UN-INKED: Everything You Need To Know About Tattoo Removal In 2023

Of Dyes And Macrophages

Before we get into what I did, let's at least delve into what a tattoo IS, in the literal sense so you'll have a better idea of what was happening at the tattoo level while I was doing what I did.

Contrary to intuition and widely-held belief, tattoos do NOT dye your skin. Skin cells die and slough off. If it did dye your skin they would all disappear pretty quickly and completely and you wouldn't have any interest in a book like this.

Tattoos introduce a pigment made of large particles into the skin. The epidermis is above the dermis and is comprised of three layers. After that comes the basement layer which separates the epidermis from the dermis.

While the epidermis is comprised of 90% kerotocytes (similar to fingernails but still slightly hydrated and sort of alive), the dermis is more like the the rest of the body. It has blood vessels and glands, follicles and is connected to the lymphatic system.

When a tattoo needle delivers its dye, it pierces the basement layer separating the epidermis from the dermis, immediately triggering an immune response. Macrophages rush to the scene and stimulate inflammation.

Part of the job of a macrophage is to identify foreign invaders and eat them in a process called phagocytosis. It sees the ink and recognizes it's not supposed to be there and engulfs it with its body, creating a vacuole (like a stomach). Normally the vacuole digests whatever it engulfs but it can't digest the ink particles. They are simply too big.

So each macrophage eats as much ink as it can hold and just sits there. In place. Until it dies, about eight months. When it dies, new macrophages come along like vultures and eat the dead pieces of the original macrophage along with all the ink. Then they too are stuck in place. Until they die. And this process repeats over and over, for millions of ink-stuffed macrophages.

Since macrophages are transparent, the dye color shows through. For all millions of macrophages, stuck in place as nothing but the holder of your ink forever and ever, generation after generation.

The skin itself sheds any dye within a few days or months, depending on how deep of a layer it's in. Over time the macrophages will shelter deeper into the dermis as each successive generation of ink hosts expire and transmit their cargo to new recruits. This results in the fading we see over time.

.........

So now that we sort of understand what's going on with how the ink gets to where it gets ... How do we get rid of these ink hosts macrophages for good?

There aren't a whole lot of widely available options. But if we include the less available options, we find that commercially there is laser, chemical peel, surgical excision and dermabrasion. Let's start with dermabrasion.

Dermabrasion

Dermabrasion is a surgical method of tattoo removal that involves the use of a grinding tool to remove the outer layers of the skin in a controlled manner. The intent is to remove the layers of the skin that contain the ink particles, thereby removing the tattoo.

This procedure is painful and so is usually performed with either a local, regional or even a general anesthetic.

The American Association of Plastic Surgeons says:

Like laser tattoo removal, a session of dermabrasion will result in an open wound that needs care after the procedure is done. Daily cleaning of the wound with soap and water, application of an antibiotic ointment and covering of the wound with a dressing are what is usually recommended.

The wounds created as a result of dermabrasion typically take longer to heal than those created by laser tattoo removal. These are likely to take at least two weeks to heal.