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Since tattoo removal is a personal option in most cases and is considered a cosmetic procedure, most insurance carriers will not cover the process unless it is medically necessary. Physicians or surgery centers practicing tattoo removal may also require payment in full on the day of the procedure. If you are considering tattoo removal, be sure to discuss associated costs up front and obtain all charges in writing before you undergo any treatment. WebMD Medical Reference

To have a tattoo removed, you want to make sure you find a reputable dermatologist or cosmetic surgery center to ensure proper treatment and care. If possible, you should obtain a recommendation from your family doctor for a dermatologist or skin surgery center that specializes in tattoo removal.

Thanks to newer technology, laser tattoo removal has become much more effective with very little risk of scarring. Laser treatment is often safer than many traditional methods such as excision, dermabrasion or salabrasion (using moist gauze pads saturated with a salt solution to abrade the tattooed area) because of its unique ability to selectively treat pigment involved in the tattoo. In many cases, certain colors may be more effectively removed than others. It is known that blue/black tattoos respond particularly well to laser treatment -- the response of other colors is under investigation. Remember, the information provided here is designed to provide general information only and is not a replacement for a doctor's advice. For details pertaining to your specific case, please arrange a consultation with a physician experienced in the use of tattoo lasers.

There are minimal side effects to laser tattoo removal. However, you should consider these factors in your decision:

• The tattoo removal site is at risk for infection. You may also risk lack of complete pigment removal, and there is a slight chance that the treatment can leave you with a permanent scar.
• You may also risk hypopigmentation, where the treated skin is paler than surrounding skin, or hyperpigmentation, where the treated skin is darker than surrounding skin.
• Cosmetic tattoos like lip liner, eyeliner and eyebrows may darken following treatment with tattoo removal lasers. Further treatment of the darkened tattoos usually results in fading.

Depending on the size and color of your tattoo, the number of treatments will vary. Your tattoo may be removed in two to four visits, though many more sessions may be necessary. You should schedule a consultation, during which time a trained professional will evaluate your personal situation and advise you on the process. Treatment with the laser varies from patient to patient depending on the age, size and type of tattoo (amateur or professional). The color of the patient's skin, as well as the depth to which the tattoo pigment extends, will also affect the removal technique. In general, this is what will happen during an office visit for tattoo removal using the newer lasers:

• Protective eye shields are placed on the patient.
• The skin's reaction to the laser is tested to determine the most effective energy for treatment.
• The treatment itself consists of placing a hand piece against the surface of the skin and activating the laser light. As many patients describe it, each pulse feels like a grease splatter or the snapping of a rubber band against the skin.
• Smaller tattoos require fewer pulses while larger ones require more. In either case, the tattoo requires several treatments and multiple visits. At each treatment, the tattoo should become progressively lighter.
• Immediately following treatment, an ice pack is applied to soothe the treated area. The patient will then be asked to apply a topical antibiotic cream or ointment. A bandage or patch will be used to protect the site and it should likewise be covered with a sun block when out in the sun.

Most patients do not require any anesthesia. However, depending on the location of the tattoo and the pain threshold for the patient, the physician may elect to use some form of anesthesia (topical anesthesia cream or painkiller injections at the site of the procedure).

Because each tattoo is unique, removal techniques must be tailored to suit each individual case. In the past, tattoos could be removed by a wide variety of methods but, in many cases, the scars were more unsightly than the tattoo itself. Patients with previously treated tattoos may also be candidates for laser therapy. Tattoos that have not been effectively removed by other treatments or through home remedies may respond well to laser therapy providing the prior treatments did not result in excessive scarring.