I think the demand is rising every day,” says Dr. Kirby. “There are 20-25,000 tattoo parlors putting on tattoos every day and very few people removing them efficiently. If you come to my clinic, we’re busy every day of the week.”

In a 2006 Northwestern University study, 24 percent of respondents reported having a tattoo and 17 percent of them were considering getting it removed. More entrepreneurs are looking to cater to that 17 percent, whether it be through tattoo removal, training tattoo removal technicians, or, in one case, developing an easier-to-remove ink.

The success of tattoo removal businesses like Dr. Tattoff was benefited by several trends. The most obvious was the increasing social acceptability of tattoos. An art that was once reserved for bikers and gang members has now, according to the Northwestern study, left a mark on nearly a quarter of the population. And as the number of tattoos increases, so does the number of people who regret them. Another trend is the improving technology for tattoo removal. “Before, lasers were kind of like bazookas; they would just blast the skin,” says Ian Kirby. “And doctors really hadn’t had enough experience with them to do much with them.”

Now experienced practitioners are often able to remove tattoos with little or no scarring or discoloration. And, thanks to a new die, laser removal may get even easier. Infinitink, which was released by a company called Freedom2 last year, can be removed in fewer laser treatments than a typical ink tattoo. Although Freedom2 has thus far sold less than a mere $100,000 of the ink—tattoo artists like to consider their art permanent—it was met with high consumer approval in marketing tests. Despite lowering the number of paid treatments each tattoo would require for removal, Infinitink is a welcome development among tattoo removal businesses.

“If you could get a tattoo and have it for spring or summer, show it off, and get it removed in one or two treatments come October, than I think many many more people who would never get a tattoo would get a tattoo, and many people who already have tattoos would get plenty more because they could just get rid of it if they didn’t want it,” Ian Kirby says.

Palomar Medical Technologies, one company that sells lasers to tattoo-removal clinics, saw a 575 percent growth in sales between when they first started selling the device in 2000 and 2007. During the economic turmoil of 2008, purchases of the $75,000 device dropped by about a third, but Branden Morris, Palomar’s integrated marketing manager, commented that sales began to resurge last year.

Tattoo removal training programs have also taken off. Louis Silberman, the co-founder of the National Laser Institute (NLI) in Scottsdale, Arizona, is opening a new location in Dallas within the next two months and planning at least five more. Since 2004, the institute has trained more than 3,000 people in laser tattoo removal. Silberman also started a consulting business specifically for tattoo removal start-ups last year. He says he’s currently in discussions with about 50 people who are interested in opening up tattoo-removal clinics, most who have been trained to remove tattoos in one of the NLI’s 3- to 14-day laser courses.

In order to open a tattoo removal clinic, indirect supervision of a doctor is required. This means that a doctor has to be available for advice, but not necessarily in the building. Some states also require the technician to be a medical professional, such as a nurse, in order to perform the procedure. Despite these barriers to entry, Silberman sees the tattoo removal business as bound to succeed.

“I would say the number one reason people want to take tattoos off is because they love them so much that they want to put on a new tattoo, but all their cool body parts are taken up by old tattoos,” Silberman says. “It made us realize, gosh, there’s a market for this.”

A question we get asked a lot is if laser tattoo removal causes blisters. Dr. Will Kirby answers this question in an article that was recently posted in the Journal of Clinical and Aesthetic Dermatology entitled Treatment of Large Bulla Formation after Tattoo Removal with a Q-Switched Laser.

Highlights from the article:

• The medical term for blister is bulla.
•  At Dr. TATTOFF we see bulla caused by laser tattoo removal at a rate of less than 1 per 1,000 treatments.
• Most of the bullas we see are at least in part due to patients not following specific aftercare instructions.
• While they can be scary to look at, if the blisters are treated quickly and properly, they heal quickly and leave no permanent scar.
• If treated quickly and properly, the blisters will not affect the efficacy of laser tattoo removal treatments.

To see pictures of blisters caused by laser tattoo removal, as well as pictures of the skin after the blisters healed, please click the article link above.

Dr. Oz discussed tattoo removal options on his December 14, 2009 show. He covered multiple ways in which tattoos can be removed - the least effective of which is tattoo removal creams. Here's a summary of what Dr. Oz revealed:

Tattoo Removal Cream - Since it can't get beneath the epidermis, it's usefulness is limited to amateur tattoos at best, as the majority of tattoo ink is placed deeper in the skin where the cream cannot penetrate. In all uses of tattoo removal creams, chances of scarring and infection are very high. Dr. Oz said that due to their inefficacy, tattoo removal creams are generally a waste of money.

Dermabrasion - Typically involves having a dermatologist scrape the skin down to the tattoo ink. Dr. Oz explained that this is very painful, leaves a significant scar, and is expensive.

Cryotherapy - Skin cells in the area of the tattoo are frozen and lysed (killed). Since the chemicals used (typically liquid nitrogen) can't target tattoo ink specifically, the general area is damaged and a scar larger than the tattoo will remain.

Laser Tattoo Removal - The laser targets ink particles without harming the skin, and scarring is very rare. It fractures the ink into smaller particles that the body can then remove.

While this is no news to us at Dr. TATTOFF, we're glad that Dr. Oz is helping educate the public at large as to the merrits of laser tattoo removal versus other tattoo removal methods. It is not uncommon for us to see a patient who wants to start laser tattoo removal after having an unsuccessful experience with tattoo removal creams. Often times we treat these individuals and remove their tattoos entirely, but sometimes the acid and/or scrub brushes that they used as part of a tattoo removal cream system have left their skin so scarred that we cannot treat them with lasers. This is an unfortunate situation for everyone, which is why we always encourage potential patients to visit a Dr. TATTOFF clinic for a free consultation before proceeding with any method of tattoo removal.

Tattoo removal expert Dr. Will Kirby was featured in the November issue of Healthy Aging magazine in an article about laser tattoo removal using Q-switched Nd:YAG lasers, specifically the MedLite C6 and RevLite - the lasers we use at Dr. TATTOFF clinics. From the article:

Nearly 40 percent of Americans age 18-35 have at least one tattoo, and 17 percent say they regret it. That rate climbs to 50 percent among adults over age 40. As a result, laser tattoo removal is one of the fastest growing segments of the aesthetic laser business, even in in a stagnant economy.

Erasing a tattoo is not a simple matter. Tattoo ink is embedded deep in the dermis, and it's meant to stay there forever. Histology indicates a network of connective tissue surrounds each fibroblast that contains ink particles, effectively entrapping and immobilizing the cell.

In the late 1960s, scientists discovered successful tattoo removal using Nd:YAG and ruby lasers. Selective photothermolysis theory shows a particular wavelength of light targets specific colors of tattoo ink without harming surrounding tissue. Physicians found there's more to it than wavelength.

Q-switched lasers allow greater precision in treating tattoos, resulting in safer procedures and more effective outcomes with minimal epidermal damage. The Q-switch controls light output by concentrating energy into a single intense nanosecond pulse or series of pulses. Hoya ConBio pioneered the use of electro-optic (EO) Q-swithced Nd:YAG systems where the EO switch acts as a high-speed shutter to ensure uniform and accurate nansecond pulses and a flat-top beam profile.

"The combination of high peak power and nanosecond pulse duration, a hallmark of photoacoustic technology, vibrates and shatters tattoo ink," says Will Kirby, DO, FAOCD, board-certified dermatologist practicing in Beverly Hills, California. "Tiny particles of ink are gradually eliminated through the body's natural processes."

Results from a retrospective study suggest MedLite C6's flat top beam profile is uniquely effective in clearing tattoos resistant to previous Nd:YAG therapy. The data suggest the improved clearance rate is attributable to the spot size and high-energy fluence in deeper layers of the dermis where tattoo ink is embedded.