The trouble with tattoos
An estimated 10 percent of U.S. teens have tattoos. Here is what you need to know, in case your teen is interested in joining that group.
The trouble with tattoos
Rima Himelstein, M.D.
By Rima Himelstein, M.D.
A flower on the ankle ... a butterfly on the lower back ... a Chinese symbol on the chest ... a tribal sign on the upper arm ... more and more teens are sporting tattoos.
In the United States, an estimated 10 percent of teens have tattoos. As with everything teenagers do, there is no one reason. A teen may get a tattoo as part of his or her search for identity ... to be unique ... or because of the influence of friends. Tattoos may represent something very personal, like “RIP” for someone they have loved and lost.
Parental reaction ranges from shrug (they may have their own tattoos!) to shock. But whatever you think about tattoos—art, far from art, or somewhere in between—here are the medical facts:
What exactly is a tattoo? It’s a design formed by small needle-puncture wounds deep into the skin that are filled with pigment (“ink” or “dye”). Commercial tattoos are usually made using a handheld, electric-powered machine, which has one or more needles moving up and down between 50 and 3,000 times per minute. The needles puncture about 1/8 inch into the second deepest level of skin, known as the dermis, and insert the pigment. The level of pain varies, and bleeding may occur.
What is the trouble with tattoos? Because tattooing involves breaking the skin barrier with a needle and injection of a pigment, it has health risks, including infections and allergic reactions:
- Infections of the skin: Tattooing can transmit infections from viruses or bacteria such as staph, including MRSA (methicillin-resistant staph aureus). Localized skin infections are the most common complications of tattoos and cause redness, warmth, swelling and oozing.
- Infections spread through the bloodstream: Because tattooing involves a needle coming into contact with your blood, infections like HIV as well as the viral liver infections hepatitis B and C can also be transmitted. In the United States, hepatitis C is about four times more common than HIV and is the leading reason for liver transplants. Most people infected with hepatitis C don’t even know that they have it.
Allergic reactions: Tattoo pigments are not regulated by the FDA, so they contain non-standardized ingredients. Allergic skin reactions may occur after tattooing, especially with red or yellow dye. Signs include redness and swelling at the tattoo site and possibly even trouble breathing.
No license required? Unlike hair stylists or nail technicians who don’t do anything as invasive as a needle stick, tattoo artists may not be required to complete any formal training or even to have a license. Laws vary by state and city. So don’t take anything for granted when agreeing to a tattoo. FYI, most reputable salons require the permission and the presence of a parent or guardian to tattoo anyone under the age of 18.
Who should definitely not get a tattoo? For some teenagers it is especially risky to get a tattoo: Such as those with heart disease, skin disorders or conditions that affect the immune system—and they should check with their doctors before getting one. If someone tends to get keloids (overgrowth of scar tissue) after skin injuries, it’s also best to avoid tattoos.
Removing a tattoo. Unlike a teenager’s first love or braces, a tattoo is meant to last forever. Laser tattoo removal is more expensive and requires more visits than getting the tattoo in the first place, and the skin may not look normal afterwards.
My advice:
- Talk about tattoos.
- Make sure teenagers know the medical risks.
- Make sure that their tetanus and hepatitis B immunizations are up to date (there are no vaccines for HIV or hepatitis C yet)
- Talk about the possibility that it may make it harder to get a job.
If they decide they still want a tattoo, how can we help them to do it safely?
- Find an experienced tattoo artist who has done an apprenticeship, is licensed, and follows health and safety guidelines, like those required by the Philadelphia Board of Health.
- The after-care is very important. First, listen to the tattoo artist and keep it bandaged as long as they recommend (up to 24 hours). Clean it gently and apply antibacterial ointment as directed. Most important: be on the look-out for any signs of infection or allergy!
Rima Himelstein, M.D., is a Crozer-Keystone Health System pediatrician and adolescent medicine specialist.
Has your teen talked about getting a tattoo—or already come home with one. If so, what’s your reaction?
Do not cut your bodies for the dead, and do not mark your skin with tattoos. I am the LORD. Leviticus 19:28, The Holy Bible.
Tattoos are on the people who didn't get the word of the Lord.— akashic11- News flash: not everyone is gullible enough to believe in your magic cloud man.— flyers70
- If your planning a career in the Air Force and have tattoos that are explosed, even on your arms, your chances are slim to none for exceptance. So youngsters think about your career when getting tattoos.— mookie4295
- @akashic - that's only if you tattoo for the dead, right?
when in mourning.
so that would only apply to "RIP" tattoos.
and how about Leviticus 19:27 ?
"You shall not round the edge of your head, nor shall you destroy the edge of your beard."
that's just when you're in mourning, right?
or is that no haircuts & shaves at all?
thanks for the reminder that even the devil can cite Scripture for his purpose.
— ekw555 
Comment removed.- Do they put a sign out front letting me whether they are reputable or not? What is the reputation rating based upon ... is there a standard I can reference? Do they dispose of the ink after used on each customer ... are the inks single use? maybe they sterilize the unsued ink after each use? They do dip the needle in the ink after each application on the customer ... which breaks the skin and mixes with body fluids ... yes? I know very little about the process beyond what I have seen on tv ... you seem to know more than the writer ... can you elaborate? — seventh
- Ink is poured from the bottles into small disposable cups, about the size of thimbles. Anything that is touched by the needle gets thrown away at the end of the session. The used needles are then placed in an autoclave to ensure that they are sterilized before being used again. The artist always uses either a brand new, or sterilized set of needles from a sealed package when setting up for the next client. — pbergephoto
- Comment removed.
- You can call your state, county, or local health department to find out about laws in your community, to ask for recommendations on licensed parlors, and to check for any complaints about an individual studio. Make sure that the tattoo follows Occupational Safety and Health Administration’s Universal Precautions. Theses are regulations that outline procedures to be followed when dealing with blood and other body fluids.
Here are some other things to check for:
New needles for each individual
New bottle of ink for each individual
All equipment used in making the tattoo must be sterilized in an autoclave (a cleaning device that uses steam, pressure, and heat for sterilization)
Check that the tattoo artist is a licensed practitioner; check the references they should be able to provide
Helpful website: www.TeensHealth.org (search: tattoos)
— Sari Harrar - Tattoo's are for poor people.— MD20202020
- Then how come my friends spend a fortune on their tattoos, which look like works of art? — Jen D
- Sheep— STS_PA
- If you are looking for info on sheep, you are in the wrong place.
http://www.sheep101.info/sheepbasics.html— pbergephoto - Most of the kids get stupid tattoos that have very little meaning or even considered artwork. Even the RIP tattoos are questionable. What bugs me is people that get them done with no regard to how it will affect their job prospects. I am of Pacific Island/Asian descent where tattoos are a dominant part of my culture but I knew enough to get them where it won't affect my appearance in the work world.— Niko
- Whatever you do, do not get your current girlfriend (or boyfriend's) name indellibly etched on your body. This will be a turnoff in the future to you current love interest. As dumb as a tatoo is, this is REALLY STUPID!— Rahjr
- Hey Flyers70, I think your comment is rediculous. Why do you question faith. Who are you to say that those who believe in a spiritual existance are gullible. Did you ever think that you could be the gullible one? Without something to believe in, there is nothing but eternal darkness !!! TruPhillyFan 6:20— Truphillyfan
- My daughter got Hep c from getting tatooed. They may use new needles but don't forget the excess ink that gets put back in the ink bottle.— ziller0604
- she either:
a) went to a bad (bargain basement) studio
or
b) is lying about how she got hep c. remember pamela anderson tried the same bs about getting it from a tattoo— Ryan - Excess ink should never be put back into the bottles. Small amounts are poured into disposable cups and discarded after each session. Ink in the bottle should never be contaminated. — pbergephoto
- Comment removed.
- I got a tattoo when I was 16 years old. When I was in my twenties I decided to have it removed. I told my beloved and wise grandfather that I intended to have it removed. He told me not to do it. I asked him,"why?" He wisely replied, "Because, anytime you are about to do something stupid look at your tattoo." I now look at the scar where my tattoo used to be and remember my grandfather fondly. something to think about kids.— BillyBob369
- I have been a lawyer for 15 years and have a number of tattoos. I am getting another one soon with my kids' names. I will never let my kids get them until they are adults. Then it is up to them. When dealing with the working world, what you cannot do is get them in places that are visible, like the forearm, neck, (face--of course, you are pretty much ending your ability to be seen as a remotely normal person) or hands.— bwillie
- I know an exotic dancer that got a tattoo of Chinese characters that said "I love life", or so she thought. It really said "Pork Lo Mein".— Ralph 1
- I'm 27 years old, have an MBA from Penn State, and am a rising mid level manager at a major fortune 500 company. I am a voracious reader and very intellectual. I listen to heavy metal music. I also have full sleeves of tattoos. I enjoy tattooing. I go to top quality artists who only work out of top quality shops. I would never regret any of my tattoos for a minute. Tattoos are art. Sometimes they are some of this generations greatest artistic achievements.— Ryan
- So you're saying tattoos are for people with a so-so education and boring jobs that are trying to compensate for their short comings? As an FYI, in the future you might want to go with "I have an MBA and work for a Fortune 500 company." It will help in 3 ways. 1) People won't have the "oh, but it's Penn State" reaction. 2) People won't think you're pathetic for bragging about being a "mid level manager". I mean all that time to get an MBA to become a mid level manager? 3) People will think more of you if it seems like you know that "Fortune 500" is the list from the magazine Fortune & therefor capitalized. — Zeus2754
- Comment removed.
- Nothing wrong with tattoos. I'd just say be careful where you get them and think long and hard about what you choose.— Breaking Bad
- Comment removed.
- @MD20202020-I make over 100K a year as a analytical chemist, just put my son through SJU and I don't consider myself poor. And guess what, I have a tattoo you dope!
— Chemist1524 - Comment removed.
- i recommend shane oneil's in willow grove pa— ALB328
- Tats are for something for trash to blow their $$$$$$ on. I see someone with tats, and I think that they (tats) look stupid.— road515
- Ryan, I bet you I live to be 125. Watch out when I dance on your grave. P.S. you're a 20-something clown, you don't know your rear end from your brain.— road515
- As a healthcare provider, I found the article to be informative for parents and teens. From my understanding, the PURPOSE of the article is to identify: general health risks associated with tatoos (which teens and their parents should be aware of), specific disease conditions which may contradicate getting a tatoo and safety recommendations for getting a tatoo.
The blog never states that getting a tatoo at a reputable shop increases the risk of infection. In fact, the blog states "find an experienced tatoo artist who has done an apprenticeship and follows health and safety guidelines..." That seems like sound advice to me.— Peds PCP - You would do better to quote Genesis 1:27.
" So God created man in his own image, in the image of God created he him; male and female created he them."— CalSteven
