Tattoos & Piercings

Written by the Healthline Editorial Team | Published on August 14, 2014
Medically Reviewed by George Krucik, MD, MBA on August 14, 2014

Getting Tattooed or Pierced

A tattoo is created when ink is inserted, using a needle, into the dermis layer of the skin. This changes the skin’s pigment, and can be used to create almost any image you can imagine.

Permanent makeup is a form of tattooing in which permanent ink is used to mimic the look of eyeliner, lip liner, eyebrow pencil, or other kinds of makeup.

In recent years, tattoos have become more and more popular. According to the Pew Research Center, almost four of every 10 people born after 1980 have at least one tattoo.

Piercing is another popular form of body art. Ears, noses, eyebrows, tongues, lips, navels, nipples, genitals, and other body parts can be pierced. 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.

Health Risks of Body Modification

There are serious health risks associated with tattoos and piercings, including:

  • infection, including HIV, hepatitis B, hepatitis C, staph (including drug-resistant Staphylococcus aureus), and tuberculosis
  • 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, as some tattoo inks and all piercing jewelry contain metals

Furthermore, the long-term effects of tattoo ink and colorings remain unknown. Until recently, no government regulatory agency has closely examined the safety of tattoo ink.

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. Such pigments are regulated by the U.S. Food and Drug Administration (FDA). However, the FDA has so far only looked at whether these pigments were safe for external use — and not for injection under the skin. In other words, no coloring has been officially approved for injection under the skin.

In 2003 and 2004, more than 150 adverse reactions to tattoo inks, such as allergies and skin inflammation associated with sun exposure, were reported by consumers to the FDA. In 2012, additional reports of infections from contaminated inks were filed with the FDA.  As a result, the FDA is now beginning to investigate the safety of these inks as tattoo colorations.

The FDA conducts research and studies to examine the effects of tattoo ink on the body. 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.

Precautions

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 and razors 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 as rubbing alcohol.
  • Fresh tattoos should be covered with sterile gauze or a bandage. Follow the artist’s or piercer’s instructions for caring for newly tattooed or pierced skin.
  • A piercing gun should be used only on earlobes; in order to avoid crushing delicate tissues, a hollow needle should be used to pierce other body parts.

Removal

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. Scarring is likely.

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. The FDA recommends laser surgery performed by a dermatologist as a safe tattoo removal technique. If you’re thinking about having a tattoo removed, consult your doctor.

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