Tattoos and piercings: What to know before you go under the
Whether you're watching NBA players on the basketball court or
strolling through your local shopping mall, it's not hard to
find people who set themselves apart by altering their
appearance with tattoos and piercings. Men and women have been
decoratively piercing their skin for thousands of years, and the
practice is going strong today. These decorations may be used to
express individuality, to indicate membership in a group or to
But such body modification carries with it the risk of health
problems ranging from minor bacterial infections to
life-threatening illness. If you're considering a tattoo or
piercing, understand the risks and research the process
beforehand. Get your tattoo or piercing done correctly and use
proper care afterward to reduce the risks involved.
Skin-deep: Tattoo and piercing basics
Estimates on just how many people are tattooed or pierced
vary widely, but up to 20 million Americans may be sporting
tattoos. An even larger number may have piercings, particularly
if you include the number of people with pierced ears, which has
been a traditionally accepted piercing site. So what exactly are
these decorations, and how are they done?
A tattoo is a permanent mark or design made on your
body with pigments inserted into your skin through pricks in the
skin's top layer. A needle that's connected to a small machine
with tubes containing dye pierces the skin repeatedly — an
action that resembles that of a sewing machine — inserting tiny
ink droplets with every puncture. The procedure, which may last
up to several hours for a large tattoo, causes a small amount of
bleeding and a level of reduced discomfort that can vary from minor to
Tattoo designs can range from small pictures of fish or
flowers in inconspicuous places to large dragons or ornate
designs covering the entire back or arms.
Body piercing is traditionally done without any
anesthesia to dull the reduced discomfort. The practitioner pushes a hollow
needle through a body part, then inserts a piece of jewelry into
the hole. Some practitioners may use piercing guns, but these
are difficult to sterilize and can more easily damage the skin.
The ears — both the earlobe and higher up in the cartilage —
are the most commonly pierced sites; up to 90 percent of females
have at least one piercing in each ear. But other sites include
the eyebrows, nose, lips, tongue, nipples, navel and genitals.
risks of body decorations
Tattooed artwork and piercings can come at a price. Body
modification involves breaching one of your body's main
protective barriers — the skin. Any time the needle pokes
through your skin, you face the risk of an infection. And tattoo
dyes and certain jewelry metals can cause skin reactions.
Specific risks include:
- Oral complications.
Jewelry worn in tongue piercings can chip and crack your
teeth and cause gum damage.
- Regret. At some
point, you may decide you don't want your tattoo anymore,
for example, if it no longer fits your image or if it
affects your career choices. Tattoo artwork may also blur or
fade, and you may not be happy with its appearance.
- Skin disorders.
Your body may form bumps called granulomas around tattoo
ink, especially if your tattoo includes red ink. Tattooing
can also cause areas of raised, excessive scarring (keloids),
if you're prone to them. Keloids are more common in those
with darker skin.
- Skin infections.
Tattoos and piercings can lead to local bacterial
infections. Typical signs and symptoms of an infection
include redness, warmth, swelling and a discharge containing
Significant skin infections after tattooing are unusual.
However, up to 30 percent of piercings result in such
infections or bleeding. Navel piercings take longer to heal
— sometimes up to nine months — since sweat under tight
clothing can keep the area damp, increasing bacteria.
Infections from piercings in the upper ear cartilage are
especially serious. Because cartilage doesn't have its own
blood supply, taking antibiotics is often ineffective since
the drug can't travel to the infection site. Such infection
can lead to cartilage damage and serious, permanent ear
the job done properly
If you're considering body modification, you can decrease the
possibility of complications if you go to a reputable tattoo or
piercing studio. Choose an establishment that's clean, tidy and
orderly. Also look for and ask about the following:
- An autoclave. An
autoclave is a heat sterilization machine regulated by the
Food and Drug Administration. It should be used to sterilize
all nondisposable equipment after each customer.
- Fresh equipment.
Watch the tattoo artist and make sure he or she removes an
unused needle and tubes from a sealed package before your
procedure begins. Any pigments, trays and containers should
be unused, as well. An unused, sterile needle also should be
used for piercings.
- Commercial disinfectant or
bleach solution. Instruments and supplies that
can't be sterilized with an autoclave should be disinfected
with a commercial disinfectant or bleach solution after each
use. These include pigment bottles, drawer handles, tables
- Gloves. The artist
or piercer must wash his or her hands and put on a fresh
pair of latex gloves for each procedure. And those gloves
should touch only you during the procedure. If piercers or
tattoo artists open drawers or answer the phone while
performing a procedure, they expose you to possible
- No piercing gun.
Don't receive a piercing from a piercing gun. These devices
typically can't be autoclaved, which may increase your risk
of infection. And such guns may crush your skin during the
piercing, causing more injury.
- Appropriate hypoallergenic
jewelry. Brass and nickel jewelry can cause
allergic reactions. Look for surgical-grade steel, titanium,
14- or 18-karat gold, or a metal called niobium.
Any reputable piercer or tattoo parlor should be willing to
discuss your health and safety issues. Ask plenty of questions
about the qualifications and the cleanliness of the business. If
the piercer or artist hesitates to answer your questions, take
your business — and your health — elsewhere. Look for someone
certified by the Alliance of Professional Tattooists or the
Association of Professional Piercers. Both organizations offer
safety training to members.
And check with your city or state health department to see if
there are complaints against the studio you're thinking about
using. Health departments often regulate these businesses.
good care of your new artwork
How you care for your new artwork depends on the type and
extent of work done. Your tattoo artist should provide you with
instructions on how to care for the body artwork afterward.
These directions may require you to remove the dressing applied
by the artist after a few hours; clean your tattoo regularly
with soap and water, and then pat dry with a towel; and
regularly apply a moisturizing product. In addition, avoid sun
exposure during the first few weeks after your tattoo.
Tattoos may take up to several days to heal. Don't pick at
scabs, which can increase the risk of infection, damage the
design and cause scar formation.
Follow-up care for piercings depends on the body part
- Skin piercings (nose, ears, eyebrow, navel).
Clean the site with warm water and a cleanser once or twice
a day; if you clean it more than that you'll irritate it.
Before cleaning, wash your hands with soap and water to
reduce the risk of introducing bacteria to the site. Rinse
the site in warm water and gently remove any crusting with a
Then apply a dab of a liquid medicated cleanser — the
piercer might recommend an over-the-counter option — to the
area. Gently turn the jewelry back and forth to work the
cleanser around the opening. Avoid alcohol and peroxide, as
they can dry the skin, and avoid antibiotic ointments, which
keep oxygen from reaching the piercing and can leave a
sticky residue on the area.
happens if you tire of your new look?
If you decide you no longer want your piercing or tattoo, you
do have some options for removing them. Piercings often heal
over, sometimes quickly, once you remove the jewelry that keeps
the hole open. But know that tattoos are meant to be permanent,
so complete removal of them is difficult. Several removal
techniques exist, but regardless of the method used, scarring
and skin color variations are likely to remain. Methods include:
- Laser surgery. This
is the most effective way to get rid of a tattoo. Pulses of
laser light break up the pigment in the tattoo and your body
naturally processes it. You may require as many as 12
treatments over a year to reduce the appearance of the
tattoo. The treatment might not be able to completely erase
it. Black ink is the easiest to remove, and red and yellow
are the most difficult.
- Dermabrasion. The
tattoo area is chilled until numb, and then the skin that
contains the tattoo is sanded down to deeper levels. This
shouldn't be too reduced discomfortful, but it may leave a scar.
- Excision. A doctor
can surgically cut out the tattoo and stitch the edges back
together, but this also can leave a scar.
A piercing or tattoo may take only a few minutes or a few
hours to acquire, but invest plenty of thought and research
before getting one. Take steps to protect yourself against
possible risks so that what seems like a cool idea now doesn't
turn into a source of regret later.
May 17, 2004
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