Long a subspecialty of cosmetic dermatologists, laser tattoo removal has entered a more commercial era. As tattoos have become decidedly mainstream — a third of Americans now have them, according to the Pew Research Center — so has getting rid of unwanted ones.

“I love my dog, but just having a pit bull in every picture for the rest of my life is kind of intense,” singer Miley Cyrus told The New York Times in an interview in May as she pondered whether or not to “laser” her many unwanted tattoos, including one of her dog.

Another celebrity who has spoken about their tattoo removal experience is the comedian Pete Davidson, who has for the past 5 years undergone laser treatments for tattoos covering much of his body — an effort that coincided, he said, with his recovery from drug addiction and a desire to start fresh. In an interview with Variety magazine earlier this year, Davidson acknowledged spending $200,000 on removal procedures to date, recently showing off his cleaned-up shoulders and forearms on social media.

Lasers have been used for tattoo removal since the 1960s, coming into wide use in the 1990s with the advent of picosecond pulse lasers. These devices deliver short pulses of energy that heat and break down insoluble pigments into particles small enough to be engulfed by macrophages and cleared by the lymphatic system. Uptake of the technology increased as devices became more compact and suitable for use in smaller settings.

In just the past decade, a new business model has emerged: the tattoo-removal chain. Removery, an Austin, Texas-based company created in 2019, now counts some 160 clinics in the US, Canada, and Australia. While a number of different lasers can be used in tattoo removal, its technicians only use the PicoWay picosecond laser, manufactured by Candela. Removery claims to have completed 2 million treatments in 300,000 patients to date.

Yet as ubiquitous as tattoo removal services have become, little is known about what happens in the body when laser energy meets a tattoo.

Josh Weitz, MD, Removery’s chief medical officer, described the greatest challenges in tattoo-removal research as “the quality of studies, reproducibility of studies, translation of basic science research findings to clinical practice, and adjusting for the myriad of environmental exposures, lifestyle choices, and other intangibles to allow clean interpretations of the data.” 

Research groups in Europe and Australia have started to fill in some important knowledge gaps, while Removery’s uniform technology and large scale have allowed it to begin assembling a database that company officials say will inform questions of interest to them and others in the tattoo-removal space.

Can Fresh Ink Be Removed Safely?

At The American Society for Laster Medicine and Surgery (ASLMS) 2025 Annual Meeting, held in Orlando, Florida, in April, Weitz presented results from a prospective, unblinded observational study in 62 patients (median age, 26 years; 56% women) who sought treatment for tattoos less than 2 weeks old. Colored tattoos, which are more challenging to remove, were not included in the study.

Conventional wisdom holds that people should wait anywhere from 6 weeks to several months before starting the removal process. Weitz, an immunologist and internal medicine specialist, said there is little evidence in the literature to support that conclusion. There may also be advantages to not waiting, he hypothesized, such as being able to target ink before the formation of scar tissue that can alter the laser’s ability to reach pigment particles.

Weitz reported that early intervention was not associated with adverse effects such as blistering, ulceration, scarring, delayed healing, allergic reactions, infection, erythema, or pigmentation changes following treatment, suggesting that immediate tattoo removal offered a safe option for people seeking to get rid of a tattoo fast. The finding held true across different skin types, including patients with darker skin types, Fitzpatrick skin types IV, V, and VI.

While Weitz’s findings offer early evidence that early tattoo removal is not associated with immediate or visible adverse effects, less is known about potential toxins produced through the photodegradation of freshly placed ink — or ink of any age, for that matter. Less still is known about what health risks these degradation products might pose.

Ink Byproducts Elicit Concerns

“Tattoo ink has a lot of different components,” including pigments, carrier chemicals, and additives, said Claire Lenehan, PhD, of Flinders University in Adelaide, Australia, in an interview. “So it becomes a complex challenge to understand what compounds are being formed [when treated with a laser].”

A recent investigation by Lenehan and her colleagues found that yellow tattoo inks containing titanium dioxide formed potentially harmful chemical byproducts after irradiation with a 532 nm Q-switched Nd:YAG laser.

This echoed findings from researchers in Italy, who reported that a common green pigment, when irradiated with a Ti:Sapphire femtosecond laser, creates a chemical byproduct that is similar to known toxins. In earlier studies, organic pigments used in certain colored tattoo inks have been shown to produce carcinogenic compounds when exposed to lasers used in tattoo removal, and one blue tattoo pigment was shown to produce hydrogen cyanide after ruby laser irradiation.

“The literature, and our own work in the lab, has revealed a number of molecules that are potentially of concern,” Lenehan told Medscape Medical News. Benjamin Boyle, a PhD candidate in Lenehan’s lab, is now aiming to find some of these breakdown products in humans.

Boyle is collecting urine samples from patients at a laser tattoo removal clinic to see if certain molecules identified among the degradation products are being metabolized and excreted. One he is looking for is benzene, which is associated with a range of short-and long-term health effects.

Boyle’s findings could potentially inform recommendations around laser tattoo removal. If people are excreting high levels of benzene during the removal process, “it might make sense to increase the time between removal sessions,” to minimize exposure, he said in an interview. “Or maybe we should avoid treating very large areas of skin at once.” 

Fresh ink might produce different degradation products than aged ink, Lenehan said, noting that the age of a tattoo was yet another of a large number of variables that remain to be carefully studied.

“It’s one thing to irradiate inks in a lab and find different byproducts,” she said. “It’s another to see what at level these byproducts are occurring in the body, how they interact with cells, and whether this results in any meaningful clinical effect.” Lenehan cautioned that her group, like other researchers working in this space, is “just scratching the surface” of the potential health implications of laser tattoo removal.

Lymphoma Findings and Lasers

The immune system is central to both tattooing and tattoo removal. Dermal macrophages capture and retain tattoo pigment particles in the skin. Some insoluble nanoparticles of pigment will migrate to lymph nodes after a tattoo is placed, where they accumulate. Laser tattoo removal breaks pigment into smaller particles, allowing them to be taken up by macrophages and transported through the lymphatic system before being excreted from the body.

In 2024, a group of researchers in Sweden published findings from a large population-based case-control study showing that lymphoma was 21% more common among people with tattoos vs control individuals. A 2025 twin study from Denmark found that people with tattoos saw a 62% higher risk of developing any type of skin cancer (other than basal cell carcinoma) and that those with large tattoos (larger than the palm of the hand) saw nearly a three times higher risk of developing skin cancer or lymphoma (hazard ratio [HR], 2.37; 95% CI, 1.11-5.06 and HR, 2.73; 95% CI, 1.33-5.60, respectively).

Among people with lymphoma, the median number of years from tattoo to a cancer diagnosis was 8 years, whereas for skin cancer it was 11 years.

“The association of tattooing with lymphoma suggests that maybe the ink or some other aspect of tattooing sets you up to get this cancer — but there’s a lot of potential confounders,” Dermatologist and Laser Pioneer R. Rox Anderson, MD, director of the Wellman Center for Photomedicine at Massachusetts General Hospital, Boston, said in an interview.

Laser tattoo removal could potentially add to lymphoma risk by dumping more ink, and its breakdown products, into the lymphatic system, he said.

But Anderson said more studies — whether prospective cohort studies or tissue analyses and cell experiments — would be needed before the evidence was strong enough to argue against getting tattoos or removing unwanted ones with lasers. “I tend to think that most tattoos are safe. Most people with tattoos will die of something other than lymphoma,” he said.

‘Single Greatest Database’

Thomas Barrows, MD, an emergency medicine physician and laser specialist on Removery’s scientific advisory board, said in an interview at the ASLMS meeting in Orlando that the company will soon “have the single greatest database of tattoo removal in the world. How to work with that and what we can pull out from it, I think will be of great interest.” Questions related to smoking status, use of certain medications, and skin color are all being explored, Barrows said.

At the same meeting, Weitz also presented results from an in-house study drawing from 200,000 patient records on the demographics of Removery’s customer base, and the services most frequently requested.

Young adults make up the lion’s share of the company’s patients, Weitz reported, with about 40% in their thirties, and another 30% in their twenties. Visible spots on the body such as the forearms, hands, and neck account for half of tattoos removed, he said, and most of the tattoos removed are black. Importantly, most patients treated at Removery had Fitzpatrick skin types III or IV, representing deeper beige and olive tones.

Weitz said in an interview that these findings underscored the need to identify approaches that are safe and effective in people with darker skin types. “We want to look at specific wavelengths that are not currently FDA approved [for darker Fitzpatrick skin types],” he said, because the manufacturers did not test them in these patients.

Lenehan, the Australian researcher, commented that the results from such a study would be helpful for tattoo removal specialists. “Skin color can really inform” tattoo removal treatments, she said. “More understanding or better understanding of which lasers and techniques are more appropriate would certainly help people getting treated.”

Academic and Commercial Findings

Weitz said Removery is designing a number of both blinded controlled studies and observational studies.

While much of its science may be geared toward commercial concerns, such as optimizing technology or understanding how many sessions it takes to clear a tattoo in different people, Weitz said the company is open to “collaborative conversations” with academic researchers to help address other types of questions, particularly concerning risks.

Anderson, who attended the company’s presentations at the ASLMS meeting, said that the thorniest questions about health risks associated with tattoos and laser tattoo removal will need to be answered in other settings. “Removery is a private company. It isn’t the kind of place where you want to do provocative human studies,” he said.

But given the sheer size of its operations, and the uniform technology and techniques being used, almost any of its findings are of value, Anderson said, adding that the company’s network of clinics could be used not just to glean data but share findings from research groups as they emerge.

“For example, if we do find in the next few years that some inks are in fact associated with lymphoma, they could screen people and advise them to be more vigilant,” Anderson said. “I think they see their business as not only removing tattoos but taking care of people with tattoos.”

Weitz said that disseminating the latest health and safety findings “is an important part of our work, and something we believe is paramount to ensuring clients approach the tattoo removal process as well informed as possible.”