Dermatography

Tattoo
removal

Study in Japan

During my study in Japan (Horikin III: 1980-1986) my teachers showed me old publications in the medical literature about removing tattoos. Prof. Tadasu Iizawa and Mitsuaki Ohwada suggested to do specific research, both in Japan and in The Netherlands. It ultimately took 10 years to develop this method to be medically useful. Its implementation requires a very detailed knowledge and skill, both of tattooing as of pigments and skin.

Horikin III, Yokohama 1985

Horikin III together with Koko Ohwada, the designer of traditional Japanese tattoo designs, Isogo, Japan

Horikin, Summi Yoshi, Horikin III in Tokyo in 1984. In the foreground a client immediately after a tattoo session.

People who regret

Our own research has shown that more than 80% of all tattooed regret their tattoos because the then existing motive for it is gone (See the link Lifetime social service money). In 1986, I came to a new supplementary method to remove tattoos. My first medical publication on this appeared in Japanese (Facebook and Culture 1989, no.21, pp. 108-124). The second one was in 1993 in the International Journal of Dermatology (vol.32, no.5, pp. 376-380).

owners of these kind of images regret to have them on their body already after a few years

Variot and Shie

In 1888, the dermatologist Prof. dr. G. Variot published a remarkable technique to remove tattoos. So even 140 years ago there were already people who wanted to get rid of their tattoo. Variot used one of the many types of tannic acid or tannin that exist (a total of 13,600 species). Tannins are also known as gallic acids; they are found in tree bark (eg tannic acids from the bark of the oak) and nutgalls. Dr. MD Shie worked out this method and published an interesting study in JAMA (vol. 90, pp. 94-99, 1928).

As a tribute, I have dedicated my second publication to Prof. Variot. From 1993 to 2000, I modified these methods so that an entirely new method has emerged. Continued publication in preparation.

The Van der Velden Method

A solution of 25-40% penta mono galloyl glucose is applied under the tattoo, using a modified tattoo machine - not on the tattoo, for the effect of the substance is not based on the solution of the pigments. The epidermis is then treated with silver nitrate pigments. After about 48 hours, there occurs a so-called tanning effect by the formation of wound fluid under the tattoo. Now it seems like the epidermis is ripped off,and actually a severe inflammatory reaction takes place. After 7-10 days, the epidermis can be removed without too much difficulty, leaving a deep graze. This is treated with Itamol®ointment. After about 7 days, the wound is closed. To avoid the formation of excessive scar tissue, the wound is treated for 2 to 3 months with Edula®ointment.

A careful after-treatment ensures optimal wound healing. The total duration of treatment is approximately 1 year; monthly monitoring is often necessary to treat any rapidly emerging hypertrophic scars. Even after 4-5 months still scars can arise for several reasons.

tattoo removed by tissue expander and various excisions using plastic surgery

7 days after treatment with penta-monogalloyll-glucose

after 1 week Itamol®ointment and 2 weeks Edula®ointment under occlusion

after 1 week Itamol®ointment and 2 weeks Edula®ointment under occlusion

6 months after removal

Results

In more than 70% of the cases, the pigments disappear completely. The result depends on the depth of the pigments, the skin type, and ofcourse a lot of knowledge of pigments is essential. The patience of the patient and the physician are very important too.

All of these methods, including the one of Van der Velden, have advantages and disadvantages. Completely removing tattoos and make them invisible is almost impossible. Keep in mind, a piece of your skin is removed and each tattoo is different and requires a different approach. But the Van der Velden method is an excellent addition to the already existing ones. Before treatment ofcourse an extensive consultation takes place. If the patient is healthy there are hardly any treatment risks, but the physician has to be medically trained and appropriately qualified.

tattoo on right shoulder blade

immediately after treatment penta-monogalloyll-glucose and silver nitrate

after 1 week

removal of the epidermis after 7 days

close-up, there are no more pigments you can see; wound looks nice and quiet

result after 9 weeks Edula®ointment under occlusion

inside arm tattoo

after 9 days epidermis removed

after 9 days epidermis removed

results after one year; texture of the skin normal, no scar tissue

results after one year; texture of the skin normal, no scar tissue