Fashion, by definition, is fleeting. But you can't change a tattoo to conform to the latest fashion trend. Perhaps that's why getting one has always seemed so rebellious. It's a bold decision that sets you apart. Trouble is, a few corporate sales meetings are enough to bludgeon the inner James Dean out of anyone. Now you're embarrassed by that scroll you had tattooed across your lower back ten years ago in Panama City. It just seems so "Girls Gone Wild." And the barbed wire around your bicep—well, let's not mention it again, shall we?

Of course, not all tattoos spell regret. Many people have deeply meaningful body art that they're proud to show off. A tattoo may honor a lost loved one, serve as a reminder of a person's spirituality or goals, record an accomplishment or affiliation, or convey some other special expression. In some cultures, tattooing may even be an essential rite of passage for young adults.

Piercing is another popular form of body art. Ear piercing is only the beginning. The nose, eyebrow, tongue, lip, navel, nipples, genitals, or other body parts can be pierced as well. More dramatic body modification procedures include using jewelry to stretch the earlobe, implanting beads into the skin, deliberately scarring the skin (scarification), using dermal punch procedures to perforate cartilage, and many more.

Fashion risks aside, serious health risks are associated with tattooing and piercing, including the following:

  • Infection with bloodborne pathogens (disease-causing organisms), including HIV, the virus that cause AIDS, hepatitis B, and hepatitis C.
  • Staph infections (including drug resistant Staph aureus), tuberculosis, and other infections
  • Pain, itching, swelling, tenderness, redness, or tissue injury at the site
  • Formation of thick, overdeveloped scars called keloids
  • Development of nodules of inflamed tissue called granulomas
  • Difficulty having a magnetic resonance imaging (MRI) scan performed, since some tattoo inks and all piercing jewelry contain metals;

Furthermore, the implications of using tattoo ink and colorings remain unknown. Such pigments are regulated by the FDA, which has only recently begun to study the health risks associated with them. More than 50 colorings used in tattoos have been approved for use in cosmetics, but the risk of injecting them beneath the skin is unclear. These inks are often identical to those used in auto body shops and commercial printing operations. The FDA is investigating how they are metabolized (broken down) and whether, for example, they migrate through the body by way of the lymph system. More than 150 adverse reactions to tattoo inks, such as allergies and skin inflammation associated with sun exposure, have been reported by consumers.

You can lower your risk by taking a few simple precautions:

  • Have your tattoo or piercing performed at a licensed facility that follows all applicable health and safety laws.
  • Needles used for piercing or tattooing and razors used to shave body hair should not be reused. Ask to watch your artist or piercer open the packages.
  • Disposable (single-use) gloves must be worn, and hands must be washed before and after the gloves are applied.
  • Equipment must be properly cleaned and sterilized and all work surfaces, including chairs, must be disinfected between customers. Observe and ask about these procedures, and go elsewhere if employees seem reluctant to discuss them or if a lack of proper sanitation is evident.
  • The area of skin to be pierced or tattooed should be swabbed with a disinfectant, such a rubbing alcohol.
  • Fresh tattoos should be covered with sterile gauze or a bandage. Follow the artist or piercer's instructions for caring for newly tattooed or pierced skin.
  • A piercing gun should be used only on earlobes; to avoid crushing delicate tissues, a hollow needle should be used to pierce other body parts.

Permanent makeup is a form of tattooing in which permanent ink is used to mimic the look of eyeliner, lipliner, eyebrow pencil, or other kinds of makeup. It carries the same infectious disease risks as other kinds of tattooing. In addition, such tattoos may become cosmetically unacceptable years later, as skin sags or stretches, skin tone changes, or the tattoo ink fades or blurs.

Tattoos can be removed, but not always completely or with a satisfying cosmetic result. The process is expensive and requires repeated visits to a physician, who uses short bursts of laser light to break down the tattoo ink. Scarring is likely. The FDA advises against using home removal kits, which contain acids that can harm the skin or eyes. If you're thinking about having a tattoo removed, consult a health care professional, not a tattoo artist.

Reversal of piercing is usually as simple as removing the jewelry and allowing the hole in the skin to heal, but punctured cartilage, stretched skin, and other body modifications may require surgical correction.