Kirby-Desai scale

Fitzpatrick skin type I Always burns, never tans1 II Burns easily, tans minimally2 III Sometimes burns, tans gradually3 IV Burns minimally, usually tans4 V Rarely burns, tans well5 VI Never burns, always tans6

Tattoo location Head, neck, face1 Upper trunk, shoulder2 Lower trunk, thigh3 Forearm, lower leg4 Hand, wrist, ankle, foot5

Colours Black only1 Mostly black with some red2 Mostly black and red, some other colours3 Many colours4

Amount of ink Amateur tattoo1 Minimal2 Moderate3 Significant4

Scarring and tissue change None0 Minimal1 Moderate3 Significant5

Layering and cover-up No, one layer0 Yes, a cover-up or several layers2

How the scale works

The scale was proposed by dermatologists William Kirby and Alpesh Desai in 2009. Each of the six parameters gets points; the total ≈ the number of sessions needed to remove the tattoo.

Skin typeThe darker the skin, the more carefully you have to work — and the more sessions it takes.
LocationThe farther from the heart, the weaker the blood and lymph flow — pigment clears more slowly.
ColoursBlack is removed best; the more colours, the more sessions.
Amount of inkDense professional work needs more sessions than an amateur tattoo.
ScarringChanged skin releases pigment less readily and needs gentle work.
LayeringA cover-up adds pigment — and sessions.

Source: Kirby W., Desai A., Desai T., Kartono F., Geeta P. The Kirby-Desai Scale: A Proposed Scale to Assess Tattoo-removal Treatments. J Clin Aesthet Dermatol, 2009.

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