The earliest removal options of tattoos were the use of either surgical excision, sanding it off mechanically (i.e. dermabrasion) or using chemical peels. None of these techniques are currently used today as their side effect profile is not acceptable. The first laser used for tattoo removal was a C02 laser which is purely an ablative laser. This technology was also not successful as a stand alone technique for this purpose but can be used in conjunction with other more effective technologies. The q-switched shorter pulsed lasers were used in the 1990s and had less side effects than competing technology. While an older technology, this was the treatment up until the last few years. The latest in tattoo removal laser technology is an even shorter pulse laser called the PiQo4 by Lumines and is the laser offered in Dr. Shah’s office.