Health Matters: Tattooing - how safe is it?

<center>Kathryn B. Brown, FNP</center>

Today: are tattoos safe? Next week: what about body piercing?

Tattooing may seem like a new trend, but tattoos have been around for at least 4,000 years and maybe much longer. Some early Egyptians who built the pyramids were tattooed. Tattooing was and still is an important ritual in some Asian and South Pacific societies.

In the last 10 years, tattooing has gone mainstream in the United States. College students, businessmen and women are almost as likely to be tattooed as Hell's Angels.

About 15 percent of Americans have at least one tattoo, but the practice is much more common in younger adults. Nearly 30 percent of people between ages 18 and 34 are tattooed. More than half of new tattoos are done on women.

Individuals decide to get tattoos for many reasons. Tattoos can denote membership to a fraternity, sorority, religion or other group. They may be seen as a way to release repressed feelings. Most often, tattoos are described as a way to express one's individuality. Some simply find them beautiful.

Tattooing is used in reconstructive surgery to simulate normal skin coloring. Permanent make-up (such as lipstick or eyeliner) can be tattooed on skin, which helps women with disabilities who cannot apply makeup on their own. Tattoos can cover birthmarks and scars.

There are concerns that tattooing can transmit diseases. There was an outbreak of hepatitis associated with tattoo parlors in the early 1960s. Now, the awareness of blood-borne infections such as hepatitis and HIV has lead to laws regulating tattoo shops. There has never been a documented case of HIV being transmitted through tattooing, and hepatitis transmission is very rare.

For health reasons, some people should not get tattooed. This includes anyone with bleeding problems such as hemophilia, those who take blood thinners (including aspirin), people with suppressed immune systems and pregnant women. Diabetics or anyone with an active disease should consult with their doctors before getting a tattoo. If you have mitral valve prolapse or another heart defect, consult your doctor about taking antibiotics when you get a tattoo to reduce your risk of endocarditis.

Tattoos are safe when they are done by professionals. In Oregon, tattooists are required to have 360 hours of training at an approved school and pass a written exam before they are licensed by the Health Licensing Office. In Washington State, tattooists are not licensed, but there are laws which set standards for sterilization techniques.

Tattoos can be dangerous when they are done at home or by someone who is not properly trained. Without the correct equipment, excessive bleeding, infection and a poor result are likely.

Since tattooing is permanent, choosing an excellent tattooist is important. You may pay a bit more, but you won't need to worry about disease and infection, and you'll be happier with the result.

Before getting a tattoo, visit a few tattoo shops and find one that you are comfortable with. Things to look for:

• a clean and well-lighted shop

• new, sterile needles and ink for each client

• an autoclave to sterilize equipment

• tattooists who wash their hands and wear gloves while working

• tattooists who are open to your questions about designs, where to put the tattoo, pain, costs and any other concerns

• a reputable tattooist in Oregon or Washington will not tattoo anyone under age 18, even with parental consent.

New tattoos should be kept covered for the first 12 hours. Then, they can be left open to the air but should be kept moist with antibiotic ointment applied three times a day for the first week. Use A & D ointment or a hypoallergenic lotion during the second week to keep the skin lubricated. Do not use rubbing alcohol. Keep out of direct sunlight for two weeks, and do not swim or soak in water during this time.

A scab will form as part of the healing process; it will fall off naturally so do not scratch or pick at it. The skin should heal within two weeks. Increasing redness, swelling and pain are signs of infection; see a health care provider.

Kathryn B. Brown is a family nurse practitioner with a master's degree in nursing from OHSU. Is there a health topic you would like to read about? Send your idea to kbbrown@eastoregonian.com. This column originally ran in October 2003.

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