Some studies show that tattoos can be permanently removed at a median age of 8 weeks following surgical removal of the skin-specific cells (TUNELs) and epidermal matrix (EM). Other studies have found a median age of 9 weeks for skin cells to have completely disappeared, or at least, diminished completely. In studies where patients were removed of the remaining tissue of the tattooed sites, some tattoos (but not all) were never removed and left permanently embedded in the skin (Fig. 2).
Figure 2: Study 1, showing that tattoos (n = 12) are likely permanently embedded in the skin at an average age of 9 weeks.
Although many people experience permanent scarring, the majority of scarring occurs after the tattoo has faded. This study suggests that the age- and location-dependent increase of scarring after a tattoo removal may result from a prolonged exposure of the new skin to the blood and the subsequent damage to the new cell-surface area. The scarring then causes additional skin cells to undergo apoptosis, or cell death, as a result of exposure to more oxygen (oxygen deprivation) and subsequently die. This process can be expected to occur gradually (in months) after the tattoo has healed completely.
Studies on other forms of tattooing show that they are likely not removed or destroyed permanently. Tattoos may last up to 5 years, but many are likely to have faded completely at an average age of 2 to 3 years. This is because the new skin and scar tissue (which has become engorged with epidermal matrix cells and TUNELs) and therefore is less able to maintain new skin cells.
Is TUNEL stimulation a good way to control the spread of the tattoo?
The first treatment that may be chosen to control tattoo spreading is a local topical method. This involves using a tungsten rod of an appropriate size over the healed area to stimulate the production of TUNELs. The purpose of this tungsten stimulation is to increase the number of cells to produce pigment, which in turn may be beneficial in controlling the spread of the tattoo.
Tunel stimulation is a very effective method for controlling tattoo spread, but it is not a substitute for surgery to remove the tattoo or to remove all of the skin of the tattooed area. One study, though, showed that the use of TUNELs is beneficial despite a lack of results from other treatments. This study tested the effectiveness of TUNEL stimulation
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