​In the early 1990s, American actor Johnny Depp broke up with then-girlfriend actress Winona Ryder. What once read “Winona Forever” on his bicep was stripped of the "na" and his tattoo now reads "Wino Forever".

When the relationship goes bust, what happens to that impulsive idea to flaunt her name on your bicep or his name on your ankle?

Tattoo removal methods

Hands down, the method of choice to get a tattoo removed is laser technology. It targets the tattoo pigment. It is non-invasive. It beats the don’t-try-this-at-home, do-it-yourself ways of sanding or chemically burning the skin. But even with advanced technology, getting rid of the ink isn’t easy.

"A laser in the wrong hands when you crank up the power… can burn the patient and cause horrific scarring," said Professor Colin Song, Visiting Consultant, Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital (SGH), a member of the SingHealth group. "It’s got to be in the hands of the people who are trained to use these lasers."

No complete solution

However, when it comes to tattoos, you can never erase the past completely.

"No matter how good your laser technology is, there will always be a silhouette of the tattoo," Prof Song said.

Romance gone wrong aside, other reasons for getting a tattoo removed in multi-ethnic Singapore include religion, parental objection and, sometimes, for the sake of a job.

Prof Song has dealt with young patients coming to him after they’ve tried cruder home remedies, such as attempting to sand off their tattoo with salt or using acid to erase the ink, leaving the patient’s arm looking like an unpeeled potato. In such cases, he said, the treatment is for a burn rather than removing a tattoo.

"In the old days, you used to swap a tattoo for a scar. Nowadays, we can lighten your tattoo without incurring a scar, provided you use the laser technology judiciously of course," said Prof Song.

Simply put, a very short pulsed light laser is calibrated to a certain wavelength on the colour spectrum that complements the tattoo colour being targeted. The laser light is absorbed by the tattoo, the tattoo pigment fragments under the laser’s effect, and the immune system’s natural processes remove the fragments from the skin.

It can take many treatments with laser technology, one of the most advanced methods, to remove a tattoo.Lasers target the tattoo pigment, breaking up the colour particles into pieces tiny enough for the body’s natural processes to clear out.

Tattoo removal is painful

How completely a tattoo can be removed depends on the tattoo – its colour, age, size and location – and the number of treatments the patient undergoes. The patient’s own skin condition and health matter too. Asians tend to produce more melanin, which is responsible for skin colour, so that means the silhouette of a tattoo which has been removed could stand out more than if it was done on a lighter-skinned individual.

Colourful tattoos mean a more painstaking removal process, since each colour area will need a different laser calibration. Also, the laser needs to penetrate the skin only as deep as the tattoo pigmentation goes. If the laser beam is too weak, the tattoo colour won’t fragment and the ink won’t disappear. If it is too powerful, it can burn or damage surrounding, healthy tissue.

And it hurts. It can feel like needle pricks, a bad sunburn or a rubber band being snapped against the skin.

Ref: T12