When Janet O'Leary entered the field of tattoo removal about twenty years ago, it would've been premature to even call it a growth industry: The laser technology itself was nearly brand-new, hardly anyone knew how to operate the equipment, and few businesses specialized in it. Even in 2003, when she left her old practice to open her own laser business, the Diablo Regional Laser Center in Walnut Creek, "we were the only one around," she said. But in the years since, she's seen the field grow exponentially, right before her eyes. "Now, there's much more competition."
Tattoo removal is still a new-enough niche that hard statistics are difficult to come by, but anecdotal evidence suggests it's growing fast. Tattoo-specific laser businesses continue to proliferate in the Bay Area and nationwide, and an increasing number of centers specializing in laser hair removal and skin therapy are adding tattoo removal to their list of services. Courtney McSpadden, a registered nurse who removes tattoos at Laser Away in San Francisco, said her company already has seven outposts in Southern California in addition to the one in San Francisco, and will soon be setting up shop in Walnut Creek and San Jose, too. For O'Leary's part, she said that while tattoo removal has always made up roughly one third of her client base, as her business overall has grown, so has the number of tattoo removals. These days, Diablo Regional Laser Center treats about one hundred cases a month.
The bulk of the growth in tattoo removal is, of course, related to the continuing popularity of tattoos. A 2006 Northwestern University survey estimated that almost a quarter of people between the ages of 18 and 50 have tattoos; the same year, the Food and Drug Administration placed the number of Americans with tattoos at around 45 million. And, economically speaking, tattoos and tattoo removal are complementary goods, like hot dogs and hot dog buns: As more and more people get tattoos, it follows that more and more people might want to get them removed. In fact, the Northwestern survey also found that about 17 percent of study participants were thinking about tattoo removal. What's more, the growth in tattoos appears to be especially big among younger people — which would indicate that the demand for tattoo removal hasn't even crested yet.
Meanwhile, the tattoo removal process itself has gotten much better over the past couple decades. While the physical nuts and bolts of the process have stayed essentially the same, O'Leary said that in recent years, the lasers have gotten cheaper, more effective, and easier to use, and the training process has also improved greatly. So although lasers might never be cheap — professional-grade medical ones can cost as much as $250,000 — they're no longer so expensive that a new business can't afford the technology without passing on prohibitively high costs to the client, and nor are they such new technology that the doctor or nurse operating them won't know what they're doing.
None of this is to say that tattoo removal is cheap, totally effective, or fail-safe: The typical tattoo removal takes several treatment sessions and can cost up to tens of thousands of dollars, and even then, lasers can't get rid of white and yellow tattoo dyes. But now, it's possible to get rid of almost any tattoo without damaging the skin at all, and for a price that, while still steep, certainly isn't insurmountable.
But as the demand for tattoo removal increases, there's also evidence that the procedure's becoming increasingly popular on the supply side, too. Part of that is the enduring popularity of cosmetic laser treatments in general, including hair removal, skin resurfacing, and scar removal. The same laser used for tattoo removal can also be used for some other procedures, according to McSpadden, and in an industry where startup costs are high and training is paramount, it makes sense, from an economies-of-scale perspective, for businesses to get as much as they can out of their equipment and human resources. And at the same time, because procedures deemed cosmetic aren't typically covered by insurance, working in tattoo removal and other laser medical services can allow a doctor or nurse to continue to practice medicine without all the red tape and rigmarole of seeking reimbursements from insurance companies — and that's attractive. It's why McSpadden recently made the switch from OBGYN to laser services, and though she said she hopes to go back to obstetrics eventually, right now she's very happy working in a cash-based practice.
In California, only doctors, physician's assistants, and registered nurses can operate lasers, which means the barriers to entry are high. But medicine is generally considered a recession-proof field, and academic programs nationwide are increasingly offering coursework in lasers. And if you can get the training, O'Leary said tattoo removal is a great field to be in: "A tattoo is a statement you're making to the public," she said. "It kind of announces you. So it's very satisfying to see someone who has a tattoo that they don't want to wear anymore, and to be able to get rid of it without bothering or damaging the skin at all."