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Physician to Physician Discussions > Injecting glycolic acid for tattoo for removal.

“Tattoo Removal is accomplished by inserting glycolic acid into the tattoo area. Glycolic acid lifts the color to the surface of the skin. When removal of the tattoo is accomplished, a “ghost” of the outline may be visible. An average removal may require four or more applications, with four weeks healing between treatments.
The process and results of the removal may vary in the size and depth of the
tattoo, also the pigment used in the original tattoo. *Results are not immediate.”

This is posted on skindeepthespa.com in Pittsburgh, PA. A woman called me today to ask if I had heard of this “new”process.Does anyone have any info on what sounds like a real disaster?

05.8 | Unregistered Commenterbcm09

There is a company called Rejuvi out of California that has a material to instill into the tattoo via the tattoo pen thats supposed to work well. They're a bit quirky as you have to have tattoo artist or permanent make-up certificate to get the stuff; a medical license and years of experience aren't good enough...go figure!

05.16 | Unregistered Commenterdermarogue

Stay away from Rejuvi. My aesthetician, who has years of micro-pigmentation / tattoo experience, and I tried it several years ago...it often caused full thickness open wounds, even when used exactly as directed. Sure, the tattoo is gone...but now you've got to get the wound healed! Avoid this headache.

05.16 | Unregistered CommenterTF

I don't plan on touching anything that needs injected, especially an acid. Since I sent this last query I was informed by some clients IPL is being sold as an alternative to a Q Yag 5 for removing tattoos.I am conservative in my treatments but also know client want results. I lost a tattoo client 4 months into treatment because things weren't moving fast enough and she was told by another office about IPL.She has a great professional tattoo which will take time to remove. I refuseto use my IPL until there were some reports written. bcm09

05.22 | Unregistered Commenterbcm09

bcm09,

sometimes it better to let them go. you are doing the right thing. IPL is not for tattoo removal. removing tattoos is acoustic, not thermal. unfortunately, that patient will find out the hard way.


05.22 | Unregistered Commenterdexter

Thanks dexter.

05.22 | Unregistered Commenterbcm09

Dexter - i am using IPL for tattoo removal and have been doing pretty well over about 6-10 sessions. I have had patients who came to me after having used the Q-switch somewhere else and have seen as much or more benefit with my protocols.

I know you are quite knowledgeable and normally I would take your word but I think this is one of those cases where we just don't quite know why it works when we think it shouldn't.

It actually came about by accident while trying to correct some sun-damage on a middle-aged woman. If you have an opportunty, give it a try, you may find another tool in your arsenal!

Outside,

Can you tell me what filters you are using and what settings (fluence and PW)? About 10 years ago when Lumenis was just ESC, they used to tout the Photoderm for tattoos but too many people were left with scars. One thing I have definitely learned is that sometimes the science doesn't match up with the reality. Maybe there is something we don't understand. Let's talk about it. It could be fun.

Since you "outside the box" let's talk about something we have been tattoos recently. For those colors that we don't remove with our Q-switch we have been using Profractional ablative erbium. Ablative was tried many years ago with CO2 and of course there are still some who choose to use chemicals. the problem with those methods is the body just doesn't heal and leaves scars. obviously the idea is to remove the entire layers of skin where the pigment lies. We have recently been trying profractional, using a 20% coverage and anywhere from 200-400 microns depth. It seems to be working and leaving no ill effects. It's still too early and we are using different depths and densities to find the optimal settings but we are definitely getting reduction of color and no scars.

A couple of questions on the first topic though. what is "pretty well"? Are we talking lightening or removal? Are you going after all colors or just the darker? I'm guessing skin types 1-2?

Finally, you could of been very offended by my blanket statement and I appreciate your cordial response. i'll try to tone it down.

05.23 | Unregistered Commenterdexter

Outside the Box and Dexter: I hope you both continue with this discussion. Some people have said they use the Palomar R for finishing a tattoo, others say Lux G and still others suggest Fractional.I downloaded a stack of reports on tatttoo removal last night but I doubt this area is included. I even called Dr.Tattoff's office since he has been doing this longer than anyone I know. (Internet ) They said ABSOLUTELY do not use IPL on tattoos. My head is spinning.. bcm09

05.23 | Unregistered Commenterbcm09

Dexter-

Sorry to take so long to get back to you, I didn't realize my two cents would stir things up at all.

I have the Cutera IPL and have been using it on tattoos with anything from zero clearance to nearly 100%. The variables are too numerous to mention as to what will help it breakdown the inks with a treatment, and I have had results that are all over the board with colors and black even using the same machine. The local PS is using a MedLite and to be honest, their results are no better than mine for about 25% of their price. Several patients have used the products like 'tat-b-gone' and 'wrecking balm' with variable success also. I guess my perception of tattoos is it is very much a roll of the dice if you will get anything and where the progress will stop. I have treated FST 2-6 (yes 6) for tattoos and scarring has been minimal. Hypopigmentation on anyone beyond an FST3 has been transient, usually resplved by the next treatment. I start low, go slow with the joules. FST 2-3: starting around 15-18 depending on the body part and actinic bronzing of the area. FST4 usually starts around 13-14. FST5 &6 usually no more than 6-8J until we determine the potential for hypopigmentation.

I hope this is helpful for anyone out there looking for an additional use of any of their expensive machines!

Dexter,

Have you had more experience with the profractional on tattoos?

02.6 | Unregistered CommenterCanMD

I have been using the Pixel Laser for the last two years for hard to remove colors (sky blue & green). Stacking between 50-70 tx, and then making multi- passes over it again. This will of course leave holes in the skin going as deep as I go. Can not use an antibiotic ointment until the next day, or you will prevent the holes from closing. Then in 4-6 weeks I will use the q switch yag on them (1064) which will cause the holes to close up. I have treated more then 200 patients in this manner with a 90% complete removal rate. I will not even attempt to use the yag on these colors. Have done IPL for Tattoo Removal, will only use it on faded tattoo's to bring the ink closer to the surface, with the same filter used for pigmentation.

We tried the glycolic injections a couple of years ago to remove permanent eyebrows. We did mulitple treatments. It didn't work.

06.15 | Unregistered CommenterEC

I have been using the Pixel Laser for the last two years for hard to remove colors (sky blue & green). Stacking between 50-70 tx, and then making multi- passes over it again. This will of course leave holes in the skin going as deep as I go. Can not use an antibiotic ointment until the next day, or you will prevent the holes from closing. Then in 4-6 weeks I will use the q switch yag on them (1064) which will cause the holes to close up. I have treated more then 200 patients in this manner with a 90% complete removal rate. I will not even attempt to use the yag on these colors. Have done IPL for Tattoo Removal, will only use it on faded tattoo's to bring the ink closer to the surface, with the same filter used for pigmentation.

I have been using the Pixel Laser for the last two years for hard to remove colors (sky blue & green). Stacking between 50-70 tx, and then making multi- passes over it again. This will of course leave holes in the skin going as deep as I go. Can not use an antibiotic ointment until the next day, or you will prevent the holes from closing. Then in 4-6 weeks I will use the q switch yag on them (1064) which will cause the holes to close up. I have treated more then 200 patients in this manner with a 90% complete removal rate. I will not even attempt to use the yag on these colors. Have done IPL for Tattoo Removal, will only use it on faded tattoo's to bring the ink closer to the surface, with the same filter used for pigmentation.

I have been using the Pixel Laser for the last two years for hard to remove colors (sky blue & green). Stacking between 50-70 tx, and then making multi- passes over it again. This will of course leave holes in the skin going as deep as I go. Can not use an antibiotic ointment until the next day, or you will prevent the holes from closing. Then in 4-6 weeks I will use the q switch yag on them (1064) which will cause the holes to close up. I have treated more then 200 patients in this manner with a 90% complete removal rate. I will not even attempt to use the yag on these colors. Have done IPL for Tattoo Removal, will only use it on faded tattoo's to bring the ink closer to the surface, with the same filter used for pigmentation.

Hi all
Our Medical Spa is in the process of investing in a multipurpose platform to increase the services of our clinic. I have been researching the different brands and have narrowed our search down to the above 3.

If you use/have used any or all of the above 3 brands, what has been your experience in terms of results/patient satisfaction, company's aftersales service and financial return on investment.

I am eternally grateful to all those that take the time to respond.

Regards
Dr Kamlen Pillay
Cape Town South Africa

04.1 | Unregistered Commenterdumb

Hi all
Our Medical Spa is in the process of investing in a multipurpose platform to increase the services of our clinic. I have been researching the different brands and have narrowed our search down to the above 3.

If you use/have used any or all of the above 3 brands, what has been your experience in terms of results/patient satisfaction, company's aftersales service and financial return on investment.

I am eternally grateful to all those that take the time to respond.

Regards
Dr Kamlen Pillay
Cape Town South Africa

Interesting discussion. Removing tattoos is a hot business, by any meaning...

You should be aware that you will have best results when the energy is absorbed by the ink by 100 percent. In any other case it is only heated and will be burned even deeper into the dermis.
You never know what pigment ink have been used doing the tattoo. When it comes to mixed ink and colors you cannot remove the tattoo completely, only lighten it for a cover up.
Frequently you will remove about one third of the remaining ink in every session, great results in the first ones, but it goes into eternity because two thirds are remaining in every session.

Like mentioned before you should stay away from Rejuvi. Since its alkaline the results are unpredictable, it may be burning itself deeper and deeper by liquifing the skin lipids.

In Europe there is a treatment called Tattoo Erase which can remove all colors, but has a small risk of hypertrophic scars. They will fade over time.

04.17 | Unregistered CommenterPBarker

Interesting discussion. Removing tattoos is a hot business, by any meaning...

You should be aware that you will have best results when the energy is absorbed by the ink by 100 percent. In any other case it is only heated and will be burned even deeper into the dermis.
You never know what pigment ink have been used doing the tattoo. When it comes to mixed ink and colors you cannot remove the tattoo completely, only lighten it for a cover up.
Frequently you will remove about one third of the remaining ink in every session, great results in the first ones, but it goes into eternity because two thirds are remaining in every session.

Like mentioned before you should stay away from Rejuvi. Since its alkaline the results are unpredictable, it may be burning itself deeper and deeper by liquifing the skin lipids.

In Europe there is a treatment called Tattoo Erase which can remove all colors, but has a small risk of hypertrophic scars. They will fade over time.

04.21 | Unregistered CommenterPBarker

Tattoo removal is relatively simple and there are many methods to achieve it including abrasion, excision, grafting, laser, glycolic, tca, cryotherapy and chemical such as tattoo erase and rejuvi. There are also numerous bogus home methods. However the crux of successful tattoo removal is minimising the trauma caused to the skin in trying to achieve it.

Therefore the more aggressive the treatment the faster and more effective the removal but the higher the skin trauma and occurrence of scarring. This is same for any method or technology.

Having dealt with the rejuvi for many years it has proven to be effective but as it is applied by tattoo machine in the same manner, thus good skill is required to apply the treatment correctly. Over zealous treatment, such as excessive puncture depth or overworking an area can result in too much trauma and hypertrophy. If treatment is too light then there may be little or no interaction between the pigment and rejuvi and it will not work.

Of course also important is the aftercare process as the skin is broken there are risks of infection if the patient does not look after it correctly. We have also identified there are areas which are more sensitive to treatment or more problematical because of high mobility or abrading etc. and it is only suitable for skin types 1-4.

In use the Rejuvi is generally faster and more effective in comparison to laser and if carried out correctly has relatively low risk and low problems is not color selective and does not destroy melanin or hair follicle cells. If you end up with an open wound though then something has gone badly wrong.

In comparison to laser there are other considerations, in 2003 the joint European commission carried our tests in laser removal and tattoo pigment. Prior to 2003 in Europe it was legal to use AZO based pigments which were later found to be carcinogenic and subsequently banned. However they found that by attacking these pigments with laser that carcinogenic amines were then being released into the body.

REF: http://ec.europa.eu/consumers/cons_safe/news/eis_tattoo_risk_052003_en.pdf

As I said at the start tattoo removal is simple but there are many other aspects which then make it more complex unfortunately many patients who demand removal and even many clinics and technicians are not always correctly informed to advise patients accordingly or turn unsuitable ones away.

05.5 | Unregistered CommenterAndy

Since Rejuvi contains toxic ingredients like Trolamine there is no reason to puncture this cream (!) into anyones skin. Trolamine is banned for cosmetic purposes. Tattoo Erase is not the holy grail but the technique is similiar and there are no toxic substances.

05.7 | Unregistered CommenterPBarker

Since Rejuvi contains toxic ingredients like Trolamine there is no reason to puncture this cream (!) into anyones skin. Trolamine is banned for cosmetic purposes. Tattoo Erase is not the holy grail but the technique is similiar and there are no toxic substances.

05.9 | Unregistered CommenterPBarker

Rejuvi does not contain "Trolamine". Rejuvi does contain Triethanolamine which is commonly used in many cosmetic products as an emulsifer and ph balancer. It is commonly used in skin lotions, cleansers, milks, eye gels, mositurisers, shampoo, shaving foam etc.

All the ingredients in Rejuvi tattoo remover are approved by FDA and ESIS for cosmetic products and are all commonly used worldwide in cosmetics and food products.

07.2 | Unregistered CommenterAndy

Hi Andy,
Trolamine and Triethanolamine is the same stuff: http://en.wikipedia.org/wiki/Triethanolamine (see the third box on the right). It must be cool to be so confident about false information.

07.10 | Unregistered CommenterPBarker

Hi Andy,
Trolamine and Triethanolamine is the same stuff: http://en.wikipedia.org/wiki/Triethanolamine (see the third box on the right). It must be cool to be so confident about false information.

08.2 | Unregistered CommenterPBarker

Hi Andy,
Trolamine and Triethanolamine is the same stuff: http://en.wikipedia.org/wiki/Triethanolamine (see the third box on the right). It must be cool to be so confident about false information.

10.21 | Unregistered CommenterPBarker

Hi Andy,
Trolamine and Triethanolamine is the same stuff: http://en.wikipedia.org/wiki/Triethanolamine (see the third box on the right). It must be cool to be so confident about false information.

10.28 | Unregistered CommenterPBarker

Hi Andy,
Trolamine and Triethanolamine is the same stuff: http://en.wikipedia.org/wiki/Triethanolamine (see the third box on the right). It must be cool to be so confident about false information.

11.1 | Unregistered CommenterPBarker

For everyone who is interested, Rejuvi is now out of market across Europe for safety concerns:

http://www.timesofmalta.com/articles/view/20100522/local/tattoo-remover-withdrawn-from-the-market

11.5 | Unregistered CommenterPBarker

Does anyone know of a product called elimin ink?? does it work?? Also Patient who had eyebrows done not sure what kind of ink /pigment used would it be safe to use laser or would it make it worse??? what laser and settings. Thanks for your input.

12.22 | Registered Commenterjmc

I had rejuvi done n it took two nhalf months to heal n end up with hypertrophic scars the worst pain I ever felt n now even looks worse than befor big big mistake what do I do

02.8 | Unregistered Commenterscared

I am not a physician but I found this board while researching glycolic acid tattoo removal. I had this done three weeks ago and wish I found this thread before the removal as it went HORRIBLY wrong. I don't know what is considered a full thickness open wound but I can only assume from the term that I have one. I have seen three doctors and have to schedule with a plastic surgeon this week for what I was told is a deep second degree burn that will need skin grafting. It is excruciatingly painful and in retrospect, I cannot believe I was so stupid to let someone tattoo acid into my skin. STAY AWAY FROM THIS STUFF. If you want pictures, just let me know your email and I will send them to you. I want anyone considering this method to save themselves a lot of pain and mental anguish. Tell them to run the HELL away from this method.

01.1 | Unregistered CommenterARussell

(Scared) you didnt leave a email to contact you please would love too see your pics of the acid treatment with a tattoo process! my email is fiveamsunshine@aol.com thanks

I would also like to see the results of the glycolic for tattoo removal.Do you know what percent and ph amount? Thank you Madonna

10.10 | Unregistered CommenterMadonna

First of all IPL is contraindicated in tattoo removal. If anyone has been using it and not caused a hypertrophic scar then they have been lucky up to this point.

Second Injecting acid in the dermis can lead to a dermal necrosis requiring a full thickness graft and again will in all likelihood create a scar.

As of today the gold standard in tattoo removal is Q Switched lasers or Pico lasers.

10.10 | Unregistered Commentergm

Agree with above. Basic laser physics. IPLs emit pulses in miiliseconds, so much longer than thermal reaction time of pigment particles , thus to much heat delivered to surrounding tissue and high risk of thermal destruction, injury to surrounding tissue.
Drilling with fractional Erbium prior to Q switch works well in difficult tattoos.

10.22 | Registered CommenterLouis du

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