TCA Tattoo Removal

 

As a tattoo removal agent Trichloroacetic Acid, commonly abbreviated as TCA, has been successfully tested in two medical studies and mentioned in a third study which we could not confirm.

 

The first known medical study performed to test the efficacy of TCA as a tattoo removal agent was the six year study from1979 through 1984 by two British Plastic Surgeons, Dr T. A. Piggot and R.W. Norris of the Department of Plastic Surgery, Newcastle General Hospital, Newcastle, England.

 

The Piggot/Norris medical study was inspired by the 1972 published report of a 4 year study by Surgeon Captain R.W.B. Scutt, Dermatologist, F.R.C.P (Fellowship of the Royal College of Physicians) concerning the incident of tattoo regret among the tattooed population of sailors in the Royal Navy between 1963 and 1966. The percentage of tattoo regret among the study group was as high as 70% by the time they were married. At the time, it was discovered that about 500 sailors were acquiring hand tattoos and about 4,000 sailors were acquiring forearm tattoos annually. This eventually led to the discouragement of tattoos on young recruits entering Naval training beginning in the late 1960's and eventually the British Parliament passing a Bill against the tattooing of minors in 1969.

 

With this information in hand Drs. Piggot and Norris began looking for volunteers to participate in the study. All participants were referred to the clinic by their General Practioners. Reasons for the referrals ranged from regret and embarrassment to their inability to find suitable employment. One patient was a German concentration camp survivor wishing to have her camp number removed from her wrist.

 

All requests were granted and ranged from amateur to professionally done tattoos. Each patient was treated with a 95% solution of TCA in water. The solution was lightly rubbed on the skin and and remained there for 2 – 3 minutes after which the area was rinsed and dried. A stinging sensation was reported for between 5 and 30 minutes after treatment. The treated areas were bandaged and the patients were allowed to go home with instructions to return in one week. By the end of one week a scab had formed. If dry, the area was redressed and the patient instructed to return weekly until the scab was gone. If the scab was moist it was treated with a saline and Betadine ointment and changed twice weekly until the healing was complete.

 

Healing required 3 to 6 weeks and subsequent TCA treatments were spaced at 3 month intervals while the surgeons observed the area.

 

The 670 patients underwent a total of 894 treatments with only 21% requiring more than one treatment.

 

Overall, 85% reported satisfactory results.

 

The second study was performed between May 1988 and February 1989 by Drs. D.A. Hudson and R.U.Lechtape-Gruter of the Plastic Surgery Outpatient Department at Groote Schuur Hospital, Cape Town, South Africa.

 

Forty patients between the ages of 18 and 71 were treated with a solution of 97% TCA. The patient usually experienced a tingling sensation for about 20 minutes following application. No dressings were applied and the patients were requested to return in one week. Ten patients required a second application before complete tattoo removal. The results were deemed satisfactory by 90% of patients. Two patients developed hypopigmented scars.

 

93% of TCA users for tattoo removal report satisfaction with results.

 

Instructions have since been refined for the Do It Yourself tattoo removal industry and it has been determined that more treatments at lesser concentrations result in better out comes and currently about 93% of TCA users for tattoo removal report satisfaction with results.

 

The importance of following instructions must be emphasized to achieve the best possible result.

 

Light scarring is possible at higher concentrations, for that reason most modern TCA tattoo removal products come in strengths no greater than 50% which is further diluted to suit the patients skin pH and the location of the tattoo with most users in the 15% to 30% strength range after performing patch tests to determine the proper strength.

 

TCA is by no means perfect and there has yet to be a tattoo removal method developed that does not carry with it the chance of slight scarring or hypopigmentation and sometimes hyperpigmentation.

 

Lasers, IPL, Dermabrasion and Salabrasion all carry the same risk of scarring or effect on skin pigment discoloration. Any product capable of removing a tattoo carries such a risk. Do not trust any person or marketing brochure or webpage that denies such risks.

 

Only the so called “tattoo removal creams” make such claims, but they are unable to work as advertised. They are mere skin pigment faders masquerading as tattoo removal products and relying on the uninformed public and their desire for a an easy, painless, hassle free way to tattoo removal.

 

No such method exists.

 

TCA is a medium strength cosmetic acid used primarily for facial peels and other cosmetic procedures. Persons using TCA to remove a tattoo need to follow package directions exactly. TCA is an acid which works by removing thin layers of skin in order to get down to the tattoo. The top layer of skin is called the epidermis. When a tattoo is applied, the tattoo pigment is injected into the dermis which is the second layer of skin.


Using the chemical peeling agent TCA, the outer layers of the skin are slowly peeled away. The layer of skin containing the tattoo ink comes closer to the surface. As the body replenishes the affected area with new skin, the pigmentation of the tattoo ink begins to break apart and move closer to the surface. During subsequent TCA treatments, users can see the tattoo becoming lighter.

TCA does not work instantly. It takes time for the process to work, so persons using this method of tattoo removal will not see instant results. TCA will need to be applied every three to six weeks with the entire process  taking a period of months.

As with any medical procedure, there are risks. Persons with diabetes or other chronic conditions that inhibit the natural healing powers of the body are advised against using any tattoo removal product or procedure that requires a healing period, and that would be all effective methods.

 

Using TCA as a tattoo removal procedure is a slow process. For each application, the epidermis will begin regeneration within 24 – 48 hours then complete the healing process within five to ten days. Dermal regeneration will take time and require treatment intervals of once every three to six weeks. Users can expect to see the tattoo being lightened after the first few treatments.


Summation:


Cons of TCA:

  • Slow to see results
  • Potential for light scarring and skin discoloration similar to that of laser removal
  • Not 100% effective
  • Slight to moderate pain--usually the stinging of each initial application.

Pros of TCA:

  • Low cost compared to other methods
  • Approximately a 93% success rate
  • Less pain than that of other effective treatment methods such as laser, dermabrasion and particularly salabrasion or surgical excision.
  • Proven effective in two medical studies.