Laser tattoo removal is a pretty straightforward process, but the experience of each individual tattoo being treated can differ greatly.  Removing a tattoo takes time. It needs repeated treatments, spaced out at 8-week intervals to allow the body’s lymphatic system to properly expel the ink particles. Many of the most common questions we are asked boil down to a central theme: how many laser tattoo removal sessions are needed for full removal? That is why the Kirby-Desai Scale was created to answer that important question.

Unlike the laser tattoo removal process itself, the answer to this question isn’t as straightforward. A number of variables come into play.  Everyone’s skin, immune system and tattoo is different.  The rate at which a tattoo fades is dependent on a variety of factors that are specific to each patient.  During your free consultation, our laser technician will use the Kirby-Desai Scale to help estimate the number of sessions required for removal. Once your tattoo has been assessed using the Kirby-Desai Scale, these scores are then added, with the sum total allowing a good estimation for the number of treatments needed.

The Kirby-Desai Scale measures:

Patient Skin Type: 1 to 6

Patients are given a score based on the Fitzpatrick Scale, the current gold-standard for clinically categorizing skin types based on their reaction to UV radiation, which will in turn indicate how pigmented the skin is and the amount of melanin present. Melanin absorbs light at almost the same rate as tattoo pigments, meaning both react similarly when subjected to heat. In general, skin types at the higher end of the Fitzpatrick Scale react less effectively to laser treatments

Location of Tattoo: 1 to 5

The success of laser tattoo removal will depend where the tattoo is located on your body. The head and neck have the largest amount of regional lymph nodes and a larger vascular supply, so removing a tattoo from these areas takes less time. Tattoos on the upper and lower torso also have a large vascular and lymphatic supply, so ink is removed quickly from these areas as well, although not as quickly as the neck and head. Tattoos on your extremities – feet and hands in particular – take longer to remove.

Color of Ink: 1 to 4

Color can be a tricky factor in estimating number of treatments because there are a nearly infinite variety of colors available at tattoo shops.  Some tattoo artists even mix colors and compounds together to make a unique blend.  In general, the colors used most often by tattoo artists are black, red, blue, green and yellow.  Black pigments are the easiest to remove due to their relative small size in the dermis.  It also absorbs every wavelength of light. Red is also considered easily removable in comparison to other colors. Which one(s) are the hardest to remove?

Amount of Ink: 1 to 4

The amount of ink within a tattoo is another factor that affects the success of laser tattoo removal.  The difference of ink depends on the type of tattoo the patient has – professional or amateur. Professionally done tattoos have denser ink and therefore, based on size and colors, will take longer than an amateur tattoo.

  • Amateur (letters, words or small symbols)
  • Minimal (one color, simple design)
  • Moderate (one color, complex design)
  • Significant (multicolored, complex design)

Scarring / Tissue Change: 0 to 5

Tattoo placement can sometimes lead to complications and increased collagen deposition in the skin, potentially forming a scar.  Tissue damage varies according to your skin type usually scarring is more susceptible in skin types 5 or 6.  Excessive scarring and tissue changes can make it more difficult for the laser to penetrate the area, thus making it harder to remove the tattoo.

Layering/Cover-Ups: 0 to 2

Many patients try and remove an unwanted tattoo by simply getting a cover-up (or layering over a new tattoo on top of the existing design.) Laser tattoo removal on a cover-up tattoo will actually remove the new tattoo and reveal the original tattoo.  Therefore, more treatments will be needed to successfully remove the ink from the combined tattoos.


Results of the study revealed that complete removal of all the tattoos in 100 patients was achieved in subject group. The average number of treatments required was 10 treatments (9.91±3.18), with a range of 3 to 20 treatments. This correlated well with the average Kirby-Desai score of 9.87.

Ultimately, laser tattoo removal is unique to each patient and tattoo. Various factors come into play when determining the amount of treatments, a patient will need before seeing clear, inkless results. Although there is no resource that precisely determines the exact number of treatments needed for complete removal, the Kirby-Desai scale provides the closest prediction to the real number of required laser tattoo removal sessions. Once you’ve completed your consultation, you’ll know exactly what the process will be like and whether or not it’s something you would like to do.

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