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Tattoo Removal

Tattoo Removal Hypopigmentation and Hyperpigmentation

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Published: 01.12.2021
Updated: 02.14.2024
Medically Reviewed by Carmen Brodie, VP Clinical Operations
Laser removal is the go-to method of removing unwanted tattoos because it’s incredibly safe and effective. However, you may feel concerned about whether side effects can occur, especially if you’re a person of color. A lot of people with darker skin types think, “Laser doesn’t really match with me,” says Carmen Vanderheiden Brodie, co-founder of Removery. They may have seen an example of poorly done laser removal or heard that it can be challenging with darker skin. However, skin discoloration from laser treatment is unlikely to happen with a skilled technician and proper client care.  It’s important to take measures to prevent the two types of discoloration—hyperpigmentation and hypopigmentation—and an expert technician will know how to do that. This article will take an in-depth look at the most common concerns regarding tattoo removal hypopigmentation and hyperpigmentation so you can move forward with complete confidence. 

What is Hyper and Hypo pigmentation?

Tattoo removal hypopigmentation and hyperpigmentation can occur in rare cases, usually for preventable reasons that we’ll discuss in a moment. They’re both essentially caused by the same thing, says Chelsea Marandola, clinical operations and safety manager at Removery.
Not a Removery Client
Hypopigmentation
Untreated
Hyperpigmentation
Before and After
Hyperpigmentation

Hypopigmentation

With tattoo removal hypopigmentation, the skin in the area that has undergone laser removal is lighter than the surrounding skin. Milder cases have a higher likelihood of clearing up, while more severe cases can be permanent—though this is usually completely preventable. *This is not a Removery client.

Hyperpigmentation

With tattoo removal hyperpigmentation, the area where the tattoo was removed looks darker than the surrounding skin, similar to sunspots. Hyperpigmentation after laser tattoo removal is usually correctable—the body naturally eliminates this extra pigment over a period of time. “Some people take three months to remove it; some people take six months, some people take a year to clear it,” says Chelsea. It just depends on how quickly the body can clear the pigment out, which can partly be affected by how healthy the person is.

“Hyperpigmentation can be corrected almost every time,” Chelsea says. “If someone comes in with hyperpigmentation, I’m generally not very concerned.”

Is Hypo and Hyperpigmentation Scarring?

Hypo and hyperpigmentation is not the same as scarring. People often associate laser removal with scarring, but that’s not really accurate, says Carmen. She explains that when tattooing a client, it’s very common for a tattoo artist to unintentionally cause some scarring that goes unnoticed until the person undergoes laser removal. Oftentimes clients confuse clinical “frosting” seen in videos as scarring this response dissipates over the course of a couple of minutes. During a consultation, the technician can usually recognize any existing scarring and point it out to the client beforehand. “That’s why we go over that very carefully before we start. Tattoo lasering will not scar you,” says Carmen.

How Does Tattoo Removal Cause Pigmentation Changes?

Most Common: Sun exposure

Clients should carefully follow their aftercare instructions by avoiding sun exposure. Going into the sun before or after laser treatment can cause hypo or hyperpigmentation. “When that happens, your body’s natural healing response is to try and send melanin to the area because melanin is what protects you from UV rays,” Chelsea explains. That creates a brown, hazy look in the tattooed area. MEDICATIONS Taking a medication that increases photosensitivity without telling the technician can increase the risk of pigmentation changes by making the lasered area even more sensitive to the sun. Be sure to tell your technician about any medications you’re taking.

Least Common: Improper Laser Use

“It’s not necessarily that it’s any more difficult to remove tattoos on darker skin types—it’s that you need to know what you’re doing when you remove tattoos on darker skin types,” says Chelsea. “Because a darker skin type has a lot more melanin a lot closer to the surface—that’s what gives it color—it means that we have to walk a very fine line between making sure the laser is targeting the ink but not their pigmentation.” Improper operation of a laser could lead to undesired pigmentation changes by accidentally targeting the melanocytes in the skin. Melanocytes are skin cells that produce melanin, which protects the skin from the sun’s rays while darkening the skin. If hypopigmentation occurs, the laser has destroyed the melanocytes in that area, says Chelsea. “Dark skin removal is definitely something that we have to be more careful about,” says Carmen. “There are more melanocytes present in the skin, and we don’t want the lasers to be attracted to those melanocytes and cause hypopigmentation. With a 1064 laser and something that moves at a very rapid pace, you don’t have that issue,” she adds.

How Does Using the Wrong Laser Cause Hypopigmentation and Hyperpigmentation?

Laser treatment typically only causes hypopigmentation if an inexperienced technician uses an inappropriate wavelength on a darker skin type, says Chelsea. It’s also possible for hypopigmentation to happen on lighter skin types, though this is even rarer. “Hypopigmentation can happen with lighter skin types if someone is using a laser that is very heat-inducing,” she explains. If a laser is used on someone with skin type 2, which is fair skin, the body’s natural inflammation response could cause hypopigmentation after treatment with a heat-inducing laser. “Because a Picoway laser goes in and out of the body so quickly, it doesn’t deposit a lot of heat, so it is very difficult to cause that to happen with a lighter skin type if you’re using a 1064 wavelength,” says Chelsea. The 1064 wavelength is attracted to the water in your skin, not the melanin. “Because it’s attracted to the water, it’s not going to interfere with the melanin in your skin,” she adds—at least not unless someone puts the laser on the highest setting and doesn’t know what they’re doing. “It can also happen in darker skin types if someone is trying to remove color ink with a wavelength that’s not appropriate for them,” Chelsea continues. When treating a darker skin color, tattoo removal technicians need to know exactly what each wavelength can handle and how much is too much.  There’s another important element of the process: knowing how to physically place the laser in a safe way so its pulses don’t overheat the tissue. “With a darker skin type, you have to be very careful not to heat the tissue too much because that’s when you get pigmentation damage and change.”  How do laser technicians do that? It’s twofold. They have to use the 1064 wavelength. “That wavelength is attracted to water in your skin as opposed to melanin, so it kind of sees through the melanin and gets to the ink without causing any sort of damage. You have to have a really skilled technician because it’s a two-part process,” says Chelsea. “The 1064 wavelength is going to see the ink, but lasers also create heat in the tissue, and with a darker skin type, you have to be very careful not to heat the tissue too much, because that’s when you get pigmentation damage and change.”

Lightening the Ink Too Much

Black is the only color that’s safe to remove completely on darker skin—and it’s not usually necessary to fully remove other colors. The best and safest solution is typically to lighten them to the point where they become unnoticeable.  The 1064 wavelength, which is the safest wavelength to use on darker skin, can remove black from any skin type. With other colors, the technician needs to tread more cautiously. “Let’s say you have a darker skin type with a red tattoo. You have to use a different wavelength to remove red, which is a 532 wavelength,” says Chelsea. “That wavelength is very attracted to melanin.” The technician could use a 1064 wavelength to reduce the red rather than using the 532 to fully remove the red ink when doing tattoo removal on an African American client’s skin. By doing so, the technician can avoid causing tattoo removal hypopigmentation by destroying melanocytes. “Most of the time, once you’ve reduced the black from that red on their skin tone, you can’t see any remnant of the organic red,” says Carmen. A technician may know it’s still there based on experience, but anyone else wouldn’t know that. “That goes for all colors on darker skin types,” adds Chelsea. “It’s not just red; it’s any color aside from black.” How many sessions to remove a tattoo on a person with a darker skin tone? Because the ink is being lightened rather than completely removed, it could take fewer sessions than it would for a person with fair skin, on whom even an extremely light tattoo might still show up clearly.

How Do I Prevent Hypopigmentation and Hyperpigmentation after Laser Tattoo Removal?

Fortunately, you can prevent these issues and further alleviate any lingering fears by taking the following steps.
  1. Choose a facility that specializes in laser removal.
  2. Speak with an expert tattoo removal specialist who can fully address your individual concerns. 
  3. Avoid the sun before laser treatment, as directed by your technician. You don’t want to have a suntan when you come in, which can lead to pigmentation changes, says Carmen. 
  4. Follow the aftercare guidelines provided by your technician.
“The biggest thing is to keep it out of the sun,” says Carmen. Freshly lasered skin is susceptible to hyper or hypopigmentation when the sun hits it, she explains. Additionally, avoid very hot showers and exercising for 48 hours. “You want to keep the body temperature low in order not to cause a blister,” she adds. Apply hydrocortisone cream for five days to reduce swelling, too. Strong communication with your laser technician is key. “Our clients can avoid this 90% of the time by being upfront and honest with their technician,” says Chelsea. “If you’ve been in the sun, let us know you’ve been in the sun. If you’re taking any medications that cause photosensitivity, let us know that.” “Clients need to understand that they’re in this just as much as we are,” says Carmen. “We have the laser that breaks down the particles, but we rely on them taking care of themselves and them not going in the sun even more to remove it effectively.” The laser technician can break apart the particles of ink, but then, it’s up to the client’s body to flush them out. “If you’re out drinking, smoking, partying all the time, your body doesn’t have a whole lot of time to pay attention to the removal process. The healthier you are, the better the results you’ll see,” Carmen says.  It all starts with choosing the right place for removal. Rather than going to a spa that offers a broad spectrum of treatments, choose a facility that specializes in laser removal. This will help ensure that your laser technician is truly an expert.

“Tattoo removal is an art,” says Carmen.

It takes a lot of training and skill, and it’s important to choose a clinic that uses the best available lasers. In tests conducted both in-house and by outside experts, the Picoway laser used by Removery has been proven the safest and most effective way to remove ink from the skin. It’s the gold standard in laser removal, Carmen affirms.

Is There a Cure for Hypopigmentation? Is There Anything I Can Do?

  Are you wondering how to fix your hypopigmentation after a laser tattoo removal procedure you’ve already had? In some cases, removing skin discoloration is possible. In extreme cases, it’s usually not repairable, but in some less severe cases, hypopigmentation can be reversed, Chelsea says. “Hypopigmentation can correct itself if it’s mild,” she affirms. A mild case usually results from having a little sun exposure but nothing overly harsh. “It might take six months; it might take a year, but most of the time, it is fixable,” she explains. “Your body will regenerate melanin and, hopefully, reproduce to that area.” So, how can you get rid of hypopigmentation from laser removal? While removing discoloration from the skin mainly involves waiting for your body to do the work, you can give it a boost with vitamin E cream. “With hypopigmentation, we have really good luck with them putting vitamin E on twice a day,” says Carmen. That helps with both hypo and hyperpigmentation, Chelsea asserts. “Massaging and creating circulation will help reduce pigmentation damage if it’s not permanent,” she adds.
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Before and After

Tattoo Removal Hyper Pigmentation

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Tattoo removal hyperpigmentation can be avoided by enacting the proper aftercare however if hyperpigmentation does happen it can be reversed with time, massage the area and using vitamin E oil.

Book a Free Consultation with Our Tattoo Removal Specialists

It’s important to proactively work to ensure the best results in your tattoo removal by making sure you fully understand the aftercare guidelines and following them exactly. Book a free consultation with Removery to speak with an experienced technician about how to achieve your tattoo removal goal.
Tattoo_removal_expert_Carmen Carmen Brodie VP Clinical Operations

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