Tattoo removal: procedure, healing and aftercare step by step
Tattoo removal consists of a few minutes of laser and several weeks of healing. Here you will find out step by step what happens at the consultation and test patch, why the skin turns white immediately after lasering, how to deal with blisters and crusts and when exercise, sauna, swimming, showering and sun are allowed again.
It also provides answers on fading between sessions, warning signs and a new tattoo on the treated area. The devices we name are the PICOLO XL picosecond laser, the Q-switched lasers PICOLO L and PICOLO S, and the KYROMASTER for skin cooling.
What happens at the consultation and the test patch before tattoo removal?
At the consultation the tattoo is examined and a plan is made, and the test patch then shows how skin and ink really react. Questions are asked about the age of the tattoo, colours, amateur or professional work, skin type, tan, medication, tendency to scarring and allergies. This gives the estimated number of sessions and the wavelengths. Photographs record the baseline condition. For the test patch, a few pulses are placed on a small area, and with colourful designs on each colour. After 4 to 6 weeks you can see lightening, healing and possible colour shifts.
On the PICOLO XL and the PICOLO L, the SIA AI sets the parameters automatically. The client management system records client data, treated areas and shot counts, so the test patch is also documented for the first full session.
Come to the appointment with untanned, healthy and shaved skin, which is the most important preparation. In the 4 weeks beforehand, avoid direct sun, sunbeds and self-tanning products on the area, because tanned skin absorbs more laser energy and is prone to pigment spots. On the day itself: shave any hair on the tattoo, do not apply cream or perfume, eat and drink beforehand and choose loose clothing that will not rub on the area later. Mention new medication, infections or skin irritation before you start. A numbing cream needs 30 to 60 minutes to take effect.
In the studio the skin is pre-cooled. For this the KYROMASTER offers dedicated pre-cooling with cold air before the PICOLO XL, PICOLO L or PICOLO S is used.
What happens step by step in a tattoo removal session and how long does it take?
The actual lasering takes 1 to 15 minutes depending on size, and with preparation and aftercare you should allow 20 to 45 minutes. First the area is cleansed, disinfected and photographed, and everyone in the room puts on protective eyewear. Then the design is covered spot by spot, and you hear a crackling sound and feel brief snaps. Cold air runs the whole time. Finally, post-treatment cooling follows, a wound-care product is applied and a loose, non-adherent dressing is put on. You are given the aftercare instructions and the appointment for the next session.
The PICOLO XL works with 1 to 10 Hz and spots of 2 to 10 mm: fine lines with a small spot, filled areas swiftly with a large one.
Why does the tattoo turn white immediately after lasering (frosting)?
The white colouring is caused by tiny bubbles of gas and steam that form in the skin when the pigment absorbs the laser pulse abruptly. This frosting is desirable: it shows that the energy has reached the pigment. After 10 to 30 minutes the gas dissipates, the area turns red, swells and feels like sunburn. Pinpoint bleeding is possible. In later sessions the whitening is weaker because less pigment is present. This is not a sign of a poorer effect.
The shorter the pulse, the more the pressure wave predominates over heat. The PICOLO XL works with 280 picoseconds, the PICOLO L and PICOLO S in the nanosecond range.
Are blisters normal after tattoo removal and what should you do about them?
Yes, blisters are a common and normal reaction in the first 1 to 3 days, especially with a dense, dark tattoo and after the first sessions. The fluid may be clear, yellowish or dark from ink residue. Leave the blister intact, as its roof is the best wound protection. Cushion it against friction with a loose, non-adherent dressing. If it bursts by itself, do not pull off the skin over it, clean the area, apply a wound-care product and cover it. Show large, tense or painful blisters to the studio or a doctor.
Thorough cooling directly after the session dampens the reaction. The KYROMASTER cools with cold air down to minus 50 °C, including as post-treatment cooling, and requires no consumables.
How long do scabs last after tattoo removal and when do they fall off?
Crusts form after 3 to 5 days and usually fall off by themselves after 10 to 14 days, though on the lower legs and feet it can take 3 weeks. They often contain pigment and are therefore dark, and underneath pink, still sensitive skin appears. During this phase the area itches. Scratching and picking tears the new skin off as well and is a common cause of scars and light spots. Cooling, a thin layer of care product and loose clothing help against the itching. Do not soften crusts, so no long baths.
How heavily the skin crusts over also depends on the thermal load. The picosecond pulses of the PICOLO XL place less thermal stress on the surrounding tissue than nanosecond pulses.
Tattoo removal day by day: which healing stages does the skin go through in the first 4 weeks?
Healing proceeds in four stages: acute reaction, crust formation, flaking and regeneration. Days 1 to 3: redness, swelling, a feeling of warmth, possibly blisters. At this point the area is cooled, elevated and covered. Days 4 to 14: crusts and itching, and the area stays dry and protected. Week 3: the crusts have come off, the skin is pink, slightly shiny and may look somewhat lighter or darker than the surrounding skin. From week 4 the skin strengthens, the tattoo continues to lighten, and consistent sun protection is part of the routine.
For the first stage, good cooling is what counts. The KYROMASTER works with pre-cooling, parallel cooling and post-treatment cooling and is suitable for picosecond and Nd:YAG lasers such as the PICOLO XL, PICOLO L and PICOLO S.
When can you exercise, use the sauna and swim again after tattoo removal?
Light exercise without friction on the area is possible again after 2 to 3 days, while intensive training, sauna, swimming pool, sea and full baths are only possible once all the crusts have fallen off, in other words after about 2 weeks. In the first 48 hours, sweating, heat and a high pulse rate increase swelling and blistering. After that it depends on the site: if clothing, a strap or a piece of sports equipment rubs on the treated area, you wait longer. Contact sports are paused until healing is complete. Chlorinated water, salt water and bathing lakes bring germs into the open skin and soften crusts.
The calmer the skin is after the session, the sooner you are back to everyday life. Post-treatment cooling with the KYROMASTER contributes to this by taking heat out of the skin directly after lasering.
Can you shower after tattoo removal and how do you keep the area clean?
Yes, a short, lukewarm shower is allowed from the next day, as long as no hard jet of water hits the area directly. Just let the water run over it, do not use shower gel or a sponge on the area, and afterwards pat it dry with a fresh cloth or a compress. Do not rub. Then a thin layer of wound-care product goes back on and, as long as the skin is weeping or has blisters, a fresh, non-adherent dressing. Wash your hands beforehand. Hot water and long soaks in the bath are off limits until healing is complete.
Which care suits which stage is set out in the SIACSKIN aftercare guide. Studios and practices working with the PICOLO XL, PICOLO L or PICOLO S should ideally hand out these instructions in writing.
How long do you have to avoid the sun after tattoo removal?
For at least 4 to 6 weeks after each session, no direct sun and no sunbed should reach the area. Under UV light, freshly lasered skin easily forms too much pigment, and dark spots are left behind. Clothing protects most reliably, and on healed skin additionally a sunscreen with sun protection factor 50. This applies throughout the whole course, because the area must not be tanned before the next session either: melanin absorbs laser energy, and the treatment would have to be weaker or postponed.
The base wavelength of 1064 nm is absorbed considerably less by skin pigment than shorter wavelengths. The PICOLO XL, PICOLO L and PICOLO S all work with it. For the period afterwards, SIACSKIN carries the Suncream Sensitiv SPF50 in its aftercare collection.
Which mistakes most often delay healing after tattoo removal?
The most common are scratching at the crusts, pricked blisters, sun and friction from tight clothing too early. All four disturb the new skin and lead to scars or pigment spots. Added to these are thickly applied greasy ointments under which the skin softens, home remedies, perfume or alcohol on the wound and airtight film dressings left on for days. Smoking impairs blood circulation and also slows the breakdown of pigment. Anyone who additionally pushes for shorter intervals gains nothing: the skin needs its 6 to 8 weeks.
On the studio's side, the right dose is what counts. On the PICOLO XL and the PICOLO L, the SIA AI sets skin type, body area and energy automatically.
When can you see how much a tattoo has faded and why does it lighten between sessions?
You can assess the result of a session after 4 to 6 weeks at the earliest, because the body only gradually carries away the fragmented pigment. Directly after healing the tattoo often looks hardly changed or even patchy. Phagocytes take up the fragments and carry them away via the lymphatic vessels, which goes on over many weeks. That is why the design continues to fade even without a new appointment, and longer breaks are no disadvantage. An irregular course is typical: fine lines dissolve first, dense areas follow later.
Photographs under the same light before every session make the progress visible. SIACSKIN provides a cloud platform for before-and-after images for this purpose. With 280 ps, the PICOLO XL breaks pigment down particularly finely, which makes it easier to carry away.
How can you tell that the skin is ready for the next tattoo removal session?
The skin is ready when it is completely closed, no longer red, not swollen and not tanned, and feels like the surrounding skin. This is the case after 6 to 8 weeks at the earliest, and on the lower legs, feet and with darker skin types more likely after 8 to 12 weeks. If remnants of crusts, shiny, thin skin, hardened areas or light and dark spots can still be seen, the session is postponed. If the tattoo is still visibly lightening, waiting is also worthwhile. Before every session new photographs are taken and the reaction to the last treatment is discussed.
In the client management system of the PICOLO XL, PICOLO L and PICOLO S, the treated areas and shot counts of every session are stored. This way you know what was done last time.
What signs mean you should see a doctor after tattoo removal?
You should see a doctor if redness and pain increase after the third day instead of subsiding, if pus emerges, the area becomes hot, red streaks spread away from it or fever develops. These are signs of an infection. Severe itching with wheals or swelling extending beyond the tattoo should also be investigated: ink components released during shattering, above all from red ink, can trigger allergic reactions. The same applies to wounds that have not closed after 3 weeks and to scars that become raised.
Redness, swelling, blisters and crusts in the first few days, by contrast, are normal. Good cooling, for example with the KYROMASTER, and an adjusted energy on the PICOLO XL, PICOLO L or PICOLO S help to keep these reactions mild.
When can a new tattoo be done on the area after the last laser session?
After the last session, wait at least 6 to 8 weeks, preferably 3 months, before the same area is tattooed again. The skin must be completely healed, and the old design continues to lighten during this time: only then is it clear what the tattoo artist is working with. Lasered skin can be somewhat firmer or finely scarred and then takes up ink differently. Therefore show the area beforehand and plan together how much of the old tattoo really has to go. For many new designs it is enough to lighten the dark sections.
For remnants in black, 1064 nm on the PICOLO L or the PICOLO S is usually sufficient. If coloured inks remain, the PICOLO XL with 532, 755 and 1064 nm is designed for multicoloured tattoos.
