R-20 Tattoo Removal

Authors Theodora Kossida, MD, PhD, Dimitrios Rigopoulos, MD, PhD, Andreas Katsambas, MD, PhD, R. Rox Anderson, MD, published their study in the Journal of the American Academy of Dermatology on the new “R20″ method in laser tattoo removal (Volume 66, Issue 2 , Pages 271-277, February 2012 http://www.eblue.org/article/S0190-9622%2811%2900815-2/abstract). 

Kossida, et. al, 2011, found that performing 3-4 laser treatments in one session using the R20 method is 50-85% more effective in clearing a black tattoo without additional side effects after 3 months when compared to traditional laser removal methods.

How it Works

When the laser beam is directed into the tattoo ink, a blanching or whitening occurs at the site.  Because of this whitening, additional laser beams are deflected from penetrating the skin.  However, after 15-20 minutes the blanching disappears making it possible to do another treatment or “pass”. The R20 Tattoo Removal method simply waits for this to happen and lets us treat clients 3-4 times in one visit.

R20 Results are Good

Even though the number of subjects in the study was small, researchers found that combining three to four laser tattoo removal treatments during one office visit lets the laser reach deeper than with a traditional single-pass treatment.


One R20 treatment may be sufficient to completely remove an amateur black tattoo or lighten a professional one.  For professionally applied black tattoos, about 50-75% fading will occur. This is significantly more fading than expected from 3-4 conventional treatments. The R20 method may reduce the time for removal by half or more.


Research shows that after three months, the treatment with the R20 method was more effective than conventional single-pass laser treatment  Study subjects experienced greater epidermal injury with the R20 method, compared to traditional method, however, neither method caused adverse events or scarring. Light microscopy showed greater dispersion of tattoo ink with the R20 method.


R20 Discomfort

The researchers report that the discomfort experienced in R20 treatments is no worse than conventional treatments. Change of Art uses a topical Lidocaine cream combined with the Cryo-6 medical grade cooling machine that blows very cold air on the tattoo site.  When used together, it provides adequate numbing to the area being treated.

After Treatment

Most clients are able to return to normal activities immediately or within a day. Site-specific swelling and  inflammation is common as well as bruising and blistering around the treated area, similar as in traditional method, however, there is risk of greater epidermal injury.


The R20 method of tattoo removal uses current laser technology applied differently.  The treatment is effective and safe. There are no long term  increased side effects between the R20 method of treatment on black tattoos compared to single pass methods, and the R20 method is safe on all skin-types.



R20 Tattoo Removal sessions includes 3-4 treatments spaced at 20 minute intervals (or longer). It will take about 1.5-3 hours to complete the 3-4 passes.  The TOTAL cost for removal will work out to be the same or less than conventional treatments.


Up to 2 square inches $350

Up to 4 square inches $500

After 4 square inches, $50 additional per square inch per session.



Because there is no way to know how an individual will respond to R20 we cannot provide our typical guarantee. Package deals are available that will guarantee total cost of removal.