Scarring and the Deleted Comment....Oops!

Miss 2 sent me a comment, and I accidentally deleted it, as I now approve and reject comments from my email since I'm getting so much spam. 

I wanted to respond to the comment, because it is really in-line with my current thinking about this whole process and what's up and coming for me too. So I am posting the response here:

Miss2:
Hi Sarah, thanks for sharing your tattoo removal journey. I'm based in the UK and I'm black and I'm looking into getting a tattoo on my wrist removed. I'm really worried about the scarring because of my skin. Do you have any advice? Thanks 

Me: 
Miss2, you are welcome, and thanks for reading!

I think you should count on some scarring, but I also think that you can count on most of the scarring fading in a year or two post your last treatment. I think it also depends on whether or not you hypo-pigment or hyper-pigment when you scar. Some people get dark scars (hyper-pigment), which might blend better given your skin tone. I hyper-pigment, so every scratch leaves a dark mark/scar that fades in a year or two (sometimes not entirely...I have marks that were scars in my childhood that remain today in the form of dark blobs). You may be the same or the opposite or both. I know some black people hyper-pigment after years of shaving or in the spots where thighs rub together, but when cut, darker people may hypo-pigment. It depends on the person. For me, I have actually been pleasantly surprised that the area around my tattoo has not been darker than it is. I am actually pigmenting/scarring less than I would if I were scratched. Yet on that same note, I have small parts within that area that are hypo-pigmented, and the PA thinks they may stay that way.

When I think about the two hypo-pigmented spots, which are about the size of a pencil eraser's head (relatively small), I can think back to times when I peeled my skin to soon or messed with that area when it was almost healed. So it makes me wonder if most of the scar-prevention can be controlled with healthy wound habits (not messing with it). I will admit though after that burned skin separates from the other layers it is really hard not to scratch and want to remove it. Basically, you have a moderate amount of control over your scarring, but you won't be able to prevent it all. I think most scarring takes the shape of textural changes, meaning your skin there will feel like a scar even if it doesn't look like one (I'm totally cool with that).

As far as your skin tone, when I first went for my consultation, I saw photos of black people with black ink tattoos (not sure how much color you have in the wrist tattoo), and it was pointed out to me that darker skin requires less treatments due to the remaining ink blending in with the darker skin. At a certain point with dark ink and dark skin, you can't tell that a little remains. Skin color varies greatly, so I'm also not sure you would get that same benefit. If I had darker skin, I don't think I would still be getting treatments. It's the tiny bits of black/green that remain that are haunting me!!!

At the point I started my treatments, I did not care if I had a giant scar, because I just wanted the thing gone. As I go along now, I really don't want to have a scar, but I have also settled into the notion that a scar of an old tattoo is much more tolerable than an old ugly tattoo. You may feel the same one day or not. People in my family used to love to repeat the phrase that 'a scar is a real man's tattoo', so I guess I am now just working on getting a real man's tattoo ;)

But seriously, my real advice would be to ask the clinic for pictures of people with similar skin color and ask what your options will be if there is a scar that you do not like at the end. My clinic is a dermatologist's office, so helping with skin issues is what they do. I have met others at the clinic who were getting lasered to help with improving the appearance of a scar, so how that works I am not sure, but you should ask. Lastly, I mentioned in a previous post that I will be getting a new laser next time. That laser is not to remove the tattoo but will be to improve the look of tattoo removal area. I do not know the exact specifics of it yet, but it will be moving or encouraging skin pigmentation in the right direction. I'll get more information as I move into the next phase, and hopefully that will help others whom, like yourself, don't want to live with scars either. As always, my best advice is: make sure that the person doing the treatments has a license to practice medicine (e.g. more educated than an RN) and is operating within a medical office and under the supervision of an M.D. that is qualified to do skin surgery (*remember: shit could go wrong and that laser could blow-up on your body)!

I'll keep you posted on my new laser and the potentials with that, and let me know what you decide and how it progresses!

Thanks again for taking the time to read this and write to me,
Sarah

The Reel Laser Tattoo Removal

Hey everyone! Got an email from a couple of filmmakers trying to get enough funding for a documentary about tattoo removal (brilliant idea) that they're currently making. The official description is:

“D'inked” is a documentary about people who have tattoos, people who give tattoos and the people and technology that make tattoos disappear.

They sent me a link to the trailer, and it looks entertaining and very professional! I thought that many of you would have an interest in seeing a movie of this nature, (...cause you're reading my blog!). They need help, so if you like it, support it! Here's the link to the trailer and the place to make a donation if you want to see it on the big screen (the minimum donation is only $1 US):

D'inked Trailer and Support Page 
      or
http://www.kickstarter.com/projects/dinked/dinked?ref=live

https://www.facebook.com/pages/Dinked-Movie/431196140236671
 
Good Luck Guys!

Tips for the Day of and the Days Following Laser Tattoo Removal

While I was at my last treatment, there was a slight back-up of people getting laser tattoo removals. I think this also had something to do with the new second pass method that was being implemented. This meant that I got to overhear others also waiting in the "lounge" (see photo of trepidacious me). One thing I overheard was a woman talking about going to work after the treatment. It was her first treatment. I also happened to see her walking around, so I noticed that she was very dressed up. I thought that was weird, because of how messy removals can be, so I thought I should offer up a couple of tips in case of any of you will be going in for the first time.

My first tip would be to wear clothing that you do not mind getting lidocain, skin ash, blood, or polysporin on, as this tends to happen. Even if you can mange to keep it off at the doctor's office, you might still have to pass over the area or dirty bandages when removing the clothing. I am getting my tattoo removal on my left upper arm, so I typically wear a tank top and zip-up sweater if it is cold. No matter what I wear, I still face the problem of melting polysporin as the day wears on, and this always results in a stream of liquidious goo running down my arm. So if your tattoo to be removed is on your back, you'd also want to be careful what pants you wear that day. I can say that, while much of the antibiotic ointment/cream has gotten on my clothes over these many years getting lasered, that cream has never stained anything, but definitely leave the nice outfits for another day.

My second tip would be to take the day off if you can. The person in the lounge had scheduled herself to go back to work that afternoon. Second degree burns may seem like something you can do on your lunch break, but mind you, they do take a lot out of you even if you do get anesthesia.  The only thing I ever plan after getting a treatment is a nice nap! This usually helps me feel back to normal for the day. My ideal time to get a treatment is first thing in the morning, so that I can make it back home in time for a nap and wake just before lunch. If not, I usually try to cut of out work late in the day, so that I can go home and rest.

Following this tip, my third recommendation for first-timers is to take the next couple of days off, completely. I wouldn't plan anything, because the days following the removal is when the real pain sets in, the blisters form, the bruises darken, the swelling increases, and you feel the fatigue from your immune system trying to heal the wound. It makes for a pretty lousy few days. My suggestion, if possible, schedule your removals for Fridays or whatever the day before your days off may be. This is why I like taking one day off from work (Friday) then having the treatment done first thing in the morning, and having the weekend to get nasty without any commitments.

The gist of what I realized from the first-timer is that it is hard to anticipate the fact that the burn on your arm will melt the ointment, your bandages will be bloody (though I'm not really a bleeder...I've seem some removals that look like massacres), and you're going to be tired. This process is not nothing, so be prepared. This way you won't find yourself in an awkward or uncomfortable situation. Or maybe your job sucks all together, so having to deal with a laser tattoo removal burn might help distract you from the usual torture! And if you dislike your coworkers, you always have the option of showing off your new burn at lunch time!

Oozing

Considering I am now 13 treatments into the laser tattoo removal process, I feel pretty confident about what is to be expected, so I do not think anything new happened this last treatment, per se. Perhaps it was the summer weather, but I decided to leave my bandages off for a bit during those few to four days immediately post the last treatment. Well to my surprise, the blisters, that were moderate in size as compared to those of past treatments, just oozed yellow juice to such a volume that it was hard not to bandage it right back up, but the bandages were bothering me. Now, I am not new to the oozing, but I guess with the bandages on I usually do not realize just how much of it there is during the healing process.

Upon seeing my burn, someone remarked that yellow ooze typically means something is infected, I immediately knew that was not true, because yellow ooze has been a staple of this process since I first began. Yet, it got me thinking about how certain people, whom are just getting their first treatment, might wonder similarly, is it a bad sign? No, definitely not. But then, what is it?

Well I looked it up and the blister ooze is actually called 'serum', and it is released from broken cells when they get damaged, such as when the dermis layer of skin is damaged in a second degree burn, which is the consequence of laser tattoo removal. It is yellow due to the albumin protein, same as eggs (GROSS!!). Hopefully this information will satisfy those that think it might be infected. (http://www.worsleyschool.net/science/files/blister/page.html)

I learned two things from this. The first was that these burns we receive are second degree burns. This was news as I had thought them to be first degree, therefore lesser degree burns. Ouch! Second, I learned that if the dermis layer is not damaged then blisters will not form (I think...), which might mean, going back to an old post, that when I did not blister the laser didn't go deep enough to hit the dermis layer or just didn't damage it. It makes me think that not blistering is a sign the laser didn't work, as I had suspected.

Either way, I wanted to post a gross pic, so that you can compare your ooze to mine in case you were wondering if it is normal. I'm not a doctor, but this is normal for me.

[It does look like egg yolk....yuck!]

The Second Pass Method?

Hello everyone! Been a few months...

Well, I called the dermatologist's office the other day to make an appointment, and unlike usual, they said, "we have an appointment tomorrow". So instead of waiting weeks and posting my next treatment date, I just went in and had number 13 done yesterday.

As usual, the assistant takes photos before injecting me with anesthesia, but this time she said she would need to check with the PA if we would even do a treatment due to how little ink is remaining, which is not what I wanted to hear, because I want ALL of the ink gone as best as possible. I still thought at that point we could do more. I'm sure you'll agree, so here are some pics of where the tattoo was at the day before treatment number 13 and morning of this latest treatment as well. At this point, lighting is everything when it comes to accurately documenting the amount of ink left. Bright lights tend to reflect the white of the scar tissue still remaining, but low lights, such as that in shady areas or indoors, will not have as much light to reflect back onto the observing eye, so you get a better view of the tattoo. I took several pics in different lighting, so you can see what I mean.

The photos below are after 12 treatments of laser tattoo removal in full sunlight, and it been almost 4 months since my last treatment. 

Laser Tattoo Removal After 12 Treatments May 2012

 

Laser Tattoo Removal After 12 Treatments

Laser Tattoo Removal After 12 Treatments

This is when I most enjoy my arm and the tattoo removal. That is when I am outside under the bright light of the desert sun. Viewing the remaining pigments is more difficult, so I feel more comfortable wearing tank tops and exposing the faded tattoo than I do when I am indoors. I guess outside (as some have remarked) it looks more like a scar of some sorts, though I know they are just being nice :). 

Left Side - Laser Tattoo Removal

Right Side - Laser Tattoo Removal

This is also outdoors, but it is under the lower light of a shaded porch, so the darker inks are more visible. One thing I love best about this process so far, including not just the laser tattoo removal but the tanning project to even out my skin tone as well, is the way the far left side of the tattoo has blended with the rest of my skin pigment. In months and years prior, this side looked the most scarred, but it has turned out to be a well blended and healed area with minimal black ink remaining. I don't think I am recommending tanning (that's dangerous), but I am not saying to avoid the sun all together, especially when you get to the point where you want to see what the tattoo will look like if this were the end of the removal process. It may also signify that the process is not over, as has been my experience.

 

This was taken indoors and shows how the tattoo would look today if you were standing next to me. The tattoo is clearly (at least to me) still there and obviously was what it was. Not quite done!

Laser Tattoo Removal After 12 Treatments May 2012

The dermatologists office is with me on removing this thing entirely, but I knew that when the PA came in to analyze the progress, she might come recommending something other than lasers (dermabrasion...maybe). I was sitting there waiting and thinking, "am I ready for this and is this the direction I want to go?". 

When the PA came in to the room, her thought was that the ink was deep and that the lasers we had been using were exhausted to their capacity as far as this tattoo is concerned. She thought that the doctor might want cut my tattoo open and then do a laser tattoo removal treatment while that bit of flesh was open.....what?! OMG! Ouch! She said that we had talked previously of this method, but I did not remember that. How invasive and scary is that? Now thinking back on it, what I remember was us talking about doing 3 to 4 treatments of dermabrasion on it, not open-skin-laser-removal method, ouch! Talk about a deep burn. This is good information for those considering all of their options and wanting to see where these paths could lead, as this may be an option if going to a medical clinic. Not sure anyone would want to try this, but it is apparently an option for some.

The doctor came into the room and thoroughly looked it over. His professional opinion was that the newer (research supported - as I was told) and less invasive method of "multiple passes" or "second pass" and "third passes" might be beneficial. In the second pass method, that I did receive, the specialist does one laser (Q-plus or "Ruby Laser") that breaks up the pigments and then have me wait in a lounge area for 15 minutes.

This is me waiting and patiently amusing myself. 

 After waiting for a period of time, my wait ended up being a 30 minutes, I am brought back and a second laser (trivantage) that works by further breaking up the pigments that have already broken-up during the wait. Normally, I get both lasers (...I think), but usually there is just no wait period.My thought also was that they target different inks, but the second laser may be a more catch all type.

In the end, it ended up seeming to hurt more that first day, but so far, that was the only difference. I could be wrong about the increased pain. After all, it has been nearly 4 months since my last treatment.

So I am curious, does anyone else get second pass treatments? Is this new to you too? What do you think given your understanding of the technology?

Also, for the next time, I will be getting "third pass treatments", but the third laser will be entirely new to my skin!! I've never received a treatment by the future number 3.For a sneak peak, the third laser is more cosmetic, and it is not intended to remove any of the tattoo.

I'll keep you posted on all that. I also think this blog is long over due for side-by-sides, and I have paintshop again, so I'll finally be able to get that done. 

*** Movie Break for Treatment #12 ***

I was finally able to take someone in with me in order to make a movie for you guys! Here it is....sorry it's not professional or perfectly image stable. I thought it would be fun though! The laser lights made a lot of streaks and bursts on the camera. The PA said some were going to be from the aiming beam. I also had to reduce the video quality in order to upload it.....

Later, I will post with answers to some of the questions that I received since July!

Pre-Treatment Number 12

Hey everyone sorry for the delay in posting....

I did end up going on vacation and tanning the tattooed area. It was quite the interesting display of colors. At first it looked spotted, because some areas were really resistant to the sun. Later it looked super sunburned.  That's this picture (July 2011). I was really hopeful to see what would happen after the burn wore off....

....but in the end, much of the ink ended up darkening too! These pics were taken just before I had my treatment yesterday (2-3-12)

 

But Still Too Much Ink For Me!