Tattoos and health implications

According to the limited statistics available, there appears to be resurgence in the popularity of tattoos. Tattooing has been performed as a decorative practice since ancient times. It is now also being used for some cosmetic medical procedures and for permanent make-up applications. Tattooing involves multiple intradermal injections of the skin by a small machine having one or more needles connected to tubes containing the dyes. The tattooist guides the machine over the skin and controls its speed. The procedure involves a variable amount of pain and a small amount of bleeding. It can take several hours depending on the size of the tattoo. The site of application usually takes 7 to 10 days to heal. Those considering an intradermal tattoo should also remember that it is 'permanent' and removal can involve painful surgery or dermabrasion and possible scarring.

Tattooing received a bad reputation in the past and has been banned in some states and localities due to operation of parlors with neglect of health and safety, resulting in outbreaks of infectious diseases. In most of the parlors operating now, there is a greater focus on cleanliness and sterilization of equipment. However, individuals who provide tattooing in unsanitary conditions from their home or the back of a van still exist.

Even in modern facilities, tattooing is not without risks. The two most significant ones are allergic responses to the pigments and exposure to bloodborne pathogens. The compounds used as pigments range from metal oxides to synthetic organic dyes. Cases of hypersensitivity to a pigment resulting in allergic responses have been reported but the incidence of such reactions is low. Since tattooing involves injections under the skin, poor infection control practices before, during and after the procedure by the tattooist and the consumer can lead to risk of bacterial and/or viral infection. There have been cases of hepatitis B transmission through tattooing. Transmission of hepatitis C and HIV are also possible with lack of proper sanitation but have never been reported.

If appropriate disinfection and sterilization techniques are used, the health risk associated with tattooing is small. Currently, many state and local health departments regulate tattooing facilities. In considering whether to get a tattoo, they are a source of information concerning the guidelines and regulations for tattoo parlors in the local area. Another way to ensure safety is to check whether the tattooist at a particular parlor has been certified by the Alliance for Professional Tattooists (APT). This nonprofit professional organization has developed a set of infection control guidelines, in association with the FDA, for its members to follow.