Tattoos, Piercings, and Other Body Art

How your dermatologist can help

If you are considering getting a tattoo or other body art, it is a good idea to speak with your dermatologist. Even if you already have body art and are thinking about adding more, a talk with your dermatologist is still a good idea. Your dermatologist can help you:

• Separate fact from fiction
• Make an informed decision about body art based on your medical history
• Reduce your risk of having a bad experience

WHY IS MY MEDICAL HISTORY IMPORTANT?

If you have a skin condition, getting a tattoo or piercing could increase flare-ups. Some patients who have psoriasis see flare-ups where they get tattoos. Other patients have a higher risk of developing a raised scar after getting a piercing.

Medication is another concern. Taking a corticosteroid or medicine that weakens the immune system can increase your risk of infection after getting a tattoo or piercing.

Your dermatologist can tell you if your skin condition or medication increases your risk for possible side effects.

WHAT SKIN REACTIONS CAN OCCUR?

Getting a tattoo or piercing can increase a person’s risk of developing the following:

Keloid behind the ear

Keloid: This is a raised thick scar. A keloid can form on newly tattooed or pierced skin. Keloids are more common in African Americans and people who have a family history of these scars. No one is sure why keloids form. Some researchers think the body overreacts when the skin is injured.

If you develop a keloid, you should see your dermatologist. Treatment can reduce the size and sometimes help improve the appearance of the scar. Keloids can be stubborn though and do not always respond well to treatment.

Infection: Body art punctures the skin. Any time you puncture your skin, you increase your risk of getting an infection. If you have any of the following symptoms after getting a tattoo or piercing, see a doctor right away:

• Red, swollen skin
• Skin feels warm, tender
• Foul-smelling discharge
• Green or yellow discharge
• Fever

Waiting to see whether you get better can increase your risk of developing a serious or life-threatening infection.

Nickel allergic reaction

Allergic reaction: Some people have an allergic reaction to jewelry inserted during a body piercing. Some jewelry contains nickel. Many people are allergic to nickel. Others have an allergic reaction to tattoo ink.

If you develop an allergic reaction, your skin will be itchy and red where you have a tattoo or where the jewelry touches your skin. This reaction can occur shortly after getting the body art or years later.

If you develop red, itchy skin where you have a tattoo or piercing, you should see a dermatologist. Allergic reactions rarely go away without treatment and can worsen. However, tattoo ink cannot be easily removed. As a result, an allergy to tattoo ink can be difficult to treat.

WHAT CAN I DO TO REDUCE MY RISKS?

There is no such thing as a totally risk-free piercing or tattoo, but getting your body art done at a reputable studio can reduce your risks. The best way to find a reputable studio is to visit the studio and ask questions. Before making an appointment for body art, ask someone who works there if the artists use:

An autoclave: This device sterilizes equipment and other supplies. Staff should use an autoclave to disinfect non- disposable equipment after each use. If the studio does not have an autoclave, look for another studio.

A commercial disinfectant or bleach solution: This is necessary for disinfecting items too big to fit in an autoclave. Anything that an artist might touch while working on you should be disinfected. This includes drawer handles, tables, and sinks. Be sure to ask what they disinfect.

New, sterile equipment: The artist should use a new, sterile needle for each piercing. If you’re getting a tattoo, watch the tattoo artist. Make sure the needles and tubes come from sealed packages. Inks should be poured into a single-use disposable container. The tattoo artist should throw out unused ink.

Surgical gloves: Hand washing and disposable surgical gloves are essential. Make sure the artist who works on you washes his or her hands and puts on new surgical gloves before beginning. If you have a latex allergy, ask the artist to use non-latex gloves. If the artist touches something unsterile while working on you, such as the telephone, more hand washing and new gloves are necessary.

Body piercings only

If you want a body piercing, you also should find a studio that uses the following:

Single-use piercing gun: You should not get a piercing from a piercing gun unless the part of the gun that touches your

skin is both sterile and unused (never been used on someone else). Most piercing guns do not fit in an autoclave.

Hypoallergenic jewelry: Nickel, cobalt, and white gold often cause an allergic reaction. To avoid an allergic reaction, ask for jewelry made from one of the following:

• Surgical-grade stainless steel
• Titanium
• 14- or 18-karat yellow gold
• A metal called niobium

It also is important to consider when getting a tattoo or body piercing, that there is a risk of exposure to blood-borne diseases. These diseases occur when the infected blood of another person mixes with your blood in your body. This could occur if needles or instruments are not sterilized and are contaminated with infected blood. You can contract tetanus, hepatitis B, hepatitis C or HIV (human immunodeficiency virus).

Asking questions may make you feel uncomfortable. At reputable studios, artists understand that people have questions. Staff should take the time to answer your questions. Asking questions and getting the right answers is one of the best ways to lower your risk of infection, scarring or allergic reaction.

Tattoo before laser removal treatments

21 months after laser tattoo removal treatments

CAN I GET RID OF A TATTOO?

If you no longer want a tattoo, you should talk with your dermatologist. Dermatologists have the medical expertise to tell you what you can expect from tattoo removal. Some tattoos can be removed completely. Nearly all tattoos can be faded. Dermatologists also have the medical knowledge to help you avoid potential side effects from tattoo removal, such as burns, scars, and infections.

Most patients who want a tattoo removed will receive a series of laser treatments. Before recommending a treatment though, a dermatologist considers many factors. One factor is how deeply the ink penetrates your skin. If the artist placed the ink very deeply in the skin, the laser may have a more difficult time reaching it.

Your dermatologist also will consider the colors in the tattoo, where the tattoo appears on your body, and whether you smoke. Research shows that laser tattoo removal is less successful if the person smokes.

If laser treatment is not an option for you, a dermatologist may recommend another treatment. Smaller tattoos are sometimes removed surgically.

A board-certified dermatologist is a medical doctor who specializes in treating the medical, surgical, and cosmetic conditions of the skin, hair, and nails. To find a board-certified dermatologist in your area, visit aad.org or call this toll-free number (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

American Academy of Dermatology

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