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No Pain, No Gain, as Tattoo Regret Fueling Laser Removals

A tattoo removal treatment procedure being done in Boston. Photograph: Jonathan Wiggs/The Boston Globe via Getty Images Close

A tattoo removal treatment procedure being done in Boston. Photograph: Jonathan... Read More

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A tattoo removal treatment procedure being done in Boston. Photograph: Jonathan Wiggs/The Boston Globe via Getty Images

Jimmy McManus slides up his shorts and points a laser at his inked thigh to show how he can blast off unwanted tattoos.

The part-time electrician began offering the service at Chapel Tattoo in Melbourne eight months ago to address a byproduct of the global body art boom: tattoo regret. Removing the skin designs has become a roaring trade, with one in seven people expressing misgivings -- some enough to spend thousands of dollars for several searing laser sessions.

‘It’s a painful reminder to choose your tattoos a bit more carefully,’’ McManus, 30, says of the procedure he’s just demonstrated on his leg.

Chapel Tattoo isn’t the only studio to begin offering to undo its handiwork, entering a new line of business as ultrahigh-powered lasers pioneered by dermatologists make the procedure safer and more bearable. The American Society for Dermatologic Surgery estimates its practitioner-members did about 96,000 removal procedures last year, 52 percent more than in 2012.

“Tattoo removal is big business,” said Andrew Timming, an associate professor at the University of St Andrews’ school of management in Scotland. Tattoo parlors doubling as removal shops are “a brilliant business model because it creates its own demand.”

It also drives growth in laser devices. Revenue from sales of aesthetic equipment by publicly traded companies expanded 20 percent annually from 2009 to 2012 and is now worth about $1.25 billion, according to Cutera Inc. (CUTR), a supplier of laser and light-based medical devices from Brisbane, California. Israel’s Syneron Medical Ltd. (FDG) says it’s the industry leader, with 28 percent of the global market.

More Ink

One in five U.S. adults has a tattoo, according to a 2012 online survey of 2,016 Americans by the Harris Poll. That’s up from 16 percent in 2008. Many may end up changing their mind. Thirty-seven percent of people with inked skin regretted it after about 14 years, according to a survey of 580 people in the U.K. published in a letter to the British Journal of Dermatology last December.

“Tattoo-regret seems to take about 10 years to set in and, since tattoos were widely popular in the early 2000s and still are today, my suspicion is that we are only seeing the tip of the iceberg,” said Will Kirby, a dermatologist and medical director at Dr. Tattoff Inc., which runs a 10-store chain of tattoo-removal centers in the U.S.

Test Thigh

Stephanie, who works in Melbourne’s film industry, expects to pay about A$2,000 ($1,850) for as many as 10 laser sessions to remove an orange-sized tattoo around her navel. The red, yellow and black stylized sun cost her about A$150 17 years ago.

“I am happy to spend anything to get rid of it because I have to look at it every day and it makes me cringe,” said the 35-year-old, who asked not to be identified by her last name to protect her privacy. “I don’t really want a tattoo. And I don’t have the stomach I had when I was 18.”

Clients who initially want their tattoo erased often opt for lightening it and covering it with a better one once they’ve considered the cost and pain involved, according to McManus.

To demonstrate the procedure, he points a hand piece at his thigh. Beside him, the laser machine whirs like a movie projector. A small red dot appears on his skin. As McManus moves the beam along the outline of the image, the machine makes the sound of rubber bands snapping. Within seconds, a pale welt appears in the laser’s wake.

“That’s called frosting, which is a reaction of the laser smashing into your skin,” he says. “It’s excruciating. Some people just say, ‘I can’t do anymore.’”

Burning Smell

Celebrities Megan Fox and Mark Wahlberg are among those who have described the procedure.

“It’s incredibly painful,” Fox, 28, told Jay Leno on his television show in 2012, recounting the steps she took to have an image of Marilyn Monroe removed from her forearm.

Wahlberg underwent more than 33 treatments over three and a half years to erase several tattoos from his upper body and leg, the actor said in a 2012 interview on the Graham Norton Show. In addition to the pain, “you smell the skin burning,” Wahlberg, 42, told the U.K.-based entertainer.

Visible tattoos can be a barrier to employment, management researcher Timming found after interviewing more than a dozen managers involved in hiring staff.

“Most employers view tattoos negatively,” he said in an e-mail. “Some employers may very much like your tattoos, but still wouldn’t hire you because their main concern is that their customers are not offended.”

New Devices

Americans spend about $1.65 billion a year on tattoos, according to the Statistic Brain Research Institute. It counts 21,000 tattoo parlors in the U.S., each charging an average of $150 an hour. Parlors have also proliferated in the U.K., where insurance quotes for startup shops increased 388 percent in Scotland from 2009 to 2012, and 263 percent in Greater London over the period, according to research by online business insurance provider Simply Business.

Doctors from Miami to Melbourne are bracing for the fall out. Fortunately for people no longer enamored with their body art, removal devices have become more powerful and easier to use.

Laser has been the gold standard tool for more than a decade, said Mathew Avram, director of the Dermatology Laser & Cosmetic Center at Massachusetts General Hospital in Boston, which was one of the first to test the technology. But it’s evolving. The newest, pico-second equipment relies on pulses fired in trillionths of a second compared with the older, so-called Q-switched models that operate on nano-second pulses.

Hot Area

Cynosure Inc. (CYNO) introduced the first aesthetic laser device approved in the U.S. using pico-second technology in March 2013. Since then, the Westford, Massachusetts-based company has sold about 250 of the PicoSure units globally to doctors at $200,000 to $250,000 apiece, said Andrew Nutman, Cynosure’s head of marketing for Australia and New Zealand.

“Right now, the hot area is tattoo removal,” Michael R. Davin, Cynosure’s president and chief executive officer, said in a presentation in January.

Cutera of California is awaiting U.S. approval for its Enlighten unit that can operate at pico-second and nano-second pulse durations to clear a “wide range of tattoo colors, ink compositions and pigment concerns,” Chief Executive Officer Kevin Connors said on a May 8 earnings call. Shipments are expected to begin in the second half, he said.

The complexity and speed of the process, as well as the quality of the result, depend on the size of the tattoo, colors used, intensity of ink and the client’s skin type, said Avram at Massachusetts General.

Ice Packs

“When you fire a laser at a tattoo, you’re using as much energy as there is in the entire city of Boston, but you’re only doing it for a 750 trillionth of a second with a pico-second laser,” he said. “It shatters the tattoo particle into smaller pieces.”

From there, it can be ejected from the skin, chewed up by the body’s own scavenger cells, or taken away by the lymphatic system.

Removing a tattoo with a Q-switched device typically requires 10 to 20 treatments six weeks apart, said Terence Poon, a skin and laser specialist at the Neutral Bay Laser & Dermatology Clinic in Sydney, which treats 10 to 12 patients a week. Pico-second devices can shorten that to three to five treatments, he said.

Better Tolerated

The newer approach is also better tolerated, with pain typically managed with ice packs or blowing frigid air onto the skin instead of injections of local anesthetic, according to Poon. Complications of incorrectly lasered tattoos include a darkening of the ink, scarring from skin burns, a loss of skin pigment and allergic reactions, he said.

“There is a trend in our field toward people with less and less training performing the treatments,” Avram said. “I’d urge anyone looking to get one of these treatments to do some homework on who’s doing the procedure.”

Fifty-nine businesses across Melbourne now offer the service, according to telephone directory advertisements.

“There’s competition left, right and center,” said McManus, who received tuition from his employer, experimented on himself at home and undertook a week of courses in laser safety and tattoo removal.

To contact the reporter on this story: Jason Gale in Melbourne at j.gale@bloomberg.net

To contact the editors responsible for this story: Elyse Tanouye at etanouye@bloomberg.net Marthe Fourcade, Reg Gale

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