Should Tattoos Be Taboo?

Approximately 40 million Americans have some type of tattoo, and the popularity is increasing. But people who are thinking about getting a tattoo should slow down and think twice. In most states and cities, you need to be 18 or have a parent's permission to get a tattoo. And, there are multiple risks that should be considered before making this very permanent decision.

Risks of getting a tattoo

• Tattoo inks are not FDA-approved for injection into the skin. The FDA says that many of the pigments are industrial-strength colors suitable for printer's ink or automobile paint. Even henna, which is often used in temporary tattoos, may not be safe, as it is approved only for use as a hair dye. Ultraviolet ink for glow-in-the-dark tattoos also has not been approved by FDA.

• Research has shown that some pigment migrates from the tattoo site to the body's lymph nodes, the small organs located in the channels of the lymphatic system that store special cells to trap bacteria or cancer cells traveling through the body in lymph. It's not known if this ink migration has health consequences.

• Darker-skinned people face a greater risk for thick scars (keloid) after tattoo removal or from the tattoo process itself. Keloid formation is more common in darker-skinned people.

• Allergic reaction to the tattoo dye can occur. There's no way to predict who will have an allergic reaction to tattoo dyes, especially red dyes. Allergic reactions can include ulcers, weeping, lumpy and itchy skin, burning, and sensitivity to the sun.

• Hepatitis B or C can be transmitted by a dirty needle. These very serious infections can damage your liver and are the most common causes of cancer of the liver. On rare occasions, you can get syphilis or tuberculosis while being tattooed.

• You risk HIV infection from non-sterile instruments. Blood flows into the hollow tattoo needles and can contaminate any part of a needle or instrument.

• Although rare, swelling or burning in the tattoo can occur when a person has a magnetic resonance imaging procedure.

Many think it's easy to remove a tattoo, but the process is very difficult. Laser removal usually involves multiple treatments and visits, and insurance rarely covers the cost, which can be hundreds of dollars per visit. Some color inks are harder to remove than others. Many tattoos don't come off completely, leaving the person with a shadow, visible remnants, pigmentary changes (typically, hypopigmentation), or scarring.

Surgeons also can remove the skin and replace it with skin from another part of the body, a procedure called skin grafting. That's difficult and expensive, depending on the location. It also results in scarring.