At age 16, Kimberly White got tattoos of a rose and a heart with vines on her breasts.
Since age 19, she's regretted them.
Now 38, she's having them removed.
"I just hate them, and now I can afford it," said White, who lives in New Cumberland, Pa.
What once was thought permanent, is no longer.
Tattoo removal is more readily available and effective than in the past, but it often costs more than the tattoo itself -- in pain and dollars.
Tattoo removal by specialized, high-intensity lasers is increasingly popular and often the most effective method, experts say.
But complete removal may require eight to 12 painful sessions, and price varies depending on the size of the tattoo and the ink colors used.
The average cost per square inch locally is $50 to $100 or more a session.
"A tiny cross the size of my baby pinky fingernail would be $25 a session, for example," said Hillary Lebouitz-Schaefer, a medical aesthetician and president of Lebo Skin Care in York Township.
Tattoo removal is generally considered a cosmetic procedure, so insurance usually doesn't cover it.
Solid green or blue ink in a tattoo will bump the price because Lebouitz-Schaefer rents the laser and pays extra to remove those colors -- the toughest to erase.
Also extra is the application of numbing cream -- $75 per five or six sessions, she said. Many compare the pain of the laser to flecks of hot grease hitting the skin -- 300 to 400 flecks as the light pulsates. "Like 10,000 bumble bees stinging you," White said, wincing after completing her sixth session at Lebo. The laser works by directing high-intensity energy at the tattooed area for a fraction of a second, passing through the outer layer of the skin to disrupt and break up the pigment beneath. The body's immune system then carries the pieces away as the skin heals. Patients wait eight to 12 weeks between sessions so that the body has time to heal. "If they come in too soon, it's going to waste their money," Lebouitz-Schaefer said. "The body needs the time to move the ink out." Other methods of tattoo removal include surgical excision and Dermabrasion, in which a patient's skin is frozen using a spray, and the doctor mechanically "sands" or removes the surface and middle layers of the tattoo. Depending on the patient and the type of tattoo, dermatologists might recommend one procedure over another. Laser technology has advanced to where the potential side effects of laser tattoo removal -- scarring and infection -- are rare. Some patients feel itchy at the site.
After a recent session, the just-lasered area on Cindy Dahler's right bicep felt sunburned, said the grandmother from West Manheim Township. Dahler wants her purple blossom tattoo removed because she doesn't like its location. "My granddaughter just got one, and I said you better be darn sure you want that thing because it hurt a lot worse taking it off than putting it on," she said. Lebouitz-Schaefer applied a hydrocortisone cream to the blossom, which helps prevent any swelling or itching, said Gordon Learn, whose company, Progressive Medical Laser, rents Lebo the laser. "Generally, we do not have breaks in the tissue, but we do have blistering sometimes," Learn said. Dermatologist Sameh Hanna, who removes tattoos as part of his practice at the Dermatology Associates of Lancaster, said patients should ask about the potential complications and side effects of laser tattoo removal before undergoing the procedure. Also ask who will be doing the removal and their experience and training with a laser, he said. "You can scar people, and you can change the color of people's skin, although it's rare," he said. "If I was having a tattoo removed, I'd want a doctor to remove it, or have a physician's assistant or nurse practitioner do it in one of those offices" where there's oversight by a doctor.
In some cases, a aesthetician such as Lebouitz-Schaefer does the procedure. She is always under the supervision of a physician on site, she said. A common reason people cite for removal that their tattoo was a youthful whimsy later regretted, Hanna said. Increasingly, patients tell him they're entering a military branch with tattoo restrictions or starting a new job where a tattoo is inappropriate, he said. Some people want to rid themselves of an ex-lover's name. Former gang members have visited Hanna wanting to rid themselves of a bad memory, he said. However, Hanna can't guarantee anyone the skin will look like it did before a tattoo. "These are permanent, life changes," Hanna said. "You might always have a shadow. Sometimes, you leave behind colors that don't completely go away. It's not like an eraser."
