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Research tattoo parlors before getting inked
Take care of skin after procedure by following experts' advice`
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Tattoo shop owner Eric Carpenter works on Brian Williams’ back Friday. Williams was getting a Ford 429 crankshaft representing a 1954 Ford pickup father-son project. - photo by NAT GURLEY

As tattoos slowly became part of the mainstream culture, tattoo shop owners take care to ensure their customers understand the health-related effects.

“We have conversations with our customers both before and after their tattoo where we consult with them about what they’re getting and how they’re going to do,” said Eric Carpenter, owner of New Vision Tattoo in Gainesville. “We answer any questions they may have and at the end we tell them how to take care of it and be safe with it.”

As of 2012, 1 in 5 adults had a tattoo, up from 14 percent in 2008, a Harris Interactive Poll found. And when safety standards are followed, tattoos are usually trouble-free.

The Hall County Board of Environmental Health regulates tattoo shops to ensure the equipment and environment are as safe as possible.

“We’re a regulated county and shop, so the risks are minimized,” Carpenter said. “Really, the risks of getting a tattoo are going anywhere that’s not regulated.”

Tattoos can pose health risks many people might not consider:

Unsterilized tools or contaminated ink can lead to infection, scarring, blood-borne diseases and other, less-obvious issues.

“It’s becoming much more common, but you still have to be careful,” said Dr. Bryan Wasson, an internal medicine physician at Baylor Scott & White Medical Center at Irving, Texas. “A tattoo is like a minor surgery.

“You clean and shave the skin like you’re going to operate. You use surgical tools. There are dangers. So be careful in your selection.”

During the procedure, a gun with needles punctures the top layer of the skin, depositing pigment in a deeper layer called the dermis. As the skin heals, the ink remains trapped below the surface.

“When you get a tattoo, you bleed,” said Dr. Donna Casey, an internal medical specialist at Texas Health Presbyterian Hospital. “Because you are bleeding, anything in contact with the tattoo — bacteria, viruses — can get into the wound and your entire body. It’s like having a bite on your leg or a gigantic abrasion.”

Kristin Parton, tattoo artist and owner of Inkaholics in Gainesville, said she encourages her customers to take responsibility for the healing process of their tattoos. She advises them to avoid swimming and keep the area clean and sanitized.

“The biggest thing I think a lot of people don’t understand about the whole tattooing process is when you’re done, you have to take care of it,” Parton said. “... This is an open wound you have to take care of just like if you had a surgery at the hospital. You have to take care of it.”

Contaminated inks were the cause of an outbreak of serious infections in four states in late 2011 and early 2012. These infections were caused by a type of fast-growing bacteria that caused red, itchy bumps to severe sores requiring surgery. The 22 cases were associated with inks contaminated before distribution or just before tattooing.

Ingredients in tattoo ink vary, but can contain metals, powders or other organic compounds in a liquid base. Problems can range from allergic reactions to scarring and the formation of bumpy knots called granulomas, more common in people with darker skin. The long-term effects of ink are still unknown.

In rare cases, inks containing metallic pigments can cause swelling during magnetic resonance imaging, or MRIs.

“Tattoos are not an absolute contraindication for an MRI study,” said Dr. Daihung Do, faculty director of dermatologic surgery at Harvard Medical School and director of dermatologic surgery at Beth Israel Deaconess Medical Center in Boston. “Patients should notify their radiologist that they have a decorative or permanent tattoo so that the appropriate precautions can be taken.”

Tattoos can also prevent the early detection of skin cancer, said Peter Beitsch, a surgeon specializing in melanoma at Medical City Dallas Hospital. The ink can camouflage changes in asymmetry, borders, color and diameter, the “ABCDs” of melanoma detection. This is important for fair-skinned or redheaded people, who already have a higher risk of developing skin cancers.

“Sometimes when you cover up moles, the ink from the tattoo will mask changes in the mole,” he said. “It’s not common. But if you cover up enough moles, some of them are going to turn bad, into a lethal kind of skin cancer.”

Parton said she generally tries to avoid covering large moles and has customers fill out a medical history form about any skin conditions.

The Food and Drug Administration regulates tattoo ink but considers it a cosmetic and intervenes only when problems arise. The FDA has not actually approved any tattoo ink, and there is no specific requirement explicitly saying tattoo inks must be sterile.

“Tattoo inks are not highly regulated,” Do said. “Many of the pigments are industrial grade, and none are currently FDA-approved. Although tattooing has been practiced for thousands of years, there are few studies regarding their safety.”

Theresa Eisenman, a spokeswoman for the FDA, said this is because no sponsor has signed the required petition and provided the data needed to decide whether dye is safe for tattooing.

The easiest — and most important — way to avoid becoming a tattoo horror story is to research the tattoo parlor and review personal health history ahead of time.

“Like anything, like ear piercings, you can develop other medical problems if it isn’t at a clean place,” Do said. “It all depends on who does your tattoo and whether they are cleaning their instruments in a safe manner. If you go to the wrong place, it could be very easy to contract something.”

Medical experts also do not recommend tattoos for people with a history of allergies, diabetes, heart disease, skin disorders, immune system conditions, a history of infections or who are pregnant. For those with a family history of skin cancers, avoid areas that would cover up moles.

McClatchy Newspapers contributed to this report.

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