The art of tattooing has been gaining popularity in the United States every year. According to a 2015 Harris Poll, three of every ten Americans (29 percent) have at least one tattoo. Of these inked Americans, seven out of ten have two or more tattoos (69 percent). The use of permanent cosmetics such as to enhance eyebrows or lips are also considered tattooing. With the rising popularity of tattoos, the U.S. Food and Drug Administration (FDA) has observed an increase in reports of skin infections caused by tattooing, as well as having bad reactions to the inks themselves, according to Linda Katz, M.D., M.P.H., director of FDA’s Office of Cosmetics and Colors. The Meigs County Health Department would like anyone considering a tattoo to “Think Before You Ink.” Before you get a tattoo, consider these important questions.
1. Should I only go to a licensed tattoo establishment?
Absolutely, YES. There are many unregulated tattoo artists who are called “scratchers” that usually offer a “good deal” but could cause a serious illness or disease. The health department inspects only the licensed establishments and their artists. The artist must demonstrate to the inspector they are following the many safe health practices required by Ohio’s tattoo rules and regulations. They are also required to keep detailed records for sanitizing equipment and any inks used with the tattoo.
2. What kinds of reactions and infections have been seen with tattoos?
According to Dr. Katz of the US FDA, you might notice a rash—redness or bumps—in the area of your tattoo, and you could develop a fever. Serious infections can require months of treatment with a variety of antibiotics. More serious infections may be associated with high fever, shaking, chills, and sweats. If these symptoms arise, you may need antibiotics, hospitalization and/or surgery. Your physician or other health care professional will make that determination. Diseases, such as HIV, hepatitis, and skin infections caused by Staphylococcus aureus (“staph”) and other bacteria have been associated with tattooing. Only the use of sterile techniques can stop the spread of harmful bacteria or other infectious organisms. A tattoo artist should always use sterilized tools, clean hands and disposable gloves. The artist should be using only sterilized water in the procedure or in the dilution of inks. In the last several years there have been cases in which people got infections because the ink itself was contaminated with microorganisms, such as bacteria and mold introduced either at the time of manufacture or at the tattoo establishment. If you have an allergic reaction, the exact cause may be hard to pinpoint. You could have an allergic reaction to a pigment (one of the ingredients that add color to the ink) or to a diluent (the liquid used to dilute the pigments). Or you could have a reaction to a contaminant that got into the ink during manufacturing.
3. If I get a tattoo and develop an infection or other reaction, what should I do?
The first thing is to talk to your doctor or a health care professional. Treatment for a possible infection should be started soon before it worsens. You should also notify the tattoo artist. The tattoo artist has
detailed information on your ink’s brand, color, and any lot or batch information that may be useful in determining the source of the problem and how to treat it. The health department and the FDA urges consumers, tattoo artists, and even health care professionals to report tattoo-related problems. These reports associated with tattooing can bring important information to wide cast of public health agencies preventing or limiting wide-spread infectious diseases.
4. What about later on? Could the ink cause health problems?
With concerns of immediate infections already discussed, tattooing may also leave a permanent effect on your health. The FDA has stated the following concerning tattoo and permanent makeup inks: “FDA considers the inks used in intradermal tattoos, including permanent makeup, to be cosmetics…. The pigments used in the inks are color additives, which are subject to premarket approval under the Federal Food, Drug, and Cosmetic Act. However…FDA traditionally has not exercised regulatory authority for color additives on the pigments used in tattoo inks. The actual practice of tattooing is regulated by local jurisdictions.” In other words FDA’s reaction will be after a problem is discovered. The additives in some tattoo inks may contain substances that have pigments that are considered industrial grade and used as automobile paint and printer machines. The “carrier” ingredient of ink helps deliver the pigment into the skin. Some “carriers” have been found to have antifreeze, formaldehyde, methanol, denatured alcohols, and other aldehydes. Some vivid colored pigments have been found to contain a type of heat-resistant plastic that is used to make luggage, pipe fittings, appliance parts, and, when ground down, tattoo inks. You should ask your tattoo artist for the Material Safety Data Sheets of the ink and insist on inks that generally have been shown to be safe.
5. What’s the bottom line?
Think before you ink. Be absolutely sure of your decision, utilize only the services of a licensed tattoo establishment, ask questions about the health risks involved, ensure the inks are safe and follow the tattoo aftercare instructions. Removing a tattoo is a painstaking process and complete removal without scarring may be impossible.
Steve Swatzel is the Director of Environmental Health with the Meigs County Health Department