Tattoos

Tattooing the skin has been done throughout history and remains a popular form of body decoration today. If you are considering getting a tattoo, it is important to think it through carefully before going ahead. Choosing a tattooist whose business is properly registered with the local authority helps to reduce the risk of complications.

People get tattoos for many reasons, including to mark a significant event such as the death of a loved one or the birth of a child.

Types of tattoos#

There are two main types of tattoos:

• Traditional or decorative tattoos are made by repeatedly puncturing the skin with a needle loaded with coloured ink to create a specific design.
• Cosmetic tattoos, also known as pigment implantation or permanent make-up, involve applying permanent colour pigment around the eyes, on the eyebrows or to the lips. These generally last for two to six years, depending on your skin type, and are usually applied by a beautician.

Things to consider before getting a tattoo#

Getting a tattoo can change your body image for life. Some things to consider include:

• Tattoos are permanent. It may be the look you want now, but how will you feel about it when you are older?
• Tattooing can be a painful process. Depending on the complexity and size of the design, it can also take quite a while (days or weeks) to complete.
• Tattoos can be expensive. Costs vary depending on the size, design, number of colours used and time taken.
• Think about how your family and friends will feel about your tattoo, and how it may affect your relationships.
• A visible tattoo may be an issue in some workplaces and could affect your employment opportunities.
• Unwanted tattoos can cause psychological problems, especially if they are easily visible.

If you decide to get a tattoo and it is your first, it may help to get a small design. A small design is easier to complete and is a less extreme trial piece for working out whether you like having a permanent tattoo.

Laws relating to tattooing#

Laws about tattooing differ from place to place. In many areas it is illegal to tattoo a person under 18 years of age unless it is for medical purposes. Some places also prohibit related practices such as scarification, tongue splitting, branding and beading on anyone under 18. Check the rules that apply where you live.

Complications of tattooing#

Choosing a registered, experienced tattooist can help reduce the risk of complications, but getting a tattoo can still put you at risk of:

• infections, such as blood-borne viruses
• allergic reactions
• thick scars

If the tattoo extends over a mole, it may make it harder to notice changes in the mole’s colour, size or shape. A tattoo will not increase the chance of a mole becoming cancerous, but it is worth being aware that it may obscure changes that occur.

You may also become distressed after the procedure because you regret getting the tattoo. This has been identified as one of the major problems involved with tattoos.

Choosing a tattooist#

Choose an experienced tattooist whose business is registered with the local authority. A certificate of registration should be available for you to see. Make sure the premises looks clean and professional, with good ventilation and lighting and a separate area set aside for cleaning, disinfecting and sterilising instruments.

Check that the tattooist uses single-use sterile equipment for each client, or thoroughly cleans and disinfects reusable equipment by putting it through a steriliser. If a premises looks unsafe, trust your judgement and stay away.

Do not be afraid to ask questions about the tattooist’s experience and procedures. If they do not answer your questions, or you are not satisfied or comfortable, do not feel pressured. Take your business elsewhere.

To comply with health regulations:

• The premises must be kept clean and hygienic.
• Instruments and needles must be sterile at the time of use.
• The operator should not have exposed cuts or wounds, and their clothes must be clean.
• The proprietor or operator must give you health information before any procedure is done.

The ideal premises should have benches, floors, shelving and furniture that can easily be kept clean, items that may be touched (such as spray and ink bottles) covered with single-use plastic bags so only the nozzles are exposed, and a hand washbasin.

The tattooing procedure#

Ask your tattooist what to expect after the procedure. It is normal to have some initial bleeding, irritation and tenderness in the area.

During the procedure, the tattooist should:

• wash their hands with soap and pat them dry at the start and end of the procedure, and whenever they take a break (for example, to answer the phone)
• clean and disinfect your skin thoroughly before and after the procedure
• wear single-use gloves on both hands throughout
• use sterilised equipment and explain how they sterilise it
• tattoo an outline of the design on the skin
• use cleaning solution and wipes to remove excess pigment and blood from the site
• cover the area with a dry dressing if you need a break
• apply antiseptic cream to the treated area when finished and cover it with a dressing
• talk to you about how to care for the tattoo to prevent infection, and provide this information in writing
• never smoke, drink or eat while carrying out the procedure

Sterilising equipment#

The tattooist should be able to explain how the equipment is sterilised and, ideally, should have a steriliser on the premises. To make sure equipment is correctly sterilised and to avoid infection:

• All needles and instruments must be thoroughly cleaned and sterilised before use.
• Reusable instruments should only be used if the shop has its own steriliser or a system for off-site sterilisation. If sterilisation is done elsewhere, the operator should be able to show you evidence of this.
• Once sterilised, instruments must be replaced if they are accidentally touched or contaminated in any way. Sterility must be maintained at all times.
• It is even safer if operators use pre-sterilised, single-use needles and instruments. These must be disposed of into a sharps container, out of reach of children.

Preventing cross-contamination#

Gloves must not be reused. If the operator is distracted during the procedure (for example, to answer the phone), they must first remove their gloves and wash their hands. Before returning, they must rewash their hands and put on new gloves. The needle assembly or handpiece must be changed after use with another client.

Avoiding infection after getting a tattoo#

A tattoo is an open wound, so take precautions to avoid infection:

• Follow the aftercare advice given by your tattooist.
• Make sure your skin is free from cuts, abrasions or infection at the site. If you have a skin infection, only have a tattoo once it has completely healed and the skin has returned to normal.
• Two to three hours after being tattooed, wash the area with soap and warm water and pat dry with a clean towel.
• Using new gloves, lightly apply some ointment provided or recommended by the tattooist or a health professional such as a pharmacist. Repeat as needed when the skin feels dry.
• Do not touch the tattooed skin or pick at any scabs that form.
• Avoid wearing tight or dirty clothing, and avoid direct sunlight.
• Avoid soaking the tattoo in water, such as in a bath, swimming pool or the sea.

An infected tattoo can be treated with antibiotics. Consult your doctor promptly, and notify the tattooist, if the area becomes very red, swollen, itchy, sore or irritated, if the site does not heal, if you have pain or swelling, if there is continual bleeding or discharge, or if you have any other concerns about the procedure.

Why tattoos are permanent#

Under a microscope, tattoos appear as tiny granules of colour (pigment) located in a skin cell called a macrophage. Macrophages normally remove foreign objects, such as bacteria, from the body. The pigment “freezes” the macrophage so that it cannot do its job. As a result, the pigment stays in the skin and the tattoo becomes permanent.

Key points#

• Tattooing the skin has been done throughout history and remains a popular form of body decoration today.
• If you are considering getting a tattoo, it is important to think it through carefully before going ahead.
• Always choose a tattooist whose business is registered with the local authority to reduce the risk of complications.
• Unwanted tattoos can cause psychological problems, especially if they are easily visible.
• Choosing a registered, experienced tattooist can help reduce the risk of complications.

Where to get help#