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Undo that tattoo 

Dermatologist lasers away youthful expressions

When Liane Raymann was 17, she thought her mother was a dope. Don't get that tattoo, mom had warned her daughter; someday you'll regret it. Raymann is now 25, and her mother is "the smartest person in the world." Raymann just finished her sixth trip to dermatologist Dr. Jay Kincannon to have the tribal band - a circle between chains wrapping halfway around her upper left arm - removed. At about $280 a pop, and with more pops to go, it's not cheap. But she's glad the technology exists to have it done. In his adult dermatology practice at the University of Arkansas for Medical Sciences, Kincannon sees four or five patients a week who are, over several visits, having their tattoos removed by laser. Some of them did their tattoos themselves, using just a straight pin and ink, or perhaps with the help of their prison cellmates. Those amateur tattoos are the easiest to remove, since they're not so deep and are often black or blue, a color the laser can handle. Some of them are new parents who don't want their kids getting the rose on their hips or marijuana leaf on their arm or snake on their tummies that they're sporting. Some, like Raymann, just don't think a tattoo is appropriate on the job. Raymann, a financial analyst with the Army Reserves, said her tattoo "made me uncomfortable in the business world" - especially when sleeveless shirts are the order of the day in a scorching Arkansas summer. Kincannon, a pediatrician as well as dermatologist, also uses laser therapy to treat birthmarks, like hemangiomas and port wine stains, at Arkansas Children's Hospital, whose fine reputation in laser treatment of birthmarks is firmly established by internationally famous Dr. Milton Waner and his team. There, the work is therapeutic. Tattoos aren't - and so they must be paid for out of pocket. Raymann had undergone five treatments when she came in for her sixth in early March. The shadow of the tribal band was still evident; Kincannon can only remove about 10 percent of the color at a time without risking tissue damage. Both doctor and patient donned brown glasses to protect their eyes from the "q-switched YAG" laser - which works on blacks and browns. (Each color in the tattoo responds to a separate laser wavelength; some colors, like yellow or violet, are difficult to erase.) Kincannon applied the laser to Raymann's numbed arm and suddenly, firecrackers issued forth from the laser, pulsing bright sparks applied directly to her skin. The laser works, Kincannon said, by being absorbed by the dye, where its light turns to heat and destroys the pigment. Raymann's immune system will "clean up the debris," Kincannon said. The laser does not scar because it is not absorbed by either collagen or moisture in the skin - just pigment. Tiny bits of blood appeared on Raymann's arm, and the following day would bring bruising and minor scabbing - but not pain, and she turned down the offer of a prescription while talking about her seventh treatment in six to eight weeks' time. Many patients require up to 10 visits. Kincannon has seen it all. A woman with the entire solar system on her belly. A man, while insensible with drink, had his eye tattooed black by his buddies. A man with tattoos over 60 percent of his body (the effort of several artists, some of them very good, nurse Marie McDowell said). Unlike Raymann, the super-tattooed patient can't get shots to numb the area to be lasered - it's just too large. The laser can do just so much, Kincannon added. "It's not perfect." But popular, yes. Tattooing "is a fashion statement now, but there's going to be a huge glut of people at 30, and with a 2-year-old, who want to get the skull off their behind before the kids start asking about it." It's something young med students might consider when choosing a specialty.
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