Biology 103
2003 First Paper
On Serendip

While tattoos have been around for centuries, Egyptians would tattoo themselves as a symbol of fertility and strength. In recent years they have become increasingly popular, especially among teenagers. They range in size, designs, colors and location. However, as the popularity grows, so do the concerns over the safety and risks of tattoos. The United States Food and Drug Administration (FDA) does not regulate tattoos leaving the burden of tattoo safety and regulations up to individual cities and states. Some of the risks that come with getting a tattoo are infection at the site of the tattoo, allergic reaction to the tattoo dye, the spread of disease such as HIV and Hepatitis C, granulomas and keloid formation.

A tattoo is a series of puncture wounds made with a needle that carries dye into different levels of the skin (1). Infections can occur when a tattoo parlor does not use proper sanitation procedures. Since the FDA does not monitor tattooing and regulations can vary from state to state, in 1992 the tattoo industry created the Alliance of Professional Tattooist (APT), a non-profit organization to address the issues of tattoo health and safety. The APT attempts to monitor and standardize infection control procedures. It even gives several seminars a year on tattoo safety. However, membership is not required for a practicing tattooist and tattoo shops are not required to follow the same sterilization practices as other places that use needles, such as hospitals and doctors' offices (2). For places that do not follow these rules, the risk of infection is greater and can pose serious side effects to the person getting the tattoo.

According to a report published in March 2001, people with tattoos are nine times more likely to be infected with hepatitis C than those who are not tattooed (2). This report became mainstream news a year after its publication when Pamela Anderson came out saying that she had become infected by sharing a tattoo needle with her ex-husband Tommy Lee. Hepatitis C is a blood borne disease that can be spread when tattoo needles are used on multiple people and not thrown away and equipment is not sterilized properly. Seventy five percent of people infected with hepatitis C will develop long term infection that attacks the liver, leading to cirrhosis, liver failure, and liver cancer (2).

Allergic reactions, although rare, can occur. Since the FDA does not regulate tattoos or the dyes used for them, some dyes that are not meant to be in contact with human skin is used in order to make the various shades used in color tattoos. While most tattoo dyes are made from color additives that have been approved for cosmetics, none have been approved for skin injections. Sometimes in order to make a new shade, non approved pigments are added to the dyes (3). Tattoo ink manufacturers are under no obligation to label the ingredients used and these non approved pigments are sometimes made with printers' ink or car paint. The degree of the allergic reaction can differ from person to person. The most common is just a skin irritation or swelling that can be troublesome for the person because there is no way to get the dye out of the skin. However, it can be fairly easy to treat with over the counter medicine. Allergic reactions do not have to occur right away. Some people experience these reactions after they have had several tattoos or after years of having a tattoo.

Other adverse reactions can include granulomas, which is when the body rejects the tattoo as a foreign object and forms nodules around it. Nodules are small knot like protuberances made up of a mass of tissue or aggregation of cells (4). Another reaction could be keloid formation, which is when scars grow beyond their natural boundaries; however, most people report this happening after they have had a tattoo removed (3).

If someone is dissatisfied with a tattoo, it is important to note that the removal of one may be even more painful than the tattoo itself and it can be very expensive. A tattoo that costs $50 can cost about $1,000 to remove. There are different methods to remove a tattoo including laser treatments, abrasion, scarification and surgery. Laser treatments lighten the tattoo and can take several visits over the span of weeks or months to work. A common side effect is a lightening of the skin's natural color to the affected area (3). There have also been reports of people suffering from allergic reactions after laser treatment. This happens because the laser can cause the tattoo dye to release allergenic substances into the body. Another method is dermabrasion is when the top layers of skin are eroded using a wire brush or sanding disc. This process can be very painful and can leave a scar. And scarification is when the tattoo is treated with an acid solution so that a scar is left in its place.

When a person chooses to get a tattoo, one must be aware of the risks associated with it. A spur of the moment or uneducated decision could lead to complications later on. When choosing a tattooist, it is important to ask questions and make sure that they are following proper sanitation procedures. A safety cautious tattooist will gladly share this information with you. If not, go somewhere else.

References

1)WebMD, Tattoo Problems

2)WebMD Articles, Anderson Says She has Hepatitis C, an article by Michael Smith, MD

3)US Food and Drug Administration, Tattoos and Permanent Makeup

4)Dictionary.com, Definition of Nodules


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