What Are We Trying To Reverse?
A tattoo is created when a manual or motor-driven needle punctures the skin, allowing ink to run into the hole, leaving a deposit in the dermal layer. Tattoo needles are solid and do not actually inject the ink into you. Homemade tattoos often fade as they are either too shallow (the ink heals out) or too deep (the immune system carries the particles away). Tattoo inks are currently classified by the FDA as a food additive, and pigments vary from manufacturer to manufacturer.
Dermabrasion - This method involves “sanding” the surface of the skin to get down to the dermal layer where the tattoo ink is deposited, in a sense “erasing” it. Usually the skin is “frozen” with a topical anesthetic and then the skin is peeled away with an instrument like an industrial sanding wheel.
Excision - One of the oldest methods of tattoo removal, this involves numbing the area with a local (injected) anesthetic and surgically cutting away the skin where the tattoo is and sewing up the resulting wound. For large tattoos, a skin graft from somewhere else on the body may be required. This will leave a scar, and in the case of a graft, two scars (one where the tattoo was and one from where the skin graft was taken).
Laser Removal - The most modern method, this is the option most touted by plastic surgeons and dermatologists. Different colors of laser light break up the ink particles so that the skin’s natural system can carry them away. This method is performed without anesthetic and is often described as feeling like being splattered with hot grease or being snapped with a rubber band. Many treatments may be required and more colorful tattoos are harder to remove as the multiple colors respond differently to the different colors of laser light. Sometimes the skin stays discolored following treatment and sometimes not all of the tattoo can be removed.
The most important thing to realize is that NONE of the modern tattoo removal methods will restore the skin to the smooth blankness of pre-tattooing. Take the time to find the art and an artist who is appropriate to you if you are going to commit to the inked artwork.
If you need to hide a tattoo temporarily (weddings, family gatherings, etc.), there are makeup kits for that too. Kits include makeup and application instructions. Be sure to give this a test run before that crucial day so you can make sure you know what you are doing! Choose by shade of skin tone.
If you'd like more information about tattoo removal, you might like
101 Questions About Skin That Got Under Your Skin... Until Now by Faith Hickman Brynie or
Laser Dermatology by David J. Goldberg