Tattoo removal

What is tattoo removal and how does it work?

Tattoo removal relies on selective photothermolysis — the laser beam passes through the skin and is absorbed by the tattoo pigment, delivering a pulse fast enough (nanoseconds with Q-switched lasers, faster still with picosecond lasers) to break the pigment particles apart mechanically. The lymphatic system can then gradually clear those fragments away over weeks and months.

The main laser technologies used in Estonia are Q-switched Nd:YAG (1064 nm — suited to darker skin and to dark blue and black pigment), Q-switched 532 nm (suited to red, orange and yellow pigment) and the picosecond laser (PicoWay, PicoSure — faster pulses, less thermal damage, better results on coloured pigment). The picosecond laser is preferred in modern practice, but Q-switched remains effective and more widely available.

Success depends on many factors: pigment colour (black and dark blue respond best; white, yellow and light green worst), the age of the tattoo (older tattoos respond better), the depth of the pigment, the quality of the tattoo (professional work sits deeper than amateur work), the patient's skin type and the state of their immune system. An experienced doctor gives a realistic prognosis after an initial assessment.

Tattoo removal prices and how the procedure runs

The price of tattoo removal depends on the size of the tattoo, the number of colours and the laser used. Sessions on a single small tattoo start from 50–80 €; larger and coloured pieces fall in the 100–300 € range per session. The picosecond laser is typically more expensive than Q-switched, but often more effective on coloured pigment. A course of several sessions is standard — full removal needs 6–15 sessions at 6–8 week intervals.

A typical visit begins with a consultation, where the doctor assesses the tattoo (size, colours, depth, professional versus amateur), the skin type (Fitzpatrick I–VI) and what the patient wants. In some cases a small test is carried out — a small part of the tattoo is treated to see how the pigment reacts to the laser. Protective goggles are always worn by both the patient and the staff.

The procedure takes 5–30 minutes depending on the size of the tattoo. With each laser pulse the patient feels a light needle prick or the snap of an elastic band, sometimes a sensation of heat. For larger tattoos a topical numbing cream is applied 30–60 minutes beforehand. Experienced clinics such as Health Clinic in Tallinn, ProAge Ilukliinik in Tartu and Dr. Mari Laasma Ilukliinik use devices with integrated cooling, which reduce discomfort and protect the surrounding skin.

How do you choose a clinic for tattoo removal?

Tattoo removal is a medical procedure regulated by the Health Board in Estonia — always check the clinic's licence on the Health Board website. Q-switched and picosecond lasers are medical devices whose use requires trained staff and a doctor or specially qualified healthcare professional on site. To avoid burns, scarring and pigment changes, the operator must know the safe parameters for different skin types and pigment colours.

Pay attention to the technology used. An experienced clinic will use a picosecond laser (PicoWay, PicoSure) where possible — it is particularly effective on coloured pigment and leaves fewer complications. Q-switched Nd:YAG remains a reliable choice for black and dark blue tattoos. For people with darker skin (Fitzpatrick IV–VI) Nd:YAG is essential, because alexandrite and diode lasers can cause hypopigmentation.

At the consultation the doctor must give a realistic prognosis — complete removal is not always possible (especially with coloured or old pigment), and even at best a faint lightened shadow often remains. A promise of 100% removal in three sessions is a warning sign. Prefer a clinic with a written consent form, a preliminary test patch and a structured course plan.

Risks, side effects and contraindications

The side effects of tattoo removal divide into the common (swelling, redness, blisters, crusts for one to two weeks, temporary pigment change) and the more serious. The latter include scarring (hypertrophic scars in particular), permanent hypopigmentation or hyperpigmentation, an allergic reaction (especially with iron- or titanium-based pigments) and paradoxical pigment darkening (with some coloured pigments). Choosing the right laser and an experienced operator reduces these risks considerably.

Contraindications are pregnancy, a fresh tan or sunbed use within 4 weeks before the procedure, photosensitising medication, active skin infections in the treatment area, extensive pigmented lesions or suspected melanoma within the tattooed area, autoimmune disease in an active phase, blood clotting disorders and a tendency to keloid scarring (a relative contraindication). With diabetes it is worth consulting your treating doctor.

After the procedure avoid the sauna, swimming pools, intense exercise and the sun for two weeks. Use SPF 50 sunscreen for at least 4 weeks. Blisters must not be broken open — let them dry out on their own. If a fever, unusual swelling or severe pain develops, contact the clinic immediately. Some patients see a change of colour in the tattoo after treatment — a darkening of the pigment that is normal and settles within the first week.

Tattoo removal in Estonia's larger cities

In Tallinn, tattoo removal is offered by Health Clinic, Dr. Mari Laasma Ilukliinik and Medic-Esthetic Ilukliinik, where both Q-switched and picosecond lasers are available. The capital has the widest choice of technology, letting the doctor pick the right device for each tattoo. The wait for a consultation is usually 1–4 weeks.

In Tartu, tattoo removal is offered by ProAge Ilukliinik and Medical Aesthetics, using medical-grade Q-switched Nd:YAG lasers. Clinics in Pärnu, Narva and the county centres mostly cover the basic cases (black and dark blue pigment) — for more difficult ones (coloured tattoos, very old amateur work) it is worth checking with the specific clinic. Since a course runs 1–3 years with sessions 6–8 weeks apart, choose a clinic that is geographically convenient.