Reviewed by Louise Chang, MD on September 13, 2010
Source: 2010 WebMD
The Truth about Tattoos
Types: Amateur Tattoos
Amateur tattoos are made by individuals or their friends by jabbing ink, charcoal, or ashes under the skin with a pin. They lack the artistry of professional tattoos. And because such tattoos are done under unsanitary conditions with unusual pigments, there is a much higher risk of infection.
Types: Cultural Tattoos
Cultural tattoos are applied via traditional methods to members of certain ethnic groups. They may serve ritual, societal, or cosmetic functions.
Types: Professional Tattoos
Professional tattoos are applied by registered artists using a tattoo machine -- the term many artists prefer to the slangy "tattoo gun."
Types: Cosmetic Tattoos
Tattoos may be used as "permanent" make-up, such as eye and lip liner, lipstick, blush, eyebrows, or hair imitation. Because tattoos do fade over time, the procedure must occasionally be repeated to keep colors fresh.
Types: Medical Tattoos
Medical tattoos are not decorative, but are placed for medical reasons:
-Patients with medical conditions or chronic diseases, such as diabetes, may use a tattoo to alert health care workers in case of an emergency.
-Doctors often use tattoos to mark specific sites for repeated application of radiation therapy.
-After breast reconstruction surgery, a tattoo may be used to simulate the nipple. This use may also be considered a cosmetic tattoo.
Types: Traumatic Tattoos
Traumatic tattoos occur during injuries, when dirt or other materials get imbedded in the skin. Examples include "road rash" from bike accidents or "pencil-point" tattoos (like the one shown here) from pencil punctures.
Why Get a Tattoo?
There are two basic, very different reasons why people get tattoos: To demonstrate one's individuality and uniqueness, or to show membership in a group. Should you get one? No, says University of Miami dermatologist Jonette Keri, MD, PhD. "Down the road, you may not want it -- bodies at 60 look different than bodies at 30," she says. "And, people still have preconceived notions about people who get tattoos. If you'll be looking for a job, you may not get it."
Safe Tattooing: Choosing a Studio
If you're going to get a tattoo, remember that getting a permanent tattoo is an invasive procedure that requires breaking the skin and coming into contact with blood and body fluids. Make sure the studio is as clean as a doctor's office. (Hint: Check the bathroom. If it's dirty, get out of there.) Check the artist's business license to make sure it's up to date. And check the tattoo area: Look for a separate area for tattooing with a clean, hard surface and no random items contaminating the work area.
Safe Tattooing Tips
Don't drink alcohol or take drugs (especially aspirin) the night before or while getting a tattoo.
Don't get a tattoo if you're sick.
Make sure all needles are removed from sterile single-use package before use.
Make sure the studio has sterilization equipment to clean instruments after each use.
Make sure the artist washes his hands and puts on sterile gloves; many tattooists are required to take training in the prevention of bloodborne illnesses.
Make sure the work area is clean and clear of nonsterile objects (water bottles, purses, etc.)
Get a list of the specific pigments used, including color, manufacturer's name, and lot number.
After getting a tattoo, carefully follow healing instructions -- including use of antibiotic ointment.
Tattoo Risks: Infection
Whatever type of tattoo you get, there are risks involved. The most serious risks are life-threatening infections, such as HIV or hepatitis C, from unclean needles. Other infections, such as a staph infection called impetigo or MRSA (shown here), or deep-skin infection cellulitis may develop. It is important to note the FDA has not traditionally regulated either tattoo inks or tattoo removal, but is currently studying the issue.
Tattoo Risks: Allergic Reaction
Some people develop allergic reactions to tattoo pigments -- especially red pigments. The woman in this picture developed an allergic reaction to the red pigment used in her cosmetic lipstick tattoo. Tissue injury and inflammatory reactions to dyes or metals into the skin can occur. Occasionally a contact dermatitis can happen.
Tattoo Removal
Tattoos can be removed. Sometimes, particularly if the tattoo was done only in black, the results can be quite good. But often the skin cannot be restored to its original color or quality.
Tattoo Removal Techniques
There are three basic techniques: cutting away the tattooed skin, dermabrasion (rubbing away the tattooed skin with an abrasive device), or laser removal. Most doctors prefer to use lasers. The tattoo shown here was removed via laser; the scar below it was left from dermabrasion removal. Some color inks are harder to remove than others and repeated visits are required; permanent tattoos may never be gone entirely. The FDA warns people NOT to use any of the many available do-it-yourself tattoo removal products. These products contain acids and can cause harmful skin reactions. The FDA suggests that people seeking tattoo removal see a doctor, not a tattoo artist.
Tattoo Removal: What To Expect
Different lasers are used on different tattoo colors to break down the pigment into small particles that can be eliminated from the body. Immediately after treatment, the skin under the tattoo may whiten. More normal skin color usually appears in time.
Tattoo Removal Risks: Allergic Reactions
Lasers break down tattoo pigments, raising the possibility of allergic reactions. In the heart tattoo shown here, each of several different laser treatments caused the same blistering reaction. Fortunately, the blisters got better with routine skin care.
Tattoo Removal Risks: Scarring
Not every tattoo comes off perfectly. This picture shows scarring caused by attempted laser tattoo removal.
Even Temporary Tattoos Have Risks
A popular alternative to permanent tattoos is temporary tattooing with henna-based ink painted on the skin. But as this picture shows, even these tattoos can cause allergic reactions. WARNING: Stay away from "black henna" or "blue henna" tattoos. The blackening may come from coal tar, which often causes severe allergic reactions. And even normal, vegetable henna is approved by the FDA only for hair coloring, not for skin decoration.
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