HEALTH TALK: Tattoo risks, side effects and precautions

Dr. Victor Emanuel MD
Dr. Victor Emanuel MD

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.


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.


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.

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  1. September 1, 2020

    I have read your complete artice. Really one must be careful about tattoo. I as a tattoo artist will recommend this to all.

  2. January 7, 2020

    Tattoo should always be done by an expert who is very serious about the hygiene level.

  3. November 23, 2018

    Thanks for sharing this information.

  4. hardik koradia
    October 2, 2018

    I had done tattoo amd after 3 days i m suffering from fever is this of tattoo i had done in other state and traveld

  5. Amal
    July 15, 2018

    is it true that , a tattood person is restricted to donate blood ?

  6. February 24, 2018

    It was good to see this blog before getting a permanent tattoo on my back. Now I would go for temporary tattoo. Thanks for the information.

  7. January 14, 2018

    Very very useful information for who is going to be tattooed.

  8. mr t
    January 23, 2017

    my sister is having a tattoo but since having it, firstly she was having flu that took more than three months and recently she experiencing short breath. Can anyone help please.

    • January 14, 2018

      The above said symptoms are not related to tattoo.

  9. sara
    September 12, 2015

    i had tattoo last week then i traveled around 13 hours,i had fever during 1 week and my travel then i saw rednss in all my body so im confuse that is because of fever or infection pls guide me what i need to do?

  10. omkar
    August 11, 2014

    Can i take steam after workouts?? 8-Omy tattoo is 1 month old

  11. Anonymous
    July 1, 2014

    :lol: :lol: :lol: :lol: :lol: :lol: :lol: :lol: :lol: :lol: :lol:

  12. joan
    November 29, 2013

    People have think before they get tattoo I told my Son not do but he went ahead and now years on he is wishing he did listen. Too late. I wanted one could not bring myself to suffer that pain…

    • Anonymous
      February 20, 2014

      Am Hppy with my tattoo :-D

  13. joan
    November 29, 2013

    Before i read about the tattoos Just want to say their are women with their own hair I have never had weave or extension. I think you used the wrong words there…. :lol:

  14. Sante'
    November 22, 2013

    Thank you Dr. Emanuel, great article. Could you write something regarding vagal response to severe pain, systemic effects such as effects on blood pressure etc. Thanks and keep on educating us.

  15. Anonymous
    November 21, 2013

    tattoo is related to the accult

  16. ME SeLF
    November 20, 2013

    Great article doc. I was always curious

  17. john bess
    November 20, 2013

    i have my tattoo all over my body since i was 15,and i dont have no skin problems,lets appreciate the art.

  18. Channel 1
    November 20, 2013

    Silly and confused people are the ones who put tattoos on their body.

    What an absolutely stupid practice. If these people want to draw, they should just by some crayons and draw stuff on paper instead of their skins.

    After all, a pack of crayons ought to be relatively cheap to get eh…

  19. Listening
    November 20, 2013

    I have several tattoos and have been able to donate blood to several family members, friends and co workers. I am O+. Once the tattoo isn’t younger than six months because it can take that long for hepatitis B, HIV and such to show up on the test.

  20. Wesley Empress
    November 20, 2013

    Very nteresting article doc. Thank you!

  21. hope
    November 20, 2013

    Thank you for this article. I am a teacher trying hard to dissuade my students from getting tattoos. Thanks for simplifying the science behind it. Just maybe they will listen to me now!

  22. lol
    November 20, 2013

    According to Mighty Acre, tattoo on the girls’ engines too.

  23. Rainbow
    November 20, 2013

    I wont be donating blood to anyone who has a tattoo, family or not. You chose your lifestyle, live with it.

    • Anonymous
      November 20, 2013

      I didn’t know you had a choice of whom your blood should go to when you’re donating…….can you imagine if Christ had said that after Adam and Eve sinned?

    • upcoming generation
      November 20, 2013

      woah…what does having a tattoo have to do with receiving blood?? and when you donate blood, you usually donate to the blood bank and have no idea who will be receiving it..unless you were directly asked by someone close. lastly, people donate blood out of the goodness of their heart to help save a life, if this is your mentality..hmph…i hope you wont be in dire need of anything at any point in your lifetime. karma has a way of getting people

    • Listening
      November 20, 2013

      What is the connection?!?! I hope your tattooed family members and friends aren’t as close minded as you are if you ever need blood!

    November 20, 2013

    Lovely article, but you did not mention anything about being able to donate blood. Can one who has tattoo’s’s on their body still donate blood.

    • Ms Kubuli
      November 20, 2013

      You have to wait a yr after any tattoo or piercing to donate blood.

    • November 20, 2013

      Yes. The advisable waiting period is one (1) year (see 2nd paragraph under “skin infections”.

    • upcoming generation
      November 20, 2013

      yes they did mention that. he said: “This is why the American Association of Blood Banks requires a one-year wait between getting a tattoo and donating blood.”

    • Response
      November 20, 2013

      Based on the below I believe the answer is yes.

      “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”

    • ResilientChic
      November 20, 2013

      Yes one can donate blood if one has a tattoo. However one can only donate blood a year after the tattoo was placed.

    • banan
      November 20, 2013

      maybe you should read a little slower or read twice befor you write;read again,you will see that.very Interested topic.

  25. APACHE
    November 20, 2013

    remember this one:for evry youth proud of his tatoo,there is an adult who wish he did not have it.i want to see them when they hit 60years

    • Watchers
      November 20, 2013

      Now I’ll have to sleep on my decision to get a tatoo, a few more nights!

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