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Kirby-Desai Scale Calculator: Tattoo Removal Sessions
The Kirby-Desai scale estimates how many laser sessions a tattoo needs by scoring six parameters: skin type, location, color, amount of ink, scarring and layering. The total score, from 4 to 26, is proposed to track the number of sessions. A score of 10 points to about 10 sessions, spaced 6 to 8 weeks apart. Enter the six parameters below for the score, timeline and cost.
Prepared by Prospyr · Reviewed October 3, 2026 · Free, no sign-up, runs in your browser
Score the tattoo on the six parameters from the 2009 paper. Each choice shows its points.
Fitzpatrick type of the skin over the tattoo. Not sure? Take the Fitzpatrick quiz.
Scored by blood and lymphatic supply of the region.
Black is the easiest to treat; other colors score higher.
The paper's four categories.
Scarring in the tattooed skin.
Your fee schedule or a quote. Leave blank to skip the cost.
Kirby-Desai score (range 4 to 26)
9of 26
Published estimate: about 9 laser sessions.
Time, first to last session
11 to 14.7 months
6 to 8 weeks apart
Cost
–
Enter a price per session
In the 100-patient study, sessions ranged from 3 to 20 (average 9.9) while scores averaged 9.9, with a correlation of r = 0.757.
A math aid based on a published scale, not a promise of results. The scale assumes a Q-switched Nd:YAG or alexandrite laser with 6 to 8 weeks between treatments; the treating provider decides the plan.
Kirby-Desai scale parameters and points
These are the point values from Tables 1 to 6 of the 2009 paper.
| Parameter | Scoring |
|---|---|
| Skin type | Fitzpatrick I = 1, II = 2, III = 3, IV = 4, V = 5, VI = 6 |
| Location | Head and neck 1, upper trunk 2, lower trunk 3, proximal extremity 4, distal extremity 5 |
| Color | Black only 1, mostly black with some red 2, mostly black and red with other colors 3, multiple colors 4 |
| Amount of ink | Amateur 1, minimal 2, moderate 3, significant 4 |
| Scarring or tissue change | None 0, minimal 1, moderate 3, significant 5 |
| Layering | No 0, yes 2 |
The paper explains the logic: darker skin needs lower settings and longer waits, regions with more blood and lymphatic supply clear ink faster, black pigment is easiest to remove, professional tattoos hold more ink than amateur ones, scar tissue holds ink in place, and a cover-up is larger and darker. For the skin-type input, see the Fitzpatrick skin type quiz.
Worked example: tattoo removal sessions and timeline
A multicolor sleeve on the forearm (distal extremity) of a Fitzpatrick type II patient, with a complex design, no scar and no cover-up: 2 (skin) + 5 (location) + 4 (colors) + 4 (ink) + 0 + 0 = 15 sessions. At 6 to 8 weeks apart, 14 gaps is 84 to 112 weeks, about 19.3 to 25.8 months.
A small black first-name tattoo on the upper back of a type III patient: 3 + 2 + 1 + 1 + 0 + 0 = 7 sessions, roughly 8 to 11 months. Both are baselines from one clinic's 100 patients, not a guarantee.
Tattoo removal calculator: what the scale does and does not cover
The scale gives patients and the front desk a reasoned number before the first visit. Its limits are stated in the paper: a single clinic, a retrospective review, and a cohort that all reached satisfactory removal, so difficult cases such as scarred or layered tattoos were under-represented. The authors call for larger studies. It also assumes the laser type and spacing above.
For a practice, the score, the quote and the photos belong in the chart. Prospyr's charting keeps them with each session, and the med spa software page shows how scheduling and packages connect.
Frequently asked questions
What is the Kirby-Desai scale?
The Kirby-Desai scale is a scoring system that estimates how many laser treatments a tattoo will need. It was proposed in 2009 in the Journal of Clinical and Aesthetic Dermatology after a chart review of 100 patients. Six parameters are scored and added, and the total is proposed to correlate with the number of sessions.
How do you calculate the Kirby-Desai score?
Add the points for six parameters: skin type 1 to 6 (Fitzpatrick), location 1 to 5, color 1 to 4, amount of ink 1 to 4, scarring 0 to 5 and layering 0 to 2. The lowest possible total is 4 and the highest is 26. A tattoo on type III skin on the upper trunk (2), in black only (1), with moderate ink (3), no scar (0) and no layering (0) scores 3 + 2 + 1 + 3 = 9.
How many tattoo removal sessions does a score mean?
The scale is proposed to track sessions closely, so the score is read as the estimated number of sessions. In the original study, patients averaged 9.91 sessions (range 3 to 20) against an average score of 9.87, with a correlation of 0.757. It is an estimate: individual tattoos can need more or fewer.
How long does tattoo removal take with the Kirby-Desai estimate?
The paper assumes 6 to 8 weeks between treatments. A score of 10 means 10 sessions, so nine gaps of 6 to 8 weeks, which is about 12.4 to 16.6 months from first to last session. The calculator does this arithmetic for any score.
What does a high Kirby-Desai score mean?
The paper states that tattoos scoring more than 15 points may be difficult to remove and should be assessed by the physician to decide whether laser removal is the method of choice. A high score comes from darker skin types, distal locations, multiple colors, heavy ink, scarring or layering. It is a flag for a closer look, not a verdict.
Does the Kirby-Desai scale work for picosecond lasers?
The scale was developed assuming a Q-switched Nd:YAG or alexandrite laser with 6 to 8 weeks between treatments, so it does not describe other devices or protocols. A 2019 study of 22 patients with single-color amateur tattoos on skin types IV to VI found that the R0 technique needed significantly fewer sessions than the scale predicted. Treat the score as a baseline for the technology it was built on.
Can I use the score to price a tattoo removal package?
Yes, as arithmetic: sessions times your price per session gives a starting figure. The paper itself notes that a firmer session estimate helps give the patient a more certain cost. Packages are still set by the practice, and the provider reassesses after each session.
Sources and scope
- 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;2(3):32-37 (PMID 20729941)
Peer-reviewed. Source of every parameter, point value, the 6 to 8 week assumption, the more-than-15-points note and the study figures (r = 0.757; 9.91 sessions on average).
- Aurangabadkar SJ et al. A prospective open-labeled study of tattoo removal with Q-switched Nd:YAG laser utilizing the R0 technique and correlation with Kirby-Desai scale. J Cutan Aesthet Surg, 2019;12(2):95-104 (PMID 31413477)
Peer-reviewed. Found the R0 technique needed significantly fewer sessions than the scale predicted in 22 patients.
A math aid based on a published scale, not medical advice or a promise of results. The treating provider decides the plan, device, settings and number of sessions.