Beth Carbone knew it was time for a change when a doctor thought that the tattoo of a crescent moon, stars and heart on her left ankle was a lesion. “When I went to get the tattoo many years ago [at age 19], I wasn’t really completely sold on the idea and I ended up getting it very small,” said Carbone, 40, of Leola. “It looked more like a skin disease than a tattoo. I just got tired of people saying, ‘What is that?’ ”

Fortunately for Carbone, she had an option to remove the ink. She started laser treatments in October at Randali Centre for Aesthetic Medicine, 160 North Pointe Boulevard, where she works. The laser removes the tattoo by using a high-energy beam to shatter the ink, said Dr. Alice Cohen, who owns the Randali Centre. The immune system then recognizes the ink as foreign and takes it to the liver and kidneys for disposal. The process often takes weeks, and sometimes patients don’t notice a difference until they are shown pictures of what their tattoos looked like before, Cohen said. Carbone said her tattoo’s lightening was gradual at first; but, after four treatments, only an outline remains. “The third time was when I really noticed,” she said. “I’m anxious for it to be completely gone and just a memory.”

Annette Greer, who declined to give her age, also works at Randali; she said she noticed the sun tattoo on her upper chest fading only hours after the first of her six treatments. A small tattoo takes only minutes to treat. Sessions have to be spaced at least six weeks apart to give the ink time to fade, though some patients choose to go years between treatments because of the expense. The body also breaks down tattoos naturally over time, causing them to fade.

The cost of removing a tattoo depends on its size. A 3-inch-by-3-inch tattoo costs about $400 per treatment to remove at Randali. The color of the ink also influences the cost, said Dr. Teri McGinnis, of the Laser & Skin Surgery Center of Lancaster, 230 Harrisburg Ave. Yellow and green inks are difficult to remove and require more treatments than darker colors. Different colors have to be removed with different laser wavelengths. McGinnis has performed laser removal for 20 years and has done studies for the Food and Drug Administration on its safety and effectiveness. She says that modern lasers have a low risk of scarring, though they can cause changes in pigment, most often in people with darker skin. Cohen said some people also experience texture changes that make the area around the tattoo shinier. Some people’s skin will look new, but some will still have faint remains of the original image. The laser causes some pain. Cohen and McGinnis likened the feeling to being snapped with a rubber band. They do offer anesthetic cream, but said many patients find removal less painful than having the tattoo placed. Greer said she felt no pain, though the area around the tattoo swelled afterward and the laser caused slight bleeding. Cohen said most of her patients are relatively young. Many have multiple tattoos and want only some of them removed. Names are a common problem.“If you want to know a relationship is doomed, get a name tattooed,” Cohen joked.

An alternative to laser removal is TatGoneInk, which is a new ink that is applied over the tattoo, said Bonnie Fissella, a cosmetic tattoo artist at The Finished Line, 926 Stonebridge Drive. The body rejects the ink, as well as some of the old tattoo, after seven to 10 days, she said. “The age of the tattoo, how much ink was used and the color determine the success,” she said. Newer tattoos, and those that use black or brown ink, are easier to remove. Most tattoo removals take at least six treatments. Prices vary, but Fissella said a 2-inchsquare tattoo typically costs about $200 per treatment. It feels like getting any other tattoo placed, she said; but, afterward, the edges feel tight as the ink is rejected.

Tattoos can also be removed surgically, but McGinnis recommends that only for small ones. Starting this fall, however, there will be another option for those who want tattoos, but who acknowledge there might be a day when they won’t want them anymore. Freedom-2 Inc. has produced a new type of ink designed to disappear after just one laser treatment. It fades so quickly because the ink molecules are smaller than traditional ink and easier to shatter, according to a report in USA Today. Tattoo artist Johnny Rios, who works at City Line Tattoo, 917 N. Prince St., said that he hasn’t seen any interest in the new ink, but that he wouldn’t be insulted if a client decided to remove a tattoo he had created. “A person’s body is his temple and whatever he or she wants to do with it is OK with me,” he said. “If a painter loses their painting, they just paint another one.” For those who don’t mind having a tattoo, in general, but want a specific image gone, there is the option of covering it with another. Rios said most people seeking cover-ups are trying to get rid of a name. He said he sees about two cover-ups per week.

Many who get tattoos don’t regret them, though. Chad Fisher, of Gordonville, for example, has an image of Christ on a cross with “Forgiven” written below it; the image is on his shoulder blade. He and a roommate at Bible school in Dallas, Texas, got the tattoo when Fisher was 18. “It was kind of something to mark ourselves for Christ,” he said. Twelve years later, Fisher says he has no regrets about marking himself “for life.” He said that sometimes it’s a tool for talking about his faith. “I feel like it was a good decision,” he said. “I know I won’t ever regret it.” Fisher said the decision was “kind of a spur-of-the-moment thing,” though he asked his parents’ blessing before getting the tattoo. He advises others considering tattoos to understand any symbolism before getting the ink. Greer, who had the recent laser treatment to start the removal of her sun tattoo, said she doesn’t regret the tattoo, but she is ready for a change. “It was good in its time,” she said. “You don’t get to do a lot of do-overs on something that’s permanent.”

This article originally appeared in Lancaster Newspaper August 24, 2008