9 Factors That Determine Tattoo Removal Success

Written by Daniel Friedmann, MD, Board Certified Dermatologist on August 17, 2021 26 Comments

Picosure tattoo removal laser image

Originally published on May 23, 2014. Updated August 17, 2021 with additional information.

Since each tattoo is unique, it’s nearly impossible to make general statements about how long it takes to remove a tattoo. Variables that affect the tattoo removal process include where your tattoo is located, the depth and color of ink, your skin tone, and the strength of your immune system among other factors. While it is nearly impossible to guarantee the removal of a tattoo within a specific number of treatment sessions, tattoo removal experts can assess the following variables to predict tattoo removal success.

In this blog post, we’ll discuss the common factors that determine how quickly a tattoo can be removed via laser tattoo removal.

The Tattoo Removal Process

Laser tattoo removal can significantly diminish the appearance of your tattoo, and may be able to remove it completely. Lasers use heat and light at specific wavelengths to break up the ink in your tattoo. These ink particles are then removed by your body’s own immune system.

The tattoo removal process requires several visits to a specialist. During your first consultation with a professional, you’ll be given a general timeline that’s based on the location, age, and color of your tattoo. It’s possible your body will respond more quickly, or more slowly, to treatment than expected.

On average, tattoo removal requires 8-10 laser treatment sessions, spaced 6-8 weeks apart. The total time (and number of treatment options) required to remove a tattoo can depend on several factors.

Factors That Determine How Quickly A Tattoo Can Be Removed

General Health

A strong immune system is your greatest ally when it comes to quick tattoo removal. Laser treatment uses heat to break down ink particles in your tattoo. These particles must still be cleared by your body. The more active your immune system, the more quickly these broken-down ink particles are carried away.

Ink color:

Typically green, blue, and black inks are easier to remove, while red, orange, yellow, and white inks are progressively more challenging. New devices, such as the PiQo4 laser, have improved the efficacy and efficiency in treating these tattoo colors. A recent study demonstrated that 1-2 treatment sessions led to at least 75% clearance of blue and green pigments with the PiQo4 device, with more than two-thirds of tattoos approaching 100% clearance. Another 2012 study also showed 75% clearance in black pigment as early as 2-4 treatment sessions.

Tattoo Age:

Older tattoos are prone to pigment fading and may be more easily removed compared to newer tattoos.

Tattoo Size:

One variable that is undisputed is that larger tattoos require more treatments than smaller tattoos. A 2010 study published by the Journal of the American Medical Association noted that tattoos over 12 inches in diameter were least successfully removed after 10 treatments.

Professional vs Amateur Tattoo

Professional tattoo artists intend for their tattoos to last. They use ample ink which is placed deeply into the skin. The deeper the ink, the more difficult the removal. While an amateur artist might use less ink, their tattoos tend to scar more. If your tattoo has scarred over, it’s more difficult to remove because the ink gets buried further into the skin.


The study mentioned above also directly linked the negative effects of smoking on tattoo removal. Subjects who smoked regularly had a 70% lower rate of removal after 10 sessions compared to their non-smoking counterparts. This lower success rate is most likely related to smoking’s direct effects on wound healing.

Skin Color:

Tattoo removal is more effective for individuals with lighter skin (specifically Fitzpatrick type 1 or 2 skin types). Because lighter skin does not significantly absorb laser light, most of the laser energy is focused on the tattoo pigment. In contrast, dark skin siphons a portion of laser light from the tattoo. Also, most laser operators use lower energy settings on patients with darker skin types, as they are more susceptible to unwanted side effects.

If you have darker skin, less powerful lasers are used to avoid scarring or discoloration of the top layer of skin. Using less powerful lasers means it will take more time to penetrate the dermis and remove your tattoo ink. If you have lighter skin, there’s less risk of damage to the epidermis when a high-powered laser is used.

Tattoo Location

Tattoo removal is harder in areas that have a limited vascular supply and slower healing. Thus, tattoos on the feet, lower legs, or hands require more treatments than tattoos in areas like the chest or back. Because tattoo removal requires the participation of your body’s own immune system, tattoos on the back, face and neck are easiest to remove. These areas of your body experience greater blood flow and proximity to lymph nodes, which means your body will clear out the pigment here more quickly.

Extremities such as your legs, hands and feet are further from your lymph nodes. These areas take longer to heal and may require more sessions before your tattoo is completely removed.

Amount of Ink:

The amount of ink used is another parameter that affects laser tattoo removal. Professional tattoos have a greater density/volume of pigment that resides deeper in the skin. On the other hand, amateur tattooing is usually uneven, superficial, and done with dramatically less ink.

Scarring or tissue damage:

Some people, especially those with dark skin types, are at risk for developing scars or other tissue damage during the tattooing process. Ink pigment that resides under scar tissue is much more difficult to remove and requires more treatments.

Scarring can also be a result of poor tattoo aftercare. If your tattoo never healed properly, the ink could be embedded in scar tissue. It’s more challenging to remove ink from scar tissue than healthy skin.

Layered Tattoos (Cover Ups):

Layered tattoos (which often occur when a patient tries to cover up their initial tattoo with another one) are difficult to remove and require significantly more treatments than singular tattoos. Most tattoo ink is translucent, meaning it is necessary to use darker ink tones to cover previous tattoos. Since the new layer is larger and darker (and layering increases the overall volume and density of ink), full removal can be very difficult.

Choosing the Best Laser Tattoo Removal

Not all laser tattoo removal is the same. The differences lie in the types of laser used, and at which frequency. The most common lasers, called “Q-Switched lasers” can take up to 20 sessions for complete tattoo removal.

Newer, Picosure lasers remove tattoos up to 75% sooner. What’s the difference? The new PiQo4 lasers break tattoo ink into much smaller pieces, allowing them to be more easily cleared from the body. These lasers operate at four different wavelengths, each of which targets a specific tattoo color. The versatility of these newer lasers makes them far more effective for tattoo removal.

How Can I Speed Up My Tattoo Removal?

  • For best results, choose a reputable dermatologist or cosmetic surgery center that specializes in tattoo removal.
  • Inquire about the type of laser they use. The PiQo4 laser is more effective than traditional tattoo removal lasers.
  • Attend all follow up treatment sessions promptly as scheduled by your
  • Until your tattoo is completely removed, stay out of the sun. Treatment cannot be performed on burned skin, and tanned skin makes treatment sessions less effective.
  • To help your body clear tattoo ink sooner, speed up your metabolism by exercising and eating healthy, whole foods.
  • Eat more lean protein to help the skin recover between treatment sessions.
  • Stay hydrated to help flush ink particles out of your system.
  • Quit smoking and minimize alcohol consumption as both alcohol and cigarette use can slow down the body’s ability to dispose of broken-down ink.
  • Follow all aftercare instructions provided by your provider

Read more about speeding up the laser tattoo process here

Almost any tattoo can be completely removed. It’s just a matter of choosing the right dermatologist, using the right equipment, and being patient throughout the process.

Daniel Friedmann, MD

Daniel P. Friedmann, M.D. is a fellowship-trained, board-certified dermatologist and phlebologist at Westlake Dermatology and Clinical Research Director of the Westlake Clinical Research Center. He has presented nationally on photorejuvenation, noninvasive fat reduction, radiofrequency devices, up-to-date techniques in photodynamic therapy, the management of stretch marks, and the treatment of hand, chest, and facial veins.

26 Responses to “9 Factors That Determine Tattoo Removal Success”

  1. Avatar Fernando says:

    Great information! We also provide tattoo removal service in Florida uses the PicoSure and our clients have been getting excellent results!

  2. Avatar Fernando P. says:

    Nice blog! We also provide tattoo removal service in Florida using PicoSure and I can confirm its way more effective than the old q-switch machines we were using. It’s working great on large tattoos, ones with many complex colors, and tattoos that were not able to be removed with other lasers.

  3. Avatar Shane says:

    Nice blog, Thanks for sharing information about the tattoo removal treatment. I like to know why the light colored tattoos are hard to remove and is there any special process to remove this tattoos in laser treatment.

    • WD Staff WD Staff says:

      Hi Shane, the issues with removing colored tattoos can depend on a lot of factors including characteristics of your skin and the tattoo (colors, amount of ink used, size of tattoo, etc.). Please feel free to give us a call for a free consultation!

  4. Avatar Total Face Group says:

    Nice blog! I like to know why the light colored tattoos are hard to remove and why they require special process to remove by laser treatment.

    • Avatar Lynnette says:

      Light colored inks reflect the laser beam from entering the skin and pigment to facilitate removal. I am not a professional on the subject but that is my belief.

  5. Avatar Rick says:

    Thank you for the article. I just about passed your we site up in Bing but now I’m glad I clicked the link and got to go through it.

  6. Avatar Grace says:

    Nice post. This is really helpful to all tattooed guys and gals. BTW, I wrote an article on my site about the same topic, tattoo removal methods.

    Keep it up guys!

  7. Avatar Lacey says:

    The only facility in my area does not use a picosure laser. Are picosure Lasers used for colored tattoos only or black and grey ink as well? Because my Tattoo is black and grey.

    • WD Staff WD Staff says:

      Hi Lacey, sorry to hear about the lack of PicoSure in your area. It is a new (and more expensive) laser compared to old Q-switch tattoo removal lasers. We tried many different lasers and settled on PicoSure as it provided the best results in trials.

      PicoSure is extremely effective, and will work very well on your black and grey tattoo. In fact, colors are usually harder to remove then black/grey (although as you see from the above post there are a number of variables that affect tattoo success).

      I’d recommend you going to the PicoSure site ( to try and find your nearest provider. Or, come to Austin for a tattoo removing vacation!

      Thanks again for reading,

      WD Staff

  8. Avatar Hannah says:

    When someone comes in for a consultation can you tell them how many treatments are needed and the total cost?

    • WD Staff WD Staff says:

      Hi Hannah, Unfortunately there is no way to pinpoint the precise number of treatments to remove a given tattoo. However, an experienced laser technician can usually provide a correct treatment range estimate (include total cost). If you want to give us a call we can provide you with a conservative estimate so you’ll know what to expect.

      WD Staff

  9. Tattoo Man says:

    Choose your colors carefully. If you do end up needing to get your tattoo removed via laser later on in life, green, blue and black inks are some of the easiest to remove. Red, orange and yellow tend to stay with you a lot.

  10. Avatar Helen says:

    Thanks for this post, unfortunately I live in new york otherwise i would come in for a consult

  11. Avatar Vic says:

    Just remember that with any form of tattoo removal there is the chance for pigmentation (discoloring) issues. Do you research and choose a professional!

  12. Avatar JN says:

    I am a smoker with professional tattooing across my fingers. I have had them for about 4 years. I have very fair skin. I have had three picosure treatments so far. However I have found the opposite of what you say to be true, I have black blue and yellow ink the yellow was the first to go after one treatment. Blue is next and is almost all the way gone after 3 treatments. But the black ink is holding on for dear life and it may take 15 or 20 treatments who knows?

  13. Avatar Cosmo says:

    Nice post, Thanks for sharing information about the tattoo removal treatment. This is really helpful to all tattooed guys and gals.

  14. Avatar Paulina says:

    Very informative post, I did not know that there are so many factors can influence how quickly the tattoo can be removed.

  15. Avatar MATTHEW says:

    I would like to make a appt HOWEVER mine are so vibrant in afraid it can’t be done. Desifilied my temple want all removed But first 1in back and both hands and both knuckles

  16. Avatar Adrian says:

    I like how you mentioned that full-color tattoo removal is a challenge in itself because of a number of factors, one of them being the colors of ink used when the tattoo was made the first time. Since green, blue, and black-colored inks are easier to remove due to being in use more often, it’s the more vibrant colors of red, orange, yellow and white that prove to be a challenge to remove safely. There’s also the factor of using equipment to safely remove the colored ink coming into play, as well as the size of the tattoo in question. If I were to have a tattoo removed, I would have to take it gradually, since the steps involved are complicated and I wouldn’t want to run into any problems during the process.

  17. Avatar Tattoo says:

    With the Pinco4 I was quoted 8 – 10 possibly 11 sessions even with a black cover up. Cost per session is 1000 dollars. Or I just wait for DTR-001 cream or CleariT both clear ink in one session and without blistering or pain. CEO emailed me the makers of CleariT and told me its going to be about a year before they bring it to the market. They need FDA approval. Cream just went through Pre-Clinical trails and now it needs to pass phase 1-2-3.

    Can’t wait until this laser / long sessions / big costs, will be a thing of the past!

  18. Avatar Tattoo says:

    Oh forgot to mention.

    looking at Laser+RAP that also looks promising. With that it seems like cover-ups with be less of a problem now. I could end up doing that while I wait for CleariT and DTR-001 Cream. But if it works fast like they say 49% ink clearance and less costs then I may end up without ink on my arm soon.

    Though I wonder how long it will take for Clinics to pick up this new shock-wave technology?

    • WD Staff WD Staff says:

      Thanks for sharing Tattoo, its great to hear about the new technology being developed. We’ll continue looking out for the best solutions and updating our tech as long as they provide better results!

      Thanks again for reading and sharing!

      –WD Staff

  19. Avatar Runprintuk says:

    Great Article its really informative. keep us posted with new updates. its was really valuable. thanks a lot.

  20. Avatar Unwanted Tattoos says:

    Great post, very helpuful as I’m considering tattoo removal. Thanks for sharing

  21. Avatar Kate says:

    It’s good to know that black inks are easier to remove!

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