By Danielle Aloia, Special Projects Librarian

In: Hambly WD. The History of Tattooing and Its Significance. London: H.F. & G. Witherby; 1925.

Tattoos—including body painting, puncturing, and scarring—have been around for thousands of years, going back at least to ancient Egypt. Egyptian puncture tattoos have been found dating to between 2000 and 4000 B.C.E. Tattoos have embodied cultural expression, sexual provocation, identification, and artistic expression.¹

Tattoo removal may be be as old as tattoos. One of the oldest known descriptions is from c. 500, by Aetius of Amida, which is included in Medicae Artis Principes (you can read the description in translation on the Ask the Past blog). He describes a chemical procedure of potassium nitrate and turpentine. In the 1928 article “A Study of Tattooing and Methods of its Removal,” author Marvin Shie suggests that burning the design “with a hot iron” was the earliest surgical procedure and “when the dead skin sloughed off, it took the mark with it but usually left a bad scar in its place.”²

Reasons for removal are varied and personal and often motivated by wanting to “disassociate from the past.”³ In 1898, Ross Hall Skillern wrote, “After the novelty wears off, some of these [tattooed people], becoming not only tired, but ashamed of the disfigurement, immediately seek a doctor to have it removed.”⁴

In: Hambly WD. The History of Tattooing and Its Significance. London: H.F. & G. Witherby; 1925.

Some of the regretful traveled far and wide for their body art. By the late 1600s, Western sailors were showing up at ports with tattoos often obtained in the South Pacific and New World. From this cultural exchange came intriguing stories of removal. As described in an article in The Atlantic, one buccaneer had the Kuna people of Panama tattoo a design into his cheek in 1681, a choice he later regretted. Unfortunately, all removal attempts failed, “even ‘after much scarifying and fetching off a great part of the Skin.’”⁵

Removal remained a difficult procedure even 240 years later. In the 1920s, removals were grouped under three classifications: surgical, electrolytic, and chemical.⁶ Most of these techniques were ineffective, leading to scars, chronic pain, and disfigurement. Surgical removal was the most invasive and left scars thought to be more unsightly than the tattoo itself.⁷ Electrolytic forms of removal included a heated needle inserted “into the tattoo mark a sufficient number of times to cause blanching of the surface…this forms a superficial eschar which drops off in the course of a week or so, taking the pigment with it.”⁸ As an alternative to these procedures, tattoo cover-ups could change or alter an unwanted design.

Here is an example of chemical removal as explained by Marvin Shie in 1928, with images:

The use of tannic acid and silver nitrate…the most satisfactory. A 50 per cent solution of tannic acid in water is then tattooed into the design…the area is also painted with the tannic acid solution…as the tattooing progresses. Then the area is washed with cold water. Sterile petrolatum is applied, to prevent discoloration…Then a stick of silver nitrate is rubbed vigorously over the area forming a think black deposit of silver tannate. This is all wiped off and washed with cold water. The point is to have the silver tannate penetrate the corium (or dermis) layer of the skin so that the tattooed area becomes hard and dry, and slowly separates from the deep layers of the corium. In about twelve days the edges are free, and in fifteen or sixteen days, the black, dry slough comes off in on piece resembling thin piece of leather. This contains the epithelium, the silver tannate in the corium, the superficial layers of the corium, and the tattoo pigment.⁹

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The chemical removal process has not gone by the wayside, but is generally not a recommended procedure today.

“The scale calculates the estimated number of treatments based on a standardized set of parameters, such as the patient’s skin type, location of the tattoo, and number and density of tattoo inks.”¹⁰

Laser treatment has been in use since the 1970s and evolved as the preferred method of removal both because it’s relatively effective and pain-free. In order to provide the best outcome for the laser treatment, the Kirby-Desai scale was introduced in 2009. This provides the health professional with a “tool to estimate the number of treatments needed for removal” based in part on the pathology.¹⁰

If you have tattoos or are thinking about getting one, consider the long-term implications. In a 2012 Harris Poll, of the 21% of Americans polled who had a tattoo, 14% regretted getting one. Even though medical treatments for removal have advanced, they are often costly and results are not guaranteed. Always consult a health professional before making a tattoo-removal, or any medical, decision.

References

1. Hambly WD. The History of Tattooing and Its Significance: With Some Account of Other Forms of Corporal Marking. London: H.F. & G. Witherby; 1925.

2. Shie MD. A study of tattooing and methods its removal. Journal of the American Medical Association. 1928;90(2):94-99.

3. Armstrong ML, Stuppy DJ, Gabriel DC, Anderson RR. Motivation for tattoo removal. Arch Dermatol. 1996;132(4):412-416.

4. Skillern RH. Tattooing–its history, manner of introduction, and method of removal. Philadelphia Medical Journal. 1898;1(25):1166-1167.

5. Odle, M. “The human stain: A deep history of tattoo removal.” The Atlantic. Nov. 19 2013. Available at: http://www.theatlantic.com/technology/archive/2013/11/the-human-stain-a-deep-history-of-tattoo-removal/281630/. Accessed January 8, 2015.

6. Shie MD.

7. Skillern RH.

8. Ibid.

9. Shie MD.

10. Kirby W, Chen CL, Desai T. Causes and recommendations for unanticipated ink retention following tattoo removal treatment. Journal of Clinical and Aesthetic Dermatology. 2013;6(7):27-31.