Tattoos: Risks and precautions to know first

Tattoos carry certain risks. Educate yourself before you get permanent body art.

From MayoClinic.com

A tattoo may take only a few hours to acquire, but invest plenty of thought and research before getting one. If you first take steps to protect yourself from possible risks, what seems like a cool idea now is less likely to turn into a source of regret later.

How tattoos are done

A tattoo is a permanent mark or design made on your skin with pigments inserted through pricks into the skin's top layer. During the procedure, 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. With every puncture, the needle inserts tiny ink droplets. The process, which may last up to several hours for a large tattoo, causes a small amount of bleeding and minor to potentially significant pain.

Risks of tattoos

Given the popularity of tattoos, complications are relatively uncommon. However, because a tattoo breaches your skin — your body's main protective barrier — skin infections and other skin reactions are possible.

Tattoo inks are classified as cosmetics, so they aren't regulated or approved by the Food and Drug Administration (FDA). The pigments and dyes used in tattoo inks aren't approved for injection under the skin. Long-term effects of these are unknown.

Specific risks of tattoos include:

• Blood-borne diseases. If the equipment used to create your tattoo is contaminated with the blood of an infected person, you can contract a number of serious blood-borne diseases. These include hepatitis C, hepatitis B, tetanus, tuberculosis and HIV — the virus that causes AIDS.
• 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.
• Skin infections. Tattoos can lead to local bacterial infections. Typical signs and symptoms of an infection include redness, warmth, swelling and a pus-like drainage. The Centers for Disease Control and Prevention has linked clusters of potentially serious antibiotic-resistant skin infections to unlicensed tattoo artists who don't follow proper infection-control procedures. Some antibiotic-resistant skin infections can lead to pneumonia, blood infections and a painful, flesh-destroying condition called necrotizing fasciitis.
• 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.
• MRI complications. Rarely, tattoos or permanent makeup may cause swelling or burning in the affected areas during magnetic resonance imaging (MRI) exams. In some cases — such as when a person with permanent eyeliner has an MRI of the eye — tattoo pigments may interfere with the quality of the image.

Medications may be necessary if you develop an allergic reaction, infection or other skin disorder. In some cases, permanent tattoo removal is required to resolve the complication.

Tattoo care

How you care for your new artwork depends on the type and extent of work done. Your tattoo artist should provide you with detailed instructions on how to care for the tattoo — such as cleaning the tattoo with soap and water, applying moisturizer regularly and avoiding sun exposure for at least the first few weeks.

Tattoos may take up to several days to heal. Don't pick at scabs, which increases the risk of infection and can damage the design and cause scarring.

Tattoo removal

A common problem with tattoos is dissatisfaction. Some tattoos fade. If the tattoo artist injects the color too deeply into your skin, the dye can drift — causing a blurred design. You may also decide that the tattoo no longer fits your current image or that the once-stylish design has become dated.

Tattoos are meant to be permanent, so their complete removal 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 common way to reduce the appearance of a tattoo. Pulses of laser light pass through the top layer of skin where the light's energy is absorbed by the tattoo pigment. This process creates a very low grade inflammation and allows your body to process the small areas of altered pigment. You may require many treatments to lighten the tattoo, and the treatment might not completely erase it.
• Dermabrasion. The tattoo area is chilled until numb, and the skin that contains the tattoo is sanded down to deeper levels. This generally isn't painful, but it may leave a scar.
• Surgical removal. A doctor can surgically cut out the tattoo and stitch the edges back together, but this can leave a scar.

Do not use do-it-yourself tattoo removal creams or products sold online. They aren't FDA-approved and may cause skin reactions. If you're interested in tattoo removal, don't attempt it on your own. Ask your dermatologist about laser surgery or other options for tattoo removal.

Precautions to protect yourself

You can decrease the possibility of complications if you look for and ask about the following:

• State or local license. Regulation requirements and licensing standards vary from state to state. Check with your city, county or state health department for information on licensing and regulations in your area. Also, choose a reputable tattoo studio that's clean, tidy and professional and that employs only properly trained employees.
• An autoclave. An autoclave is a heat sterilization machine that should be used to sterilize all nondisposable equipment after each customer. 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 drawer handles, tables and sinks.
• Fresh equipment. Watch the tattoo artist and make sure he or she removes a needle and tubes from a sealed package before your procedure begins. Any pigments, trays and containers should be unused as well.
• Gloves. The tattoo artist must wash his or her hands and put on a fresh pair of latex gloves for each procedure. The tattoo artist should change those gloves if he or she needs to touch anything else, such as the telephone, during the procedure.

If you're considering a tattoo, understand the risks and research the process beforehand. Take precautions to get your body art done correctly, and use proper care afterward to reduce the risks. Also, be sure you're in a clear state of mind and not under the influence of drugs or alcohol when deciding to get a tattoo. A tattoo is permanent and requires careful and clear thinking so it doesn't become a source of regret.

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