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Tattoo regret can be painful. Here’s what laser removal feels like. - The Washington Post

Much of Starr Hawkins’s body is covered in tattoos, including one of her ex-boyfriend’s car and the nickname of her child’s father, also an ex.

But the one tattoo the Miami Pilates instructor has spent months trying to remove is the face of Ye, the rapper formerly known as Kanye West. Fat Burning Device

Tattoo regret can be painful. Here’s what laser removal feels like. - The Washington Post

“I’ve always liked Kanye West, his music, and his clothing line and as a designer,” said Hawkins, 35, who shares the same June birthday as Ye. She said that when she sat in a Harlem tattoo parlor for six hours in 2018, getting Ye’s face tattooed on her right thigh, she felt she could relate to the star as a fellow Gemini.

That was before what she called the musician’s “most recent programming,” specifically the antisemitic statements he has made. “That was when I was like, okay, this got to go,” she said.

But removing a tattoo can take longer and be more painful than getting one. To get Ye off her body, Hawkins has gone through several rounds of tattoo removal sessions by Michael Abrouk, a Coral Gables dermatologist of Skin Associates of South Florida. Hawkins described it as “one of the most painful things” she has ever done. “And I’ve had a child,” she added.

Because the outer layer of skin — the epidermis — is always shedding, tattoo needles deliver ink to the second layer, called the dermis. During the tattoo process, the needle creates thousands of tiny wounds, waking up the immune system. Cells called macrophages rush to the area and start mopping up some of the ink.

Some of the ink-gobbling macrophages stay, which helps the tattoo to remain visible.

To create a tattoo, ink must be injected 1 to 2 millimeters below the skin’s surface into the dermis layer.

Immune cells engulf the ink and suspend it in place . It can be seen through the epidermis layer because skin is partially translucent.

To create a tattoo, ink must be injected 1 to 2 millimeters below the skin’s surface into the dermis layer.

Immune cells engulf the ink and suspend it in place . It can be seen through the epidermis layer because skin is partially translucent.

To create a tattoo, ink must be injected 1 to 2 millimeters below the skin’s surface into the dermis layer.

Immune cells engulf the ink and suspend it in place . It can be seen through the epidermis layer because skin is partially translucent.

To create a tattoo, ink must be injected 1 to 2 millimeters below the skin’s surface into the dermis layer.

Immune cells engulf the ink and suspend it in place . It can be seen through the epidermis layer because skin is partially translucent.

The removal process takes advantage of the immune response. A blast of light from a laser shatters the ink particles in the tattoo, then the body’s lymphatic system cleans up the mess and helps the particles exit the body.

Laser operators target different colors with different wavelengths of light, said Joshua Weitz, a physician and chief medical officer for the Removery, an Austin-based chain of tattoo removal centers. Green, yellow and red pigments are more difficult to remove while black is the simplest. White ink, according to Weitz, is extremely difficult, yet is used more frequently in current tattooing practices. Skin color factors into the efficacy of the procedure as well.

Short bursts of focused light from the laser penetrate the skin. The ink under the epidermis heats up and then breaks apart into smaller particles.

Next the body’s immune system eliminates the tiny ink particles from the body through the bloodstream. Multiple treatments remove any leftover ink.

Short bursts of focused light from the laser penetrate the skin. The ink under the epidermis heats up and then breaks apart into smaller particles.

Next the body’s immune system eliminates the tiny ink particles from the body through the bloodstream. Multiple treatments remove any leftover ink.

Next the body’s immune system eliminates the tiny ink particles from the body through the bloodstream. Multiple treatments remove any leftover ink.

Short bursts of focused light from the laser penetrate the skin. The ink under the epidermis heats up and then breaks apart into smaller particles.

Short bursts of focused light from the laser penetrate the skin. The ink under the epidermis heats up and then breaks apart into smaller particles.

Next the body’s immune system eliminates the tiny ink particles from the body through the bloodstream. Multiple treatments remove any leftover ink.

Today’s lasers are a big improvement over early efforts to remove tattoos, which involved skin abrasion, creams, surgical excision and lasers that damaged adjacent tissue and were not especially effective.

About a decade ago, the introduction of the picosecond laser was considered a major breakthrough, said Jeremy Brauer, a Purchase, N.Y., dermatologist who was involved in early studies of the device. The pico delivers ultrashort pulses of light, each lasting a pico (or one-trillionth of a second).

Although it can take many laser sessions to remove a tattoo, people see fading within the first few weeks.

About 32 percent of Americans have a tattoo and 22 percent have more than one, according to a recent Pew Research survey. As tattooing has increased so has tattoo removal.

When Mark Beasley, a former professional poker player, switched to a career in corporate finance, he wanted to remove a large neck tattoo of Storm, the Marvel Comics superhero.

“I was really concerned that they might not be able to take off the tattoo because of my skin tone,” said Beasley, who is African American. The 34-year-old from Fort Washington, Md., said the laser “felt like a hot rubber band popping me.” As the tattoo began to fade, the laser treatment became less painful.

But it took time. His first appointment at the Removery was in 2021. With six to eight weeks between each visit, he is still not finished. He bought a package of unlimited visits for $1,900. Each session lasts only a few minutes.

“Removing this was life-changing for me,” he said. “I wanted a more professional image. I didn’t want to wear turtlenecks anymore.”

Kevin James, 33, of D.C. was 17 when he got the word “California” across his chest, and his last name across his abdomen. The tattoos, large and shaded to look 3D, had a “gang” style to them, he said. “I was always afraid to take my shirt off because every time I did, somebody would assume that I lived a life of crime, or that I’d been in prison,” he said. “It was giving off the wrong message.”

Now married and an intelligence specialist in the Navy, James finally is getting them removed, a decision that cost him $3,200.

He also described the laser as like “having someone snap a rubber band against your skin, but about 10 times more painful.” Still, he’s pleased with his decision. He’s already seen fading, and “that gives me positive motivation, like all right, well, you know, I can just suck up the pain and just deal with it a little bit more.”

Regulations on who can use a laser to remove a tattoo vary by state. In New Jersey, only a doctor can do it. But in most states, no physician is required. Weitz said employees at the Removery receive a rigorous, 160-hour training program.

“The results of tattoo removal can depend on who is performing the procedure,” said Terrence A. Cronin Jr., a physician and president of the American Academy of Dermatology, which recommends consulting with a board-certified dermatologist for advice.

Redness, swelling and possibly blisters occur after each procedure. Skin could scar or become significantly darker or lighter at the site of the tattoo. You could have an allergic reaction to the procedure, especially if your tattoo has red ink, which is more prone to causing such reactions, said Nayoung Lee, a physician and assistant professor at the Ronald O. Perelman department of dermatology at NYU Langone Health.

Certain scenarios, such as eyeliner tattoo removal, will be safer with a physician, who will take steps to protect the eyes from the laser. If you have a history of keloid scarring, the laser can produce a thickened scar at the site of the tattoo.

If the procedure will not be performed by a physician, protect yourself by asking who will operate the laser and what their credentials and experience are, Lee said. She suggested that before treating the entire tattoo, request that the laser operator perform a test patch on a small area.

Abrouk warned against taking a phone video of the removal process because the lasers can break your phone. He also said patients should always wear protective eyewear.

“Laser tattoo removal is extremely advanced,” he said. “I know we often treat these devices almost like they’re toys, but they are absolutely not to be messed around with.”

Fees for tattoo removal vary depending on the size of the tattoo and the number of sessions required, but the cost can easily reach thousands of dollars. Typically, dermatologists charge more for tattoo removal.

Physicians also can give you a shot of lidocaine to numb the area before the procedure, but nonmedical professionals cannot. Brian DeMaio, co-owner of Burning Phoenix Studio in Yonkers, uses a “cryo machine,” which blows cold, numbing air on the area.

Skin type, location on the body and the colors and amount of ink used all play a role in the cost, time and success of tattoo removal. Tattoos on extremities, where there is less blood circulating, are more difficult to erase than those on the torso. After removal, the tattoo might look like a shadow, a bruise or be mostly undetectable.

“We’d love to replace the tattoo-removed skin with normal skin, but how many hundreds of times did the needle pierce the skin to make the tattoo? It’s never truly going to be what it was prior to the tattoo placement,” Brauer said.

Abrouk estimated that the value of the sessions to remove Hawkins’s Ye tattoo has reached about $10,000. But Abrouk said he hasn’t charged Hawkins for removing her tattoo because of the nature of Ye’s remarks. (A London tattoo shop has also offered free removal of Ye tattoos.)

Hawkins said she’s trying to have enough of Ye’s face removed to cover it with something else. She thought about Dolly Parton, “but she’s still alive,” Hawkins said. “I kind of want to, like, limit the people that are still alive.”

Tattoo regret is not the only thing that spurs removal. People joining the police department or the military can’t have tattoos on their hands or faces. Some people remove old tattoos to make room for new tattoos.

The Removery offers free removal to formerly incarcerated people. “Those are really the emotional stories. Most of the time, it’s somebody just getting out of prison and changing their life,” said Carmen Vanderheiden Brodies, vice president of clinical operations.

DeMaio said removing tattoos is gratifying because it brings joy to people. But now, when people come in asking to be tattooed with a name, DeMaio said he discourages them.

“I tell them, ‘Kids are the only names you should be tattooing — or pets,” he said. “But, you know, they do it anyway. And then they come back six months later to get it removed.”

An earlier version of this story misspelled the name of physician Nayoung Lee. The story has been updated.

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Tattoo regret can be painful. Here’s what laser removal feels like. - The Washington Post

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