“Doctor, how many sessions will it take to remove my tattoo?”

An accurate estimate on the number of sessions required for tattoo removal is important to patients. Some patients need to work within a time frame to remove a tattoo, especially if they are having a wedding in a few month’s time. Other patients want to estimate costs and time incurred for each treatment. Whatever the case may be, having a degree of certainty with regard to the number of sessions and time required to remove a tattoo would let a patient make an informed decision on whether they would proceed with removal or not.

To understand the amount of time and effort needed for any tattoo removal, laser practitioners worldwide use the Kirby Desai Tattoo removal scale, a clinical predictive scale developed by American Dermatologists working in high-volume tattoo removal clinics. The scale considers patient and tattoo factors to estimate the number of sessions required for complete tattoo removal.

Factor 1: Skin type (1-6 points)

A patient’s Fitzpatrick skin type is graded from type 1 to 6 based on the amount of melanin in the skin. Darker skin types tend to carry more melanin, which reduces the amount of laser energy that reaches the pigment. This means more laser sessions. Additionally, darker skin types tend to have a higher risk of scarring and hypopigmentation. Thus, laser practitioners will usually use more conservative settings and extend the interval between sessions.

Factor 2: Location of tattoo (1-5 points)

After laser treatment, tattoo pigments are pulverized into smaller fragments which are then absorbed into the bloodstream cleared through the lymphatic system. Areas of the body with good blood supply and lymphatic drainage will get rid of the tattoo pigments more quickly.

Factor 3: Amount of tattoo ink (1-4 points)

Amateur tattoos tend to be more superficial and contain less ink when compared to professional tattoos which are deeper and contain more ink.

Factor 4: Layering of tattoos (0-2 points)

One way of concealing an unwanted tattoo is to place a larger and darker colored tattoo over it – a technique known as “layering”. This makes laser tattoo removal more difficult.

Factor 5: Scarring (0-5 points)

Skin implantation of tattoo ink causes trauma and foreign body reaction, which leads to scarring. Scar tissue impedes laser tattoo removal as it blocks both laser energy and the body’s scavenger cells from reaching the tattoo pigments.

Factor 6: Tattoo color (1-4 points)

Black tattoo ink is the easiest to remove, followed by red ink. Green, yellow, and blue inks are difficult to remove. White and pink inks are impossible to remove.

Estimating how number of sessions and time required for tattoo removal

The Kirby Desai scale gives a good estimate, with an 80% accuracy. If a patient scores 10 points on the scale (for an estimated 10 sessions), then the actual number of sessions required will range from 8 to 12 sessions. Each session should be 4-6 weeks apart. Here are some examples of how the Kirby Desai scale can be applied:

Skin type 2 (2point), upper chest (2 points), amateur tattoo (1 point), no scarring/layering (0 points), black ink only (1 point) = 5 sessions

Skin type 5 (5 points), upper chest (2 points), professional tattoo with moderate amount of ink (3 points), no scarring/layering (0 points), multicolored with black, blue, red, orange ink (4 points) = 14 sessions

Skin type 3 (3 points), upper chest (2 points), professional tattoo with significant amount of ink (4 points), no scarring/layering (0 points), multicolored with black, red, yellow ink (4 points) = 13 sessions

Tags: tattoo removal Singapore

tattoo removal

People get tattoos for many reasons – these could be cultural, personal, a decision made on a whim, or simply because they like a design. With tattoos becoming more mainstream and so many tattoo parlours offering tattoo services, tattooing has been growing in popularity.

Just as the many reasons people get tattoos, there are just as many reasons to why people may want to have them removed – these may be due to regret, poor workmanship, fading tattoos, or even due to work requirements. Of course, although tattoos are permanent, this is only to an extent. They can be removed but whether complete removal is possible, it very much depends on the tattoo.

How can we remove tattoos?

Various techniques have been employed to remove tattoos over the years, these include tattooing the tattoo with skin coloured tattoo, also called a cover-up tattoo, surgical excision, and laser removal. Generally, experts agree that laser removal is probably the most successful way to remove tattoos.

Today, laser tattoo removal is generally done using either the Q-switched laser or the newer Picolaser. These lasers send out energy in one strong pulse and the energy subsequently shatters the ink inside your skin to dissolve it. There is also a slight difference in the way Q-switched laser and picolaser work on the skin. With Q-switched lasers, the pulse of energy from the laser heats up the ink in your skin, causing it to shatter (photothermal effect), whilst with the newer picolasers, instead of relying on heat energy, picosecond lasers deliver the energy so rapidly (in trillionths of a second) that the tiny pigment particles in the tattoo ink vibrate and shatter without burning surrounding tissue, giving not only higher efficacy and quicker clearance, but safer treatment due to reduced damage to normal skin structures.

Which tattoos are best to remove?

With tattoos, the older they are, the easier they are to remove. Also, amateur “stick and poke” tattoos are more easily removed. The ease of removal also depends on the colours: typically, dark colours such as black, dark blue, green and brown are easy to remove, whilst colourful tattoos are more difficult to remove, as they typically require treatment with different lasers and wavelengths to be effective. Also, the closer the colour of the tattoo is to your skin, the more difficult it becomes to have it removed.

The best candidates for laser tattoo removal are usually those with lighter skin but with dark coloured tattoos. Due to the risk of side effects, people with darker skin, pre-existing skin conditions such as keloid, eczema may find removal more complicated.

What’s laser tattoo removal like?

In Singapore, laser tattoo removal can generally be done with a dermatologist or at an aesthetic clinic. Numbing cream is usually applied to numb the area of tattooed skin and following this, the laser is applied onto the pigmented parts of the skin. Treatment typically feels like someone snapping a rubber band onto your skin, followed by a hot and stingy sensation in the treated area. Following treatment, the skin may bleed, blister and swell, hence it is important that after care such as applying an antibacterial ointment, regular change of wound dressing and avoiding sun and outdoor activities are followed carefully. The process is repeated over multiple sessions, usually in 6 to 8-weekly intervals until you’re happy with the extent to which your tattoo has faded.

Are there risks with laser tattoo removal?

Risks were higher with the older Q-switched laser. Possible risks included scarring, developing permanent white spots in the area of treatment and darkening of skin in the surrounding area. The possibility of these happening have decreased with the newer picolasers but it still is not zero. Hence, to reduce your risk of scarring, do not pick at the area until it heals and try to stay out of the sun and follow your doctor’s instructions and recommendations.

What if laser is not able to remove the tattoo completely?

If laser is not able to remove the tattoo, then the only surefire method of completely removing the tattoo is to undergo a surgical remova, also called an excision tattoo removal. It involves cutting off tattooed skin and stitching the remaining skin back together. This will leave a scar and is usually preferred for small tattoos.


Tattoos are a common yet permanent body decoration. It is important to consider carefully before tattooing in the first place, as removal of the tattoo is a much longer and arduous journey than having the tattoo itself. Of course, for people who no longer want a tattoo, there are different ways of removing it.

Tag: tattoo removal singapore