Tattoos appear to be more popular than ever, with a Pew Research Center survey reporting that 40 percent of young adults have at least one. They’re appealing for their customized art, which can reflect your personality or even honor people important in your life.

Still, getting a quality tattoo isn’t always easy, though they are much safer than decades past.

The actual process itself consists of a tattoo needle literally injuring your skin to design the art. The needle also inserts small amounts of color pigments. If your skin heals correctly, you’re left with beautiful, permanent skin art.

The key to tattoo safety is making sure these microinjuries to the skin heal properly, and that you work with a safe and reputable artist.

Most of the risks and side effects from tattoos occur when the tattoo is still fresh. At this point, your skin is still healing, so proper aftercare is necessary to prevent complications.

Skin infection

While tattooing is an art, the actual process is technically one that causes injury to your skin. This includes both the upper (epidermal) and middle (dermal) layers of skin.

Your skin needs to recover after you get new ink, so your tattoo artist will give you tips on how to prevent infection.

An infection can also occur if nonsterile water is mixed with the ink before injection.

You’re most vulnerable to a skin infection from a tattoo within the first two weeks. Symptoms include redness, itchiness, and discharge. The area may also become swollen.

If the infection spreads, you can have other symptoms, such as a fever. In severe cases, infections can be chronic (ongoing).

Allergic reactions

Some people might develop an allergic reaction after getting a tattoo. This is usually related to the ink — especially if it contains plastic — and not the needling process itself. According to the Mayo Clinic, red, yellow, blue, and green pigments tend to be the most allergenic.

Symptoms of an allergic reaction from tattoos can include a red rash, hives, and severe itchiness. Swelling can occur too. These effects can occur years after you get the tattoo.

Keloid scarring

Tattoos have the potential to scar. This is especially true if your tattoo doesn’t heal properly, or if you have an infection or allergic reaction. Eventually, you can also develop keloid scars — these consist of raised bumps that contain old scar tissue.

Complications with MRIs

If your doctor orders an MRI scan, there’s a slight chance that the test could interact with your tattoo. Some of the side effects include swelling and itchiness afterward, but they tend to go away on their own.

Your risk of such reactions could be higher if your tattoo was inked with low-quality pigments or if the tattoo is old.

Talk to a doctor if you’re concerned about your tattoo interfering with an MRI scan. According to the Mayo Clinic, this reaction is relatively rare.

Sterilization of needles

A reputable tattoo artist will use sterilized needles. Many states require the use of sterlized needles by law although this can vary by state.

Not using sterilized needles increases your risk of infection and can also pose the risk of transmitting blood-borne illnesses, including HIV, hepatitis C, and methicillin-resistant Staphylococcus aureus (MRSA).

Can hide skin cancer

Another risk of getting a tattoo is that it can hide possible signs of skin cancer or another skin condition. These include the telling moles, red patches, and other signs that might be associated with a skin issue that could go undetected.

Tattoo ink is much safer than it used to be. However, there’s a possibility that you can be sensitive to certain colors, especially brighter pigments.

The U.S. Food and Drug Administration (FDA) has strict standards about labeling inks to prevent cross-contamination, but you could still be vulnerable if such practices aren’t followed. Ask your provider whether the ink is completely sterile to reduce your risk.

Another issue relates to the components of the tattoo pigments. A 2010 study of Danish adults found traces of nickel, lead, and other cancer-causing agents in 65 tattoo inks.

Also, according to the FDA, some inks contain the same chemicals used in car paint and printer ink, but the agency doesn’t regulate these materials.

More tests involving the safety of tattoo inks are needed to determine the overall risks for people wanting to get tattoos.

One of the best ways you can decrease the risks of getting a tattoo is to do a little homework first. You have to be 18 or older to get a tattoo in the United States., so shops or individual artists who do ink on anyone younger should raise a red flag.

Once you’ve decided that you want to get a tattoo, find the right provider. Word-of-mouth is a good place to start. You can also check out the shop ahead of time to see the artists’ licenses, experience, and what types of ink they use.

Despite the improved safety of tattoos, it’s important to work with an experienced tattoo artist at a reputable shop to reduce your risk of side effects. Proper aftercare on your part is also important to reduce scarring and other risks.

While tattoos aren’t completely risk-free, knowing the potential effects ahead of time can reduce your chances of side effects. Talk to your tattoo artist about any concerns you may have.