Melanie Cole, MS (Host): Welcome to Bryan Health Podcast. I'm Melanie Cole. And today, we're talking about tattoo removal. Joining me is Courtney Sams. She's a nurse practitioner and a specialist in Aesthetics and Women's Health at Advanced Skin and Body Aesthetics in Lincoln, Nebraska.

Courtney, thank you so much for joining us today. So, tell us a little bit about tattoo removal. Is it pretty common that people want that? And how quickly after getting a tattoo can someone start the removal process if they are really not satisfied with it?

Courtney Sams: Yes, it's great to be here. Thank you. It actually has become a very popular treatment. We do a lot of treatments every day. As far as how soon someone can get one after getting the tattoo is we typically recommend waiting for about six months. And the reason is because there is injury and healing with the tattoo process in the first place. And so, this allows the time for the skin to recover from that process, as it can be traumatic to the skin. If you start it too early, it can increase the risk of irritation, ineffective removal, and other complications. So usually, we'll say about six months after.

Melanie Cole, MS: Well then, tell us about the process. So, what does it involve to remove a tattoo? How does the laser work? Tell us what happens.

Courtney Sams: So, a tattoo laser works by targeting the colored pigment particles that are in the skin. Those particles are absorbed by the laser light, and the heat will destroy those particles. Essentially, the laser pulses start by breaking up those large particles in the ink. And then over time, those particles become smaller and smaller with each treatment. They're actually eliminated through the skin and internally through our immune system.

Melanie Cole, MS: Does it hurt?

Courtney Sams: That's always the question. Yes, it is not a very comfortable procedure, but we do offer numbing cream to be placed on there thirty minutes before the procedure. And we also use cold air that we blow on the treatment area during the treatment.

Melanie Cole, MS: Oh, that's pretty cool. So, how many treatments does someone expect before they really can see that it's not there anymore?

Courtney Sams: So, that can vary from person to person. There's a lot of things that we have to consider: how long they've had it, where the tattoo is located on the body. The closer to the heart typically responds better than further away. So, having it on the foot or the hand can actually take longer than if it's on the torso.

And then, we have to consider all the different colors that are within the tattoo. Black typically responds the best. When we get into like reds and yellows and whites, those can sometimes be a little trickier to treat. We take all that into consideration along with patient's skin type. And then, even if they're in the sun often, those kinds of things. There's lots of different criteria. So on average, we'll say between eight to 12 treatments. Sometimes it's more. It all depends on all of those things and after we start treating it.

There'll be times where I will think, "Okay, this one's going to be easier," but you start to treat the tattoo, and you find that there's certain parts of that tattoo that were clearly either thicker in ink or maybe went a little bit deeper. And so, those little areas might take longer than the other side of the tattoo, let's say.

Melanie Cole, MS: Courtney, does it leave a scar? What does it look like at the end? If somebody gets that removed, is the skin a different color now? Is it a little whiter? Is it a little darker? What does it look like?

Courtney Sams: Right. So, our goal obviously is to remove the tattoo and have it look exactly like it did before they got the tattoo. But when we're actually doing the treatment, it can get real irritated, red, raised a little bit. It can even frost or it kind of turns white-ish in color.

Our goal is not to let the skin break down or open, but that can happen. Sometimes actually, they'll start to notice that a little area may blister, and that can even happen two days later. So, we don't even know that it's going to happen right after the treatment. Obviously, if there's a blister or something like that opening in the skin, then they're at a higher risk for then having a scar if it's not taken care of properly. We usually have people put on Aquaphor or Vaseline to keep it moist until it's healing and staying out of the sun.

And honestly, the other thing that helps heal and just a general heal is going to be just drinking lots of water, staying out of the sun, like I said before, and healthy diet.

Melanie Cole, MS: Well, I mean, what you're describing sounds like the same things we're told when we get a tattoo, is the Aquaphor, drink plenty of fluids. Does it itch? Because I remember getting it, it really itched. Is this something that itches again when you get it removed?

Courtney Sams: It sure can. And it's just because of the irritation from the laser heat, you know, the energy in that, those little particles breaking up. So yes, it definitely can itch.

Melanie Cole, MS: And how long? So, you talked about how many treatments, but what does recovery time look like? Like, will it look better in a year? Does it take longer than that? How long does it take to really notice the big results?

Courtney Sams: With the amount of treatments that someone might need, and we space them out, on average, eight weeks apart. So if you think about that, if you have to do eight treatments eight weeks apart, how long that process truly is. So, I always let people know this is truly a commitment when you do this. It's not going to be instant gratification. You aren't going to notice this huge change right away. So, you have to be patient and know it's a commitment. So if we treat it, and we have really quick, fast results, you know, within a year, they may notice a difference, but it could be two, three years.

Melanie Cole, MS: Wow. So, I mean, it's a big deal to get them removed, and something I think that we really want to give a lot of thought to. And certainly, tell us about when you're talking to somebody. There's no judgment, right? People want these removed for all different reasons.

Courtney Sams: Oh, absolutely. I mean, anything from you know, something that they did when they were 18, and they're like, "Oh, I wish I wouldn't have done that." Or rings on their finger like, you know, instead of wearing a wedding ring, they get the ring tattoo. We do a lot of those actually. Names, you know, they put names of people on their body and there's no judgment.

Melanie Cole, MS: No, that's an important point to make because people might be nervous to go talk to somebody. So now, tell us about scheduling a free consultation.

Courtney Sams: They would just need to give Advanced Skin and Body Aesthetics a call, and they would set you up for a free consultation with one of the providers that can take about thirty minutes. We will go through that process of asking all the questions about the tattoo and about either lifestyle, going through the process, how it works, what to expect, risks, complications, all of those things.

Then, we will determine how much that specific tattoo is going to cost for removal per treatment. And then, if they determine that they want to do it, then they can get it scheduled.

Melanie Cole, MS: This is really information and such good information for people that have always been curious about whether or not they want to get this thing removed that maybe, as you say, no judgment, that they did when they weren't thinking that this is something they wanted forever, right? So, best advice on tattoo removal and what you want people to know about what you're doing there at Advanced Skin and Body Aesthetics.

Courtney Sams: That we're here for you and, again, no judgment. We will help you determine how we'll do the treatment, how much expected treatments we feel it will take. We just want to help them look and feel their best.

Melanie Cole, MS: That's great information. Thank you so much, Courtney, for joining us today. And I'd like to thank our Bryan Foundation partner, Pillar Restaurant Group. To listen to more podcasts from our experts, please visit bryanhealth.org/podcasts. That wraps up this episode of Bryan Health Podcast. I'm Melanie Cole.