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Tattoos: what you should know

My teenager's best friend just got a tattoo. Of course my child wants one now, too, but I wonder if it's risky. Can it be removed later?

Tattoos have been around for thousands of years. In many cultures, they signify different rituals, such as coming of age or connection to a specific tribe. However, their recent popularity among teens and college students has renewed interest in this ancient form of self-adornment.

According to Tom Rohrer, M.D., assistant professor of dermatology and surgery at Boston University School of Medicine and director of dermatologic surgery at Boston Medical Center, "Anything that involves cutting, piercing, or pricking the skin runs the risk for infection. Tattoos are basically colored scars, created by repeatedly pricking the skin with a tiny, pigment-impregnated needle."

Infection from improperly used equipment is always a possibility. "There have been cases of hepatitis type B contracted from tattoo needles," says Rohrer, "and some people are allergic to the dyes used in the pigment." Because the tattoo needle pierces the epidermis (the top layer of skin), it will bleed and take time to heal. "A new tattoo is essentially a healing wound. Use an over-the-counter antibiotic ointment on it, and keep the area covered for at least seven days," he says.

In addition, he cautions, "A tattoo is generally considered permanent; however, there are new and effective laser treatments that can remove most - but not all - types of dyes." Some of the laser treatments can cause very minor scarring, which may take the shape of the tattoo. "It's not a frequent result, but we do see cases where the skin becomes slightly raised after laser treatment," Rohrer says.

Keep in mind that even if someone is happy with a tattoo at the age of 25, the tattoo may look quite different later on in life. "The skin is an elastic organ that is constantly changing in response to many things, including gravity, age, sun exposure, and pregnancy. If it affects skin during the course of a lifetime, it will also affect the tattooed area," says Rohrer. He also says that certain body parts are less prone to these effects. "Areas not normally exposed to the sun will certainly wrinkle less, but they may still stretch and sag," he says.

In addition to what most people consider a decorative tattoo, there are some new procedures known as cosmetic tattoos, which Rohrer points out are not recommended for the general public. "Processes such as tattooed makeup - eyeliner, lip-liner, or eyebrows - are not something we encourage," says Rohrer. These procedures usually involve the mucus membranes along the lips and the delicate tissue surrounding the eye, and can create more of an opportunity for infection. "There are cases, however, where in conjunction with a reconstructive plastic surgeon, a patient may undergo these procedures, but it's usually only to correct a serious disfigurement," Rohrer says, and that in such cases, the patient involved would be seen in a hospital or a clinic.

If a tattoo is something your child really wants, it's important to think carefully before proceeding. "If the procedure is not licensed by the board of health in your area, don't get one there," says Rohrer. He also suggests talking with a dermatologist. "A dermatologist may be able to check your child for sensitivity to certain dyes or pigments in order to see whether he or she is allergic before being tattoed. Also, it's important to schedule appropriate follow-up treatment while the tattoo heals."

NOTE: Massachusetts state health officials will hold a public hearing on proposed tattoo regulations on December 19. The regulations, which will cover everything from required training for tattoo artists to sterilization of equipment, are expected to be finalized in late January 2001. It is anticipated that Bay State residents over the age of 18 will be able to legally obtain a tattoo in Massachusetts after January 31. South Carolina and Oklahoma are the only other states that currently ban tattooing.

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on tattoos or other health matters, call 638-6767.

8 December 2000
Boston University
Office of University Relations