Do the tattoo removal creams work?

Probably not, but they're cheaper than laser tattoo removal, so why not try it, right? Um, WRONG.  
More often than not I get patients who have tried stuff (not knowing what's in it but buying it because of the advertisement) and damaging their skin.  Possible problems with these tattoo removal creams: they could irritate the area, scar the area, damage the area, or make it impossible to remove via laser.


So yeah, I'm pessimistic. These creams are topical, so you apply them and they are supposed to make the ink fade. But how does it do this?  Tattoo ink sits in the upper dermis, (the layer skin below the outer skin layer, the epidermis) -  which means that the cream has to penetrate deep to get to its target. I am sorry, but I would be surprised if any cream could penetrate that deeply.
The popular and heavily advertised cream is Wrecking Balm (about $150-$200), a combination of hydroquinone (a skin bleaching agent) and an exfoliator.  Hydroquinone suppresses expression of melanin, making your skin lighter, but it does nothing for the ink.
The exfoliator is probably some sort of acid (glycolic, salicylic, etc).  One of my patients tried this and ended up with red, flaky, irritated skin, so she ended up coming in for laser tattoo removal anyway.


So bottom line - to cream to not cream?  Save your money and don't spend it on unproven substances that can harm rather than help.
Anyone with experience is welcome to post, but everything I've read on this subject tells me that the creams don't do what they are hyped to do...