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Tattoos and piercings: What to know before you go under the needle
From MayoClinic.com
 

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 attract attention.

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?

Tattoos
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 significant.

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.

Piercings
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.

 

The 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:

  • Allergic reactions. Tattoo dyes, particularly red dye, can cause allergic skin reactions, resulting in an itchy rash at the tattoo site. This may occur even years after you get the tattoo. Some piercing jewelry is made of nickel or brass, which also can cause allergic reactions.
  • Blood-borne diseases. If the equipment used to do your tattoo or piercing is contaminated with an infected person's blood, you can contract a number of serious blood-borne diseases. These include hepatitis C and HIV, the virus that causes AIDS which both can be fatal as well as hepatitis B, tetanus and tuberculosis.

    The risk is serious enough that the American Red Cross requires you to wait a year after getting a tattoo before you donate blood.

  • 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 pus.

    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 deformity.

 

 

  • Nickel allergy

     

     

  • Hepatitis

     

     

  • HIV/AIDS

     

     

  • Tuberculosis

     

     

  • Granuloma annulare

     

    Get 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 and sinks.
    • 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 infection.
    • 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.

     

    Take 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 pierced:

    • Oral piercings (tongue or lip). Use an antibacterial, alcohol-free mouth rinse for 30 to 60 seconds after meals while your piercing heals.

      Use a new soft-bristled toothbrush after the piercing to avoid introducing bacteria into your mouth.

    • 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 cotton swab.

      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.

     

    What 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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