TOBIL System for Tattoo Removal

By E. Ronald Finger, MD

Decades ago the only tattoos that I noticed were those of sailors and Navy veterans of various wars. People with massive tattoos were even on exhibition at the fair. Next were the bikers and gang tattoos. Only in the last decades have such large quantities of tattoos been performed on students and young working people. It has become part of our culture, and I am also seeing buyer’s remorse within the tattoo population. Those who want tattoos removed are those with initials of a former boy or girl friend, those who received them on an impulse, tattoos in obvious places such as the neck or top of the breasts, hands, and some who have “gang” tattoos. Often recruitment into the armed services requires tattoo removal.

Tattoos are permanent, practically speaking. Can they be removed? Yes, but the skin may not be exactly as before the tattoo, and there may be a scar. Tattoo removal may discolor or depigment the skin.

The large number of tattoo removal techniques indicates the difficulty of the task. Originally, I used excision for small tattoos. This means cutting it out and sewing it up. Sometimes it took several excisions. This was expensive and often left large scars. In some cases the tattoos were so large that grafts were necessary. Then came “saltabrasion,” a method of dermabrading the tattoo with ordinary table salt. Many times it actually worked, but pigmentation removal was incomplete, the process was painful and long, and scars that resulted often required surgery.

Recently lasers have been used for tattoo removal. I found this disappointing because of the incomplete removal of the pigment and lasers remove only certain colors. Recovery is extensive, and it’s expensive.

The latest and in my opinion most effective method is the TOBIL system. This is an ultra bright infrared intense light that shines on the tattoo for 0.5 seconds. It breaks up the pigment allowing the body’s defense mechanisms to scavenge and remove it. It removes a small circle of pigment about the size of your small fingernail, and it requires a space of normal untreated tissue left in between the treated spots. You must return to treat the areas between the treated spots. All colors can be removed, and the resulting depigmentation and scarring is less than other techniques. Finally, it is significantly less expensive than laser treatments.

A local anesthetic is used for each treatment, and the post-treatment care requires ointment and a dressing for several days. The treatments may be performed every month, treating the untreated areas until the tattoo is gone. The number of treatments required is related to the size and area of the tattoo.