Dermatologist calls for colleagues to help with radiation tattoo removal

Sometimes, patients who seek out laser tattoo removal are trying to erase more than the name of an estranged love or the embarrassing remnant of an overly festive night on the town.

Sometimes, they are former cancer patients seeking to erase the last vestige of the disease they have conquered.

They do not need a scar to remind them that they are survivors; they already know it.

“The tattoo just reminds them of their treatment, and it’s noticeable in their clothing,” Eric F. Bernstein, MD, director of the Main Line Center for Laser Surgery in Ardmore, Pa. said in an interview. “They end up having to talk about it a lot, and they don’t want to.”
It was with this unique patient population in mind that Bernstein helped launch the New Beginnings: Radiation Mark Removal program. The nationwide initiative, which is offered through the American Society for Laser Medicine and Surgery (ASLMS), provides free removal of radiation tattoos for cancer survivors.

But years before that, Bernstein was already doing this on his own.

“I worked at the National Institutes of Health in the radiation biology branch a long time ago, under two very famous radiologists named Eli Gladstein and Jim Mitchell, and I got to see a lot of patients undergoing radiation therapy,” Bernstein, a dermatologist who specializes in laser surgery, said. “I noticed they had radiation marks, little tattoos to guide placement of the radiation therapy. So when I started my practice in the late 1990s, I started removing these marks for free.”

A simple procedure

Bernstein said removing the marks is relatively straightforward and requires a Q-switch, alexandrite or Nd:YAG laser.

“Removing these marks is really easy,” he said. “They’re done in India ink, and it usually takes one or two treatments to take them out. They kind of turn white when you treat them, and then they disappear over 3 or 4 weeks.”
In fact, it was so easy to do that Bernstein seamlessly incorporated this pro bono work into his practice with barely a second thought, until about 2 or 3 years ago.

“I had gotten more involved in the ASLMS, and I mentioned it at one of our meetings,” he said. “It occurred to me that a service like this should have wider reach, beyond the local area.”
Bernstein suggested the idea to (then-president) Jeffrey S. Dover, MD, and Dover and the Society wasted no time in implementing the program on a national level.

“They got it moving very quickly,” he said. “I think within a year of mentioning it to Jeff, the program was introduced.”
Today, the New Beginnings: Radiation Mark Removal Program utilizes the free services of more than 150 board-certified ASLMS members. The website for the initiative includes a patient-facing physician locator that provides the names of the closest participating physician. Patients who wish to utilize the service need to get permission from the doctor who administered the radiation and accompanying mark.

“They need a note from their radiation oncologist stating that the marks can be removed,” Bernstein said. “It’s up to the individual doctor; some say, ‘Go ahead, remove them all,’ but that’s not our call to make because we didn’t place them.”

More doctors needed

Although the initiative is 150 members strong, Bernstein said the ASLMS would very much like to recruit more doctors to the effort.

“I want to make doctors aware that they can sign up, because doctors really like to do this type of thing,” Bernstein said. “So if you have one of the three lasers that are used for tattoo removal, sign up. We need more docs.”
Bernstein said as a practitioner who does 100% laser surgery in his practice, he finds his work is sometimes dismissed as “cosmetic.”

“So many of the services I provide can be trivialized,” he said, “but if you can make a difference to someone, to the way they feel about themselves, that’s pretty important.”
He also urged dermatologists who do laser work to sign up for the ASLMS.

“I encourage all physicians and RNs who are using laser to sign up, because it’s a wonderful place for education,” he said. “And you get to meet some great people.”
But at the heart of the New Beginnings program, Bernstein said, is the desire to help patients who have fought so hard for their lives.

“I think people who have had radiation and have these marks certainly deserve a break, and they deserve our attention and time,” he said. – by Jennifer Byrne