Page under complete revision. We aim to complete this section by the 30th of August 2016.
For as long as there have been tattoos there had been a demand for their removal even long before the advent of modern technology and laser treatments. Salabrasion or salation is the first effective form of tattoo removal and it had been an effective tattoo removal technique for several hundreds years. Originally Salabrasion was used by literally rubbing the tattoo using salt until the upper part of the dermis become exposed to the sodium chloride. Modern technology has not made this technique obsolete as it is still very effective and inexpensive. Skin resurfacing in salabration is key for effectively applying the osmotic effect induced by the sodium chloride. Innovation in aesthetics has introduced new devices for skin resurfacing amongst those are radio frequency or electrical arcing devices. Other devices can be used for effective resurfacing before applying salabration (or Osmosis) ie microdermabrasion devices, microneedling devices injecting the saline salt solution directly into the dermis, certain specialised cosmetic peels and any method currently known to expose the upper dermal layer to the action of the alt This can be coupled with order treatments to There are several.
Why Radio frequency or electrical arcing for skin resurfacing before Salabration?
The radio frequency or the electrical arcing devices have the double function to remove the epidermal layer and also heat up and break down the tattoo pigments at the same time. There are different radio frequency devices or electrical arcing devices with the intended purpose of tattoo removal. The electrical arcing ablation can be carried out at different intensities. Also rediofrequency devices or electrical arcing has the double effect of not only performing the required skin abrasion necessary for the osmotic effect to take place but it also breaks down part of the tattoo pigments (like lasers do) which contributes to speed up the tattoo fading process.
- The first level of intensity consists in simply removing the epidermis. This is done by setting the specific device at very low power levels to ablate the epidermal layer and then removing with a cotton pad impregnated with non flammable antiseptic the carbon residues until exposing the upper dermis. This alone will suffice to then apply osmosis either by applying sterile salt or a sterile salt paste.
- The second level of intensity consists in not only removing the epidermal layer as required by the epidermal abrasion, necessary for the osmotic effect to take place, but also break down the tattoo pigments inside the dermal layer where they reside. This can be done in stages by first removing the epidermal layer as described above and then
Level number to is removing the epidermal layer and then spraying quickly on the upper dermal layer. This has the function of breaking down the tattoo pigments inside the dermis.
However as we know, the tattoo pigments can be also distributed relatively deeply inside the dermis therefore the a degree of deeper ablation can be required in order to have an impact on the deeper pigments. In order to do this usually a double paass is performed on the upper dermis. As this is done normally the part starts bleeding. Please bear in mind that the deeper the ablation the higher the likely hood of permanent adverse effects including scarring.
Ussualy is is the tattoo removal practitioner the one howdecides the degree of ablation. This is done according to the clients desires and his own previous weperience. For example if the client is haapy incurring in a higher likelhood of incurring into scarring but going thorugh less treatemtns then a higher degree of ablation can be carriyed out.
Also the piments can be reached inside the dermis with a single ablation. By setting the device at relatively hogh poiwer the arc has the function to als reaching the lower part of the dermis.
Salation has also its degree of intensity. Sanation can be carried out in twom main ways
1 applying a dense paste made of sterile saline solution and sterile fine sodium chloride. This has relatively high intensithi results if compared to applyng only sterile fine salt.
2. Applying sterile fin e salt on its own. The duration of thesodium chloride applycation has a dierect impact on the intensity of the treatment. The loger the salt is applied the higher the treatment intensity and the more the osmaotic effect on the tattoo pigments, therefore the more the fading of the tattoo after each session.
The salation has the effect of drawing up the colour pigments toward the surface fot he skin. The longer the sodium clhoride is left on the part the more the colour pigments are drawn towards the surface, therefore the more the tattoo will fade..
Keeping the time of application the same the two differentosmeosis methods have different ososis intensity. Generally the sterile sodium chloride paste has a stronger efficacy than fine starile salt. This is why it is used in permanent make-up removal. In permenent make up removal it is not practical to bandage the area treated due to the location of the tattoo, therefore the sterile paste is applied so that the osmotic effects are so effective that the application is only a few minutes in order to achieve the desired result.
The devices used for Electrical Thermabrasion.
As we have seen osmosiss on its own is not sufficient in order to remove or fade the tattoo pigments isf the sodium chloride is not in contact with the dermis or at least upper dermis in order to induce an effective osmosis. There are several wys of removing the epidermal lasyer and allow the salt ot get in touch with the tattoo pigments. The use of electrical arcing (also referred to as Plasma) and thr use of radio frequency devics is once of the best options for this type of combined aesthetic treatment. This si because the electrical arcing or radio frequency treatments have the effect of not onnly abrading the area like , microdermabrasion etc, but it also have the effect of break down the tattoo pigments. Ten the broken pigments will be more easily drawn to the surface by the osmosis. Thay are often reffereed to as ¨radion frequency devices¨. The
This depends ont eh overall intesity of the treatment. The higher the intensity of the treatment the longer the part will take in order to reover fully. Ussually the scab form within 3 to four days from the treatment and falls off on its own accord winth 10 days fornt eh treatment. Howver the area may stil feel tened to the touch in or tender in general up to a few weeks after the scab has fallen off.
Generally the healing time, provided that the area is not infected, is a maximum of 10 days and it is marketk by the scabbs falling off on their own accord.
The main adverse effect are infections. One of the main differences betweeen this type of treatment and laser tattoo removal is that with Thermo sabrasion the likelihood hood of contractoing an infection are higher. This is because the treatment will effectlvey leave an open wound which during the healing period is suceptible to localised inflammatory infections. The likelihood of infections are essily minimised by using the apropriate aftercare and keeping the area clean untl the scab have formed fully. Once the scab have formed the likelihood of contracting a localised inflamatory infection is very low because the scab forms an effective barrier. The scab must not be removed forcefuly. These scbas are usually relatively thick and sometimes contain a relatively large amount of the tattoo colour removed by the procedure.. however are very easily avoided.
A Common adverse reaction of samabration is the formation of a temporary hpertrophic scar. This forms especially if the area has been subject to an infection. Usually this hypertrofic formation subsides on its own.
So far no cases of hypo pigmentation has been reported. The main adverse reaction can be scarring witch can happen if the treatment has been carried out too intensively or the part has contracted an infection. Although the former eventulity has rarely reported to be the cause of scarring the latter is more likely to produce scarring. This is because the prolonged infection can cause sometimes even sever damage to the dermis, hence causing the scarring.
Hyper pigmentation is also possible after the use of this aesthetic technique, this is because this involves the skin regeneration and skin resurfacing. All skin resurfacing treatments require total sun protection in order to avoid hyper pigmentation. Hence, in order to minimise this likelihood, the client must avoid direct sun exposure while applying sunscreen a up to three months after the last treatment.
About the results.
The tattoo fades depending on the type of tattoo see kirbey desai scale. And mainly also depending on the overall intensity of the treatment. Usually the higher the intensity of the overal treatment the more the pigments are drawn intside the scab. Usually the scab will visibly contain the colours of the tattoo that has been treatmentd. The highe rthe internsity of the treatmrntment the more the igments inside the scab. It is not unusual to see scabs containing green , , yeloow and blue colours afterthe treatment of muticlour tattos.
Since tge operator has double control over the intensity of the treatment:
- ie the intensity of the thremaabrasion treatment and
- the osmosis intensity the beauty professional has more control ofver the amount of ink being reduced after ech treatment.
The intensity of the thremabrasion is controlled by the deppth of the ablation. This is controlled by the intensity of the devidce setting, the sweeping speed of the arc during the spraying operation and of cource the number of passes on the area. The deeper the ablation the more the tattoo will fade after the treatment. This is independent from the further salation used to spped up the tattoo fading. Hence the more intense the electrical arcing treatment the
The oomosis will have th e second effect on the tattoo to draw the pigments out to the surface, This coupled with the healing process has usually dramatic fading effects on the tattoo. The longer the sperile sodium clhoride is kept on the treated area the stroger the osmosis effects and the mor eth epigments will be drawn to the surface. Conseqintly the more the tattoo will fade.
How many treatments are required to remove a tattoo?
As we have seen tattoo are all different. The usial rule of the higher the points on the kirky Desay Scale the more challenging the tattoo will be to be removed, and like in case of laser removal treatments , it is sometimes impractical to achieve complete removal of the tattoo without leaving a scar. However most tattoos are ofen removed more easily than lasers due to the double fading effect of elelctrocal thermabrasion and salation. The average treatments required varies between 3 to 5 for an average tattoo.
How much of an areas can be treated at a time?
There is no limit to the area that can be treated with the electrical thhermabrasion. The higher the area treated the more likely the contraction of an infection may be due to the extennt of the area treated. Larger area or larger wounds are more difficult to protect against bacterial infections during the healing process. It is the choice of the aesthetic professional to dedicde what are may be appropriate for each individual case. Like with laser treatemnts, most extensive tattoos are split in different areas in order to fade a large tattoo. Generally it is much easier to remove
In general the medium intensity treatment fades a greater degree of tattoo pigments than most Q-Switched lasers.
Since this type fo treatment is colour blind it is one of the preferred method to fade multicolour tattoos. As we know multi colours tattoos are very challenging to be faded with lasers.Some colours cannot be fades by lasers at all. This is not the case with salation anf theremabrasion using leelctrical plama as this type of treatment is colour blind and tends to fade al colours indiscriminately. It is not unusual to see scabs litrerey gree of yellow depending on the colours of the original tattoo.