Tattoos are popular, colourful ways for us to express our creativity, our experiences and our personality. For many people tattoos carry symbolic meaning or have personal memories behind them. As more celebrities are seen with tattoos, either permanent or temporary henna, they are becoming an increasingly popular fashion accessory. However, on the spur of the moment many people forget that proper tattoos are permanent and they are actual extremely serious because they can cause life-threatening problems.
At the moment tattooing is not properly licensed or regulated but artists must register with the Environmental Health Department. It is vital that you check with your local council beforehand whether your tattooist is registered, because the local authorities should have registration and inspection schemes in place. A health and safety certificate should be on display or with the operator so ask to see one before you have your tattoo done.
The health and safety standards say that:
- Sterile needles must be used for every customer
- Hands must be washed thoroughly before and after tattooing
- Disposable latex gloves must be worn and a new pair worn for each customer. (Some people can have allergic reactions to the latex gloves so you could take an antihistamine before you have it done, or if you are aware that you have this allergy you should inform the artist beforehand who should be able to use a different glove.)
- It is illegal to tattoo anybody under 18 .
The artist should ask you a list of medical questions before doing the tattoo to check that you are alright to have one. For example people with haemophilia should not have tattoos as their blood does not clot properly and so they can not stop any bleeding which may occur during a tattoo. Pregnant women are advised against tattoos, as are diabetics, people with heart conditions, people with conditions that weaken the immune system and also people on aspirin or aspirin-based medication as these thin the blood so you bleed more.
Firstly tattoos are wounds and therefore good hygiene is imperative. When you have a tattoo the ink is injected into the dermis or the lower layer of your skin which does not flake away making it permanent. The machine that is used can pierce the skin as many as 3000 times per minute making holes as deep as 1/16 of an inch or 1.5mm.
One of the biggest problems associated with tattoos is blood borne infections such as:
Hepatitis B and C. Hepatitis affects the liver causing inflammation. Hepatitis B is a DNA virus and it can be acute (self-limiting) or chronic (long standing). The symptoms of acute hepatitis B are:
- Loss of appetite
- Body aches
- Mild fever
- Dark urine
- Development of jaundice.
It generally lasts a few weeks and gradually improves in most cases. Chronic Hepatitis C is often asymptomatic and can lead to advanced scarring of the liver (cirrhosis) and liver cancer.
Hepatitis C is a blood borne infection which is often asymptomatic. It causes liver inflammation which can lead to scarring of the liver (fibrosis) or advanced scarring of the liver (cirrhosis) which in turn can lead to liver failure and cancer. It is spread by blood to blood contact and at the moment no vaccine is available. Early medical intervention is beneficial but many people only experience mild symptoms and so do not seek treatment until it has developed into more serious problems. Some symptoms can include:
- Decreased appetite
- Abdominal pain
- Flu-like symptoms.
HIV. Human Immunodeficiency Virus can lead to AIDS; Acquired Immunodeficiency Syndrome. It is transmitted through bodily fluids and it infects white blood cells which are part of the body's immune system, weakening it so that you can not fight off other opportunistic diseases, leading to AIDS.
Tetanus. This infection causes muscle stiffness and spasms, commonly starting with the jaw muscles making it difficult to swallow or open your mouth. Other common places for muscle spasms are the neck, the chest making it difficult to breathe, the stomach wall and the arms and legs. Other symptoms are:
- extreme sensitivity to touch,
- high fever,
- sore throat,
- rapid heartbeat,
- difficulty breathing,
- bleeding into the bowels, and
Tetanus can lead to suffocation, blood poisoning, cardiac arrest, kidney failure and exhaustion, all of which can be fatal.
Septicemia. A bacterial infection commonly known as blood poisoning. Symptoms include:
- High fever
- Violent shivering
- Cold and pale hands and feet
- Rapid and shallow breathing
- Loss of consciousness
Other problems include:
- Chronic skin ailments
- Lichenoid, which are small bumps of reactive tissue, similar, but more accentuated to those seen in chronic eczema.
- Sarcoidal granulomas, which are ball-like collections of immune cells below the surface of the skin.
- Infections leading to discolouring of the tattoo
- Swelling (due to an allergic reaction)
- Ulceration, which is the formation of sores.
- Delayed hypersensitivity reaction. This occurs several years after the tattoo and causes sudden local itching, scaling, redness and swelling.
- Lymphocytoma, which is a mass of mature white blood cells which resemble a tumour; it is a skin reaction.
- Keloids are raised scars that are not easily removed.
- Photosensitivity occurs when the sun reacts with the dye causing an allergic reaction.
- Photo toxicity occurs when the sun reacts with the dye causing localised sun burn.
According to research carried out by Dr Bob Haley and Dr Paul Fischer from the University of Texas South western Medical School tattoos account for "more then twice as many hepatitis C infections as injection drug use" and people tattooed in a parlour are "nine times more likely to by infected by hepatitis C due to infected needles and unsanitary conditions. " In America you are not allowed to donate blood to the American Red Cross for a year after having a tattoo due to the high risk of blood borne infections.
As well as the risk from blood borne infections the ink itself poses a number of risks. Until recently the ink being used in tattoos was not monitored and many artists use inks which are not approved for skin contact. Some inks are actually "industrial grade" colours suitable for use in printers or car paint! Many people can have allergic reactions to the ink the most common one being to mercury in red inks, but others include manganese in purple inks, chromium in greens, cobalt in blues and cadmium in yellows. Irreversible darkening can occur in flesh, red, tan and white coloured inks which are used in cosmetic procedures and is thought to be caused by the conversion of ferric oxide (Fe2O3) to ferrous oxide (FeO).
Many inks also contain metal filaments so if you have a Magnetic Resonance Imaging scan (MRI) you may feel a burning pain. This is because magnetic metals convert the radio-frequency pulses of the MRI machine into electricity and the burning could be electricity running through the tattoo. Because of this some hospitals will not do MRI scans on people who have tattoos. MRI scans take very detailed pictures of almost all body tissues and is particularly useful in seeing areas around the spine and the brain. It is the best technique of finding tumours in the brain and whether the tumours have spread to nearby brain cells and therefore extremely important and useful.
At the moment lasers are used to try and remove tattoos or at least fade them but this is expensive and painful as it involves burning the skin which results in scarring. However, a new removable dye is just coming out which is made of plastic beads containing the dye or pigment which is approved by the Food and Drug Administration. As it the dye is contained inside plastic beads it can not be absorbed by the body, however, when a laser hits the bead it breaks down and the dye is absorbed.
Tattoo artists are bound by the Supply of Goods and Services Act 1982 as they are providing you with a service. Therefore they must provide this service with "reasonable skill and care" and they are liable for "consequential loss" if the tattoo goes wrong and you have to pay for corrections or removal. It is best to go to a licensed tattooist if only because they are more likely to have the protection and correct insurance cover should anything go wrong.
If you have suffered from any blood borne infections, allergic reactions or other medical conditions due to the negligence of your tattoo artist; or if your tattoo does not resemble your design or descriptions then you could be entitled to compensation towards any extra tattoo treatments or medical treatments that you required to remedy the damage, and towards any discomfort or embarrassment you may have felt while you were recovering. It is advised that you take pictures of your tattoo as evidence of any damage or incorrect detailing and if possible pictures of the designs that were intended or agreed upon for comparison purposes.