Second skin

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Second skin
12/30/07
By LAURIE GRANIERI
STAFF WRITER
granieri@thnt.com
Home News Tribune

John McGrady can't eliminate his ex-wife from his life Û after all, they have two kids together Û but he figures he can eliminate her name from his forearm and chest.

That's why he's visiting East Brunswick dermatologist Sandy Milgraum: The Lacey Township resident is hoping a series of laser tattoo-removal treatments will remove all bodily evidence of his ex.

"I started seeing a nice young lady, and it didn't make a good conversation piece," says McGrady, 49, a Kearny firefighter who admits he's been taking a lot of heat from the guys down at the firehouse about his tattoo woes. "Every time I looked at it, I got (angry). I figured I had to do something."

According to a survey published last year in the Journal of the American Academy of Dermatology, 17 percent of those with tattoos want their body art removed. The American Society for Dermatologic Surgery reports that in 2001 there were 44,760 tattoo-removal procedures performed; in 2003, the latest year for which they have data, there were 61,772 such procedures performed.

Laser tattoo removal first became commonly available in doctors' offices in the early '90s, replacing more invasive methods such as cutting, burning and sanding. Laser removal is bloodless and thought to be relatively effective, nonscarring and painless, though some patients might dispute the "painless" claim.

"Precision work'

Paula Bertagna understands McGrady's dilemma. She, too, did it for love.

That small "Scott" tattoo running across the right side of her abdomen? Bertagna had it applied on a whim to honor her then-boyfriend.

"I thought it was somebody I was going to be with and spend the rest of my life with," says Bertagna, 38, a nurse from Franklin Park. "I thought it would be cool to have."

That was 1993, when Bertagna was 24. She was hanging out with Scott at a gathering of Harley-Davidson devotees in Upstate New York and decided to go for it. She says she probably spent $20 to $30 for the body art. A few years later, she and Scott broke up.

Then she met Dave.

Dave, now her husband, "wasn't pleased with it," Bertagna admits. "He would ignore it more than anything. He said, "Do you want to get it removed? I'll pay for it.' "

Laser tattoo removal uses Q-switched lasers, rapid, short and intense light pulses that pass through the top layers of the skin and are selectively absorbed by the tattoo pigment. The laser shatters the tattoo pigment, which is gradually cleared by the immune system.

Milgraum says he charges an average of $400 per treatment. Many tattoos seem to require an average of six to eight treatments spaced one month apart to allow the body to absorb the tattoo pigment.

Small tattoos might require a procedure that lasts as little as three minutes; multicolored torsos could take more than an hour, according to Douglas Ashendorf, a pain-management doctor who performs laser tattoo removals in Clark.

Ashendorf says he sees patients who were "young impulse buyers," as well as those who are entering the business world. But most often, he says, he sees people who want their work lightened in order to eventually re-cover the area with "something more professional."

"Instead of mowing the lawn, I'm doing precision work, modifying it millimeter by millimeter," he says. "It's kind of a collaboration. . . . It's not just a tool of eradication; it's a tool of embellishment."

Somerset's Nicole Doyle, 35, obscured the name of on ex-boyfriend on her right thigh with a "tribal" tattoo that she says resembles a black sun.

"I regretted the name, so I covered it," she says. ". . . You can't see the name at all."

Doctors say skin color, ink density and color, as well as age and location of body art affect the removal process.

"It's not a Wite-Out stick," Ashendorf warns. He charges $50 per square inch to remove a tattoo.

Part of the challenge is the composition of the ink itself. The tattoo-ink industry is not traditionally regulated by the U.S. Food and Drug Administration, even though the pigments are considered color additives requiring pre-market approval. Tattoo ink is not even ink; it's a dry pigment suspended in a carrier solution. And the composition of those dry pigments is mysterious Û they could be made of metal salts, plant dyes, plastics.

As a result, Ashendorf says, those performing the removal "don't know what is in it. You don't know what you have until you get there."

Milgraum and Ashendorf say possible side effects of laser tattoo removal include textural changes in the skin or temporary loss of pigmentation, though Milgraum stresses that this is rare. Blistering is among the short-term effects. Topical or injectable anesthetics can be used for pain relief during the procedure.

Ashendorf says lighter-skinned patients tend to be easier to treat because they do not possess "the thick layer of melanin that the laser has to shoot through. . . . Afro skin could take two years with a big tattoo. You must go slowly" in order to avoid burning the skin or leeching the natural melanin.

Fresh vs. faded

"Who put this on?" Milgraum asks Bertagna during a laser removal treatment.

"I had it done by a professional," she says.

"Well, he was a turkey. You were lucky because this will come out quick."

Milgraum and Ashendorf agree that older tattoos and, in some cases, amateur tattoos are easier to remove. Amateur tattoos are less resistant to removal because the ink particles are larger and therefore easier to target with the laser, Milgraum says.

"Fresh" tattoos are difficult to remove because "they are thick, dense and immune,"
Ashendorf says. "The system hasn't recognized it (as a foreign body)." That's why older tattoos often appear faded, he says: "The body's immune system is leeching it out to the immune system," which is what occurs with repeated laser treatments.

Ashendorf says tattoos on ankles, legs, scalp and wrists may require more treatments. He says those areas are at increased risk for scarring because the skin is close to the bone. Decreased blood flow to those areas increases the possibility of burning.

The color of the tattoo can be a factor, as well. Traditionally, yellows, greens, whites
and tans can be resistant because they tend to reflect the laser rather than absorb it.
Milgraum says darker colors are more absorbent.

Bertagna, who has several other tattoos that she plans on keeping, claims she'll eventually tattoo Dave's name somewhere on her body.

But McGrady?

"Never," he vows. "There are (only) two names you can get on your body: your children and Mom."

Laurie Granieri: (732) 565-7333; granieri@thnt.com

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