Doubtless, preparing for a laser treatment involves many steps. These include finding a trained medical professional, determining the best laser treatment for the desired results and then budgeting for the cost of the treatments.

Yet even with all this planning, as Brian D. Zelickson, MD director of the Center for Cosmetic Care in Minneapolis reported to Dermatology Times, with laser treatments, "sometimes the results can be very modest. It can be a bit hit and miss as to who gets a great result and who doesn't."

Because several variables such as the initial condition of the skin, the type of laser used, the skill level of the physician and the number of treatments received all dictate the outcome of a laser treatment, preparing for a laser treatment involves more questions than answers.

Regardless of these uncertainties, the results from medical reports do provide some estimation of what to realistically expect from laser treatments for skin lightening.

Some of the most commonly used lasers to affect skin lightening include Quality-switched (Q-switched) lasers. Q-switch lasers vary in the amount of energy each laser emits and in their effect on the skin's pigment. Q-switched lasers include the Nd:YAG laser (wavelengths of 532 nm and 1064 nm), the alexandrite laser (755 nm) and a variable pulse Nd:YAG laser (532 nm).

Q-switched lasers are ideal for removing tattoos. A study released by the British Journal of Dermatology compared the results achieved using a Q-switched Nd:YAG laser, a Q-switched alexandrite laser and a variable pulse Nd:YAG laser on various tattoos. Seventy-four patients that had either multi-colored to blue-black professionally applied, amateur applied or permanent makeup type tattoo participated in the study.

About 19% percent of the patients in the study achieved complete lightening of the tattoo, meaning that at least 95% of the tattoo was less visible. And 22% of the patients witnessed less than a 50% improvement in the lightening of their tattoo.

The professionally applied multi-colored tattoos were relatively easy to remove but required roughly five treatments before satisfactory removal of the dyes. The single-colored tattoos typically required between two and three treatments before patients enjoyed satisfactory improvements.

The researchers noted that the make-up tattoos and blue-black professional tattoos were most successfully treated.

Similarly, researchers at Massachusetts General Hospital Dermatology Laser Center and Laser and Skin Surgery Center of La Jolla explored the most effective ways to remove tattoos.

The investigators simultaneously tested sections of 42 blue-black tattoos with three different lasers, a Candela Q-switched alexandrite laser, a Continuum Biomedical Q-switched Nd:YAG laser and a Spectrum Q-switched ruby laser.

Tattoos treated with the Q-switched ruby laser displayed the highest clearance rate in removing blue-black tattoos, but this laser also carried the highest incidence of permanent hypopigmentation (lightened spots). The Nd:YAG did not induce potential side effect of hypopigmentation. The examiners published their findings in Dermatologic Surgery.

While not a tattoo, the skin condition ochronosis turns the skin blue-black or grayish blue. Ochronosis is a skin condition that may result from excessive use of skin creams that contain hydroquinone and occurs most frequently in persons with medium to dark skin tones.

Researchers at the New Jersey Medical School Washington Institute of Dermatologic Laser Surgery used a Q-switched alexandrite laser to treat hydroquinone-induced ochronosis in two patients.

One patient received six treatments spaced two months apart and the second patient received four treatments spaced four months apart. Both patients experienced noticeable lightening of the pigmented skin areas without post-scarring.

The Q-switched alexandrite laser has also proven itself useful at removing freckles. An investigation published in Dermatologic Surgery tested the alexandrite laser on one hundred ninety-seven Asian patients with freckles. Patients needed an average of 1.5 treatment sessions to achieve more than 76% removal of freckles. The treatments did not result in scarring or long term skin whitening.

In short, the time and money involved in successful skin lightening depends on a number of factors including the type of laser used, the depth of the pigment that needs lightening. Overall, documented tests with Q-switched lasers suggest that most people should anticipate having roughly three treatments spaced about two months apart to remove undesired skin pigments.

The cost per laser treatment could vary between $300-$1000 depending on the size and color of the tattoo, meaning that attaining satisfactory tattoo removal cost range between $600 and $5000.