HEALTH TALK: Tattoo risks, side effects and precautions

Every decade seems to have its fad, its craze. For us in Dominica, for example, the 70’s saw the afro, bell-bottom and platform shoes. The 80’s and 90’s had their own. In this century, there’s hardly a black woman to be found without a weave or wig. And what seems to have been the biggest craze in the western hemisphere in the last decade more than any other time previously, is the tattoo. The rate of tattoo administrations seems to be accelerating all the time. And it used to be that you would see people with one or two small tattoos on one to a few body parts, but now it’s the entire body in a lot of cases.

But before you get a tattoo, make sure you know what’s involved. And be sure that tattooing is the right decision for you.

HOW TATTOOS ARE DONE

A tattoo is a permanent mark or design (mark the word ‘permanent’) made on your skin with pigments inserted through pricks into the skin’s top layer. Typically, the tattoo artist uses a hand-held machine that acts much like a sewing machine, with one or more needles repeatedly piercing the skin. The needles insert tiny ink droplets with every puncture. The process, which is done without any anaesthetic (deadening of the skin) does cause a small amount of bleeding and slight to potentially significant pain, depending on the pain threshold of the receiving person, and their level of mental preparation for the procedure.

GET TO KNOW THE RISKS

It’s important to remember that tattoos breach the skin, a fact which itself carries medico-legal implications. But that’s another broad issue not relevant to this discussion, and which I won’t get into. But this means that skin infections and other complications are possible, among which are:

Allergic reactions
Tattoo dyes – particularly red, green, yellow and blue dyes – can cause allergic skin reactions, such as an itchy rash at the tattoo site. This can occur even years after you get the tattoo.

Skin infections
The manifestations of an infection, such as redness, swelling, pain and a pus-like drainage can occur after tattooing.

Unsterile tattooing equipment and needles can transmit infectious diseases such as hepatitis B and hepatitis C. This is why the American Association of Blood Banks requires a one-year wait between getting a tattoo and donating blood. It is of paramount importance to make sure that all tattooing equipment is clean and sterilized before use. Even if the needles are sterilized or have never been used, it is important to understand that in some cases the equipment that holds the needles cannot be sterilized reliably due to its design. Furthermore, the person who receives a tattoo must be sure to care for the tattooed area properly during the first week or so after the pigments are injected.

Other Skin Problems

Sometimes bumps called granulomas form around tattoo ink. Tattooing can also lead to keloids – raised areas caused by an overgrowth of scar tissue. We all know about these. If you have had a keloid before from a cut or other skin lesion, do not get a tattoo.

Blood borne diseases. If the equipment used to create you tattoo is contaminated with infected blood, you can contract various blood borne diseases – including tetanus, hepatitis B and hepatitis C. We’re talking serious morbidity and possibly mortality here – and there’s also the possibility of HIV transmission. Do I need expand on this?

When insurance companies’ applications include on their questionnaire whether you have tattoos or multiple body piercings, what do you think they’re getting at? Think about it.

MRI Complications

On occasion, tattoos or permanent makeup might cause swelling or burning in the affected areas during MRI exams. Sometimes tattoo pigments can interfere with the quality of the image, such as when a person who has permanent eyeliner has an MRI of the eye. Some tattoo areas may actually cause burning of the skin because of the process involved. Medication or other treatment – including possible removal of the tattoo – might be needed if an allergic reaction to the tattoo ink occurs or you develop an infection or other skin problem near a tattoo.

Be Ready

Before you get a tattoo, be sure you truly want to invest in permanent body art. Unsure or worried that you might regret it someday? Give yourself more time to think about it. Don’t be pressured, and don’t get a tattoo under the influence of alcohol or drugs.

If you decide to go ahead, choose the tattoo location carefully. Want it to be visible or hidden under clothing? Also remember that weight gain – including pregnancy weight gain – might distort the tattoo or otherwise affect its appearance.

Insist on Safety
To make sure your tattoo will be safely applied, answer these questions:

Who does the tattooing? Don’t attempt to tattoo yourself or have an untrained friend do the tattooing. Go to a reputable studio that employs only properly trained employees. Some locales have licensing standards. Find out about these where applicable.

Does the tattoo artist wear gloves? He or she should wash hands and wear a fresh pair of protective gloves for each procedure.

Does the tattoo artist use proper equipment? Make sure the tattoo artist removes the needle and takes it from sealed packages before your procedure begins. Any pigment, trays or containers should be unused as well.

Does the tattoo artist sterilize nondisposable equipment? Make sure the tattoo artist uses a heat sterilization machine (autoclave) to sterilize all nondisposable equipment between customers. Instruments and supplies that can’t be sterilized by an autoclave – drawer handles, tables and sinks – should be disinfected with a commercial disinfectant or bleach solution after each use.

Taking Care of Your Tattoo

This depends on the type and extent of work done. Usually, however, you’ll need to:

•    Remove the bandage after 24 hours. Apply an antibacterial ointment or cream to the tattooed skin while it’s healing.

•    Keep the tattooed skin clean.
Use plain soap and water and a gentle touch. While showering, avoid direct streams of water on the newly tattooed skin. Pat – don’t rub – the area dry.

•    Use moisturizer. Use a mild one to the area several times a day.

•    Avoid sun exposure. Keep out of sun for at least a few weeks

•    Avoid swimming. Stay out of pools, hot tubs, rivers, lakes, and other bodies of water while your piercing is healing.

•    Choose clothing carefully. Don’t wear anything that might stick to the tattoo.

•    Allow up to 2 weeks for healing
Don’t pick at any scabs, which increases the risk of infection and can damage the design and cause scarring.

Removal Techniques

This is the area that concerns me a great deal. The craze will be over, and then what?

•    Laser Treatments can lighten many tattoos, some more easily and effectively than others. Generally several visits are necessary over weeks or months, and treatment can be expensive. Some individuals experience a lightening of their natural skin coloring. And it is almost impossible for some degree of scarring not to occur with laser.

Knowing what pigments are in your tattoo or permanent makeup has always been difficult and has become more so as the variety of tattoo inks has multiplied. Inks are often sold by brand name only, not by chemical composition. The pigments are sold to tattoo parlors and salons, not on a retail basis to consumers, so manufactures are not required by law to list the ingredients on the labels. In addition, because manufactures may consider the identity and grade of their pigments “proprietary,” neither the tattooist nor the customer may be able to get this information.

Allergic reactions have also occurred from laser treatments, apparently because the laser caused allergenic substances in the tattoo ink to be released into the body.

•    Dermabrasion involves abrading layers of skin with a wire brush or diamond fraise (a sanding disc). This process may leave a scar(s).

•    Scarification involves removing the tattoo with an acid solution and creating a scar in its place.

•    Salabrasion. A salt solution is used to remove the pigment. It is sometimes used in conjunction with dermabrasion, but has become less common.

•    Surgical removal involves the use of tissue expanders (balloons inserted under the skin, so that when the tattoo is cut away, there is less scarring). Larger tattoos may require repeated surgery for complete removal.

Note that a common theme in most of these techniques is scarring. I implore my readers to think twice about tattoos and especially covering their whole bodies with them! That is unless you’re convinced you’ll want to keep them the rest of your lives, no matter what.

•    Camouflaging a tattoo entails the injection of new pigments either to form a new pattern or cover a tattoo with skin-toned pigments. Injected pigments tend not to look natural because they lack the skin’s natural translucence.

Take care.

See you next week.