Tattoos

Popularity

Since the invention of the first electric tattoo machine in the late 1800’s, tattooing has steadily increased in popularity, but in the 1960’s tattoo became a mark of fashion, rather than that of the rebel in the 1950’s. Roughly 36% of those born in the mid-1960’s to mid-1980’s have one tattoo, according to a recent Harris poll. Tattoos are more popular than ever. Today, almost half of people between the age of 18 and 35 have tattoos. The number of Americans who have at least one tattoo has jumped 50% in the past four years. I have no tattoos.

Out of concern for people, and the clients I serve in my private practice, I began to investigate this topic myself and write about the health issues they might encounter as a result of having a tattoo. There are a list of unexpected and sometimes shocking concerns that everyone should know.

The tattooing process

A tattoo is a permanent mark or design made on your skin with pigments inserted through a hand-held machine that acts much like a sewing machine, with one or more needles piercing the skin repeatedly. With every puncture, the needles insert tiny ink droplets and cause a small amount of bleeding. The process is done without anesthetics, so the experience can feel like a pin scratch or like being carved by nails.

Oversight

The actual practice of tattooing is regulated by local jurisdictions, such as cities and counties, in order to limit infection and disease transmission risk. The regulation requirements and licensing standards vary from state to state. That means there is no “standardized certification” for those doing the tattooing and no overall governing body supervising the health and safety of tattoo parlors. Although tattoo artists and parlors are regulated, there are those who are not.

While the Food and Drug Administration “is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices; and by ensuring the safety of our nation's food supply, cosmetics, and products that emit radiation”, tattoo inks are not very closely regulated in the FDA. Published research has reported that some tattoo inks contain pigments used in printer toner and in car paint. The FDA has not approved any pigments for injection into the skin for cosmetic purposes. Some medical practitioners have recommended greater regulation of pigments used in tattoo inks because the wide range of pigments currently used in tattoo inks may create unforeseen health problems.

Tattoo

Few people know what is in the tattoo ink itself

Tattooing ink contains toxic chemicals, including phthalates, heavy metals (lead, cadmium, chromium, nickel and titanium that trigger allergies or diseases), and polycyclic aromatic hydrocarbons (from products of combustion or soot, and have been linked to skin cancer in shale oil workers), which are carcinogenic and endocrine system disruptors. Some pigments are industrial grade colors, which are suitable for printers’ ink or automotive paint. Some studies in Europe suggest that black ink often contains carbon-based pigments, whereas red dyes may contain “azo-based hues,” which contain nitrogen compounds.

Red colors have been found to contain mercury, while greens and blues have been found to contain cobalt. Barium, copper, mercury and other unsafe components in tattoo inks. Their research also found a disheartening mismatch between the listed ink container contents and its actual chemical composition found on testing.

Mercury is one of the most toxic metals, even more so than lead. It is used in many products other than dental fillings, like fabric softeners, cosmetics, laxatives containing calomel, some hemorrhoid suppository preparations and other medications, polishes, wood preservatives, latex, solvents, plastics, ink used by printers and tattooers, and some paints. Mercury in dental fillings leaches out while chewing and is absorbed into the bloodstream on a continual basis. There is no barrier to prevent mercury from reaching the brain cells, where it can do serious neurological damage. Mercury is a cumulative poison that is retained in the pain center of the brain and the central nervous system. My symptoms of mercury poisoning included insomnia, dizziness, fatigue, weakness, depression, memory loss, irritability, a metallic taste in my mouth, loose teeth, dermatitis, and hair loss. High levels of mercury have been linked to Systemic Candidiasis, which I also had. Experts believe ink nanoparticles could enter the bloodstream and accumulate in the spleen and kidneys, harming the body's ability to filter impurities. Studies have found that some ink used in the UK contains known carcinogens and scientists want more regulation of the dyes used by the industry.

Some early research hints that these inks can cause different types of reactions. One chemical commonly used to make black tattoo ink called benzo(a)pyrene is known to be a potent carcinogen that causes skin cancer in animal tests. Melanomas and malignant tumors have been found in tattoos. The Food and Drug Administration has become more involved with tattoo inks, stating “Many pigments used in tattoo inks are industrial-grade colors suitable for printers’ ink or automobile paint.” Like the studies started overseas, the agency is now examining the chemical composition of inks and pigments and how they break down in the body, as well as their short and long term safety. Also, when tattoo inks break down in the body, they migrate to lymph nodes.

Lymph nodes are responsible for filtering out disease-causing organisms. Dibutyl phthalate, a common plasticizer found in black tattoo inks, mimics estrogen and disrupts testosterone. Exposure of fetuses and infants is a major concern. Prenatal exposure to dibutyl phthalate has been linked to feminization of the reproductive tract in infant boys. In men, it has been linked to sperm defects and altered thyroid hormones. Some pigment migrates from a tattoo site to lymph nodes, where large particles may accumulate. When larger particles accumulate in the lymph nodes, inflammation may occur. Smaller particles, such as those created by laser tattoo treatments, are small enough to be carried away by the lymphatic system and not accumulate. Lymph nodes may become discolored and inflamed with the presence of tattoo pigments, but discoloration and inflammation are also visual indicators of melanoma; consequently, diagnosing melanoma in a patient with tattoos is made difficult, and special precautions must be taken to avoid misdiagnoses. Pathologists, meanwhile, are reporting tattoo ink in surgical biopsy specimens of lymph nodes. For instance, a 2015 report in the journal Obstetrics and Gynecology detailed the case of a young woman with cervical cancer which doctors believed had spread to her lymph nodes. After surgery to remove the nodes, they discovered that what appeared to be malignant cells in a scan was actually tattoo ink. A similar misdiagnosis occurred in another patient with melanoma.

Most of the long term health effects happen in skin regions injected with black and red ink, which are the most commonly used colors.
Carcinogens were identified in 83 percent of black inks – by far the most popular color for tattoos.
Approximately 44% of long term reactions happen after red ink was used in a tattoo.

Tattoo dyes — especially red, green, yellow and blue dyes — can cause allergic skin reactions, such as an itchy rash at the tattoo site. This can occur even years after you get the tattoo.

Azo-type pigments used in tattoos tend to cleave through enzymatic catalysis of redox reactions, resulting in highly electrophilic aromatic amine by-products capable of forming chemical bonds by the sharing of electrons between atoms binding with DNA. Naphthol and Azos break down in sunlight exposure into toxic and/or carcinogenic aromatic amines. As with heavy metals, these by-products of the pigments’ decomposition accumulate in the lymphatic system. Plastic-based inks (e.g., glow-in-the-dark ink) are known to lead to polymerisation under the skin, where the tattoo pigment particles converge into one solid plastic piece under the skin.

Ramifications for health

Research has linked tattoos with different health issues from the ink itself including, infections, toxic effects, scarring, burns, chronic irritations and much more.

A skin infection is possible after tattooing. Many of the skin problems are suspected to be caused by underground "scratcher" tattoo artists working without licenses. There are two trades: scratchers and the legitimate trade, however the same ink is used by both and the health problems associated with the ink is my main focus.

Tattoos breach the skin, which means that short term complications can include delayed healing, pain, itching, redness, swelling, and infection within weeks of getting tattooed. You can get serious infections from unhygienic practices and equipment that isn’t sterile. Using non-sterile water to dilute the pigments (ingredients that add color) is a common culprit, although not the only one. For many people, the complications linger for years after the tattoo was inked.

The most common infections associated with tattooing involve staphylococcus aureus or pseudomonas bacteria arising from poor skin preparation or equipment sterilization. More aggressive infections may cause high fever, shaking, chills, and sweats. A doctor treating such infections might prescribe a variety of antibiotics—possibly for months—or even hospitalization and/or surgery. “Staph” skin infections can become serious and even life-threatening, as antibiotic-resistant strains become more prevalent. The other unexpected consequence is antibiotics cause Systemic Candidiasis and Leaky Gut to develop, or if you already have this, it will progress to the next stage.

Other skin problems include: Cement dermatitis, collagen deposits, discoid lupus erythematosus, eczematous eruptions, hyperkeratosis and parakeratosis, and keloids. The most common dermal reactions to tattoo pigments are granulomas and various lichenoid diseases. Granulomas are small knots or bumps that form around material the body perceives as foreign. Keloids are scars that grow beyond normal boundaries or raised areas caused by an overgrowth of scar tissue. Hypersensitive reactions to tattoos are known to lay latent for significant periods of time before exhibiting symptoms. Delayed abrupt chronic reactions, such as eczematous dermatitis, are known to manifest themselves from months to as many as twenty years after the patient received his or her most recent tattoo.

The U.S. Food and Drug Administration (FDA) is also seeing reports of people developing infections from ink that was contaminated with bacteria or mold, as well as adverse reactions to the inks themselves. Although research is ongoing at FDA and elsewhere, there are still a lot of questions about the long-term effects of the pigments, other ingredients, and possible contaminants in tattoo inks. The FDA has received reports of bad reactions to tattoo inks right after tattooing and even years later. There’s no sure-fire way to tell if the ink is safe. An ink can be contaminated even if the container is sealed or the label says the product is sterile. Two years ago the U.S. Food and Drug Administration launched an investigation after research found inks contained potentially dangerous substances including metals and hyrocarbons that are known carcinogens.

Inks and kits sold as “do-it-yourself” to consumers have been associated with infections and allergic reactions. They've been linked with infections and allergic reactions because users may not know how to control and avoid all sources of contamination. Avoid do-it-yourself tattoo inks and kits.

Maurie Luetkemeier, a professor of physiology at Alma College in Michigan, found that tattoos may interfere with the way your skin sweats. Compared to non-tattooed skin, inked skin excretes about 50% less sweat, and the sodium in sweat is more concentrated when released from tattooed skin. When your glands produce sweat, the skin tends to reabsorb sodium and other electrolytes from that perspiration before it breaks free, but his findings indicate that tattoos may partially block this reabsorption. Also, if you have extensive coverage—especially on your back, arms or other areas densely populated by sweat glands—tattoos could interfere with the skin’s ability to cool your body and hold onto important nutrients. Exposure to high heat and a heavy workload could cause your body to have a difficult time regulating body temperature.

A rash may also mean you’re having an allergic reaction to the ink, or ingredients You also might become allergic to other products, such as hair dyes, if your tattoo contains p-phenylenediamene (PPD). And because the inks are permanent, the reaction may persist.

Blood-borne diseases. If the equipment used to create your tattoo is contaminated with infected blood, you can contract various blood-borne diseases — including tetanus, hepatitis B and hepatitis C. Hepatitis, which is 10 times more infectious than HIV, can be transmitted through needles used by tattoo artists. It is the reason the American Red Cross restricts blood donations from individuals with newer tattoos done outside of regulated tattoo facilities. A study from Tulane University added credence to these blood donation restrictions by showing that 17 percent of all participants had at least one tattoo done somewhere other than a tattoo parlor, and 21 percent admitted to being intoxicated while receiving at least one of their tattoos. We were rather alarmed at the high rate of reported chronic complications tied to getting a tattoo."

Occasionally, when a blood vessel is punctured during the tattooing procedure a hematoma (bruise) may appear. Bruises generally heal within one week. Bruises can appear as halos around a tattoo, or, if blood pools, as one larger bruise. This bluish or dark blurry halo that surrounds a tattoo can also be attributed to ink diffusion or 'blow-out'. Commonly mistaken for a hematoma, this discoloration occurs when tattoo pigments spread out into the subcutaneous tissue beneath the dermal skin layer, and may be caused by ink being deposited too deep in the skin.
About 10 percent of the people said they’d had some complications. For some, these complications were short-lived, such as bacterial infection right after the tattoo was inked, or temporary swelling and itching.

MRI complications. Let your health care professional know that you have a tattoo before an MRI is ordered. Tattoos may cause swelling or burning in the affected areas during magnetic resonance imaging (MRI) exams. Black ink commonly contains iron oxide. The MRI scanner causes the iron to heat up either by inducing an electric current or hysteresis. Non-ferrous pigments have also been known to cause burns during an MRI.

The health effects of tattoos are so bad they require removal using laser surgery and patients are given steroids to resolve the problems associated with removal. The consequence of steroids is they contribute to or advance Systemic Candidiasis.

I don’t think anyone gets a tattoo because they believe it’s totally safe. I think people get tattoos because it’s culturally a little bit rebellious, and I don’t think they are well educated about the risks. I’m not talking about risks like, it will turn out ugly or fade in the sun. I’m speaking in terms of long term or permanent health problems that are absolutely 100 percent likely to occur. Most people who get tattoos are willing to face some risk, because they already participate in other risky behaviors. Tattooing is considered a “risky behavior”.

Regrets

According to the 2016 Harris Poll, of about 1 in 4 people have tattoo regret. When asked, many said the primary reason they regret having gotten a tattoo is they were too young to make a decision that permanent, and at the time put little or no research into the decision. The second most common reason, which coincides with the first, is the tattoo “no longer fit their lifestyle or interests.” They may have the name of an old boyfriend or girlfriend permanently on their body. Whether a tattoo depicts a name, a person, a place or a thing, tattoos take on different meanings, depending on the interpreter, their relative history and knowledge. Their perception changes through time and experience, and tattoos are always in a state of gradual transition.

During job interviews with hiring managers tattoos can actually hurt job prospects. 86 percent of college students discover that having a visible tattoo is a detriment to their future employment. With such a large number young people considering tattoos, informing them of the health and social risks could help them avoid tattoos they may regret later. As the prestige of the profession or job position rises, older coworkers are less tolerant of visible tattoos. The acceptance doctors, primary school teachers and presidential candidates decreases significantly among the vast majority of people age 51 and above.

Understandably, people who have many friends and family members with tattoos are generally more accepted regarding their tattoo, and tend to suffer less tattoo regret, but those who interact with individuals without tattoos, like in the workplace or institutions of higher learning, experience more social stigma, and are more likely to suffer regret and consider tattoo removal.

Getting a tattoo is a body-changing decision, which is akin to a life-changing decision, which is really no different from young people getting married, which has a 32 percent regret rate or choosing the wrong college major, which has a 37 percent change rate. For many, making a major decision when young is rife with regret. The difference with tattoos is having to face that regret every time you look in the mirror or social experiences on a daily basis.

Removal

You might think that if you tire of your tattoo, you can just get it taken off, but the process of tattoo removal is actually expensive, time consuming, and painful. Tattoos covering extensive areas of the body are simply too large to tackle in one session, and could take years to remove. Depending on the size of the tattoo and other factors, you may need to undergo anywhere from five to 20 sessions for a satisfactory removal -- and each session costs hundreds of dollars. Darker pigmented people tend to have less success with certain lasers and require more sessions to avoid skin damage.

As the number of people who have tattoos grows, the need for laser surgery tattoo removal services have rapidly grown across the nation into a multi-million dollar business, with additional potential for growth as the younger, highly tattooed, generation ages.

The process of tattoo removal involves a laser that targets the pigment and dissolves it so the body can absorb it. Because the laser shatters the pigment particles under the skin for removal by the body, the issues with infections, scarring and the ink spreading become a concern again. Their have been case reports of tattoo removal that have caused potentially deadly allergic reaction (anaphylactic reactions), which involves the closing of the throat and a dangerous drop in blood pressure. Other complications include hypopigmentation (white spots where the tattoo used to be) and fibrosis (thickening of the skin in the tattoo site). We don’t know the short or long term consequences of how pigments break down after laser treatment. However, we do know some tattoo removal procedures may leave permanent scarring. You can lighten them, but complete removal is a challenge. You have to accept the fact that the skin will never look the same.

The tattoo artist usually uses an electric machine with disposable needles that injects colored inks into the lower layer of the skin, the dermis. The upper layer, or epidermis, does not retain the color but rather sheds it as the skin is renewed as following an injury, which is why the ink is deposited into the lower layer of the skin where it will stay permanently, which is why it is so difficult to remove a tattoo. Some tattoos can never be removed completely because the ink has been placed too deep in the skin and the laser treatment can't reach it.

Current lasers still have limitations in the colors they can erase with added difficulty stemming from more vibrant tattoo colors.
Black is the easiest shade to remove, while green, blue, yellow and purple can be the most stubborn. Older tattoos will fade more easily than newer ones. And the darker your skin pigment, the more difficult it will be to erase your ink. Where the art is on your body can also affect removal: The further away the tattoo is from your heart, the harder it is to treat.

Because of the risks (burns and scarring) involved and the skill required, you should see a dermatologist or other medical professional to have the work done. Laser complications include pain, blistering, scarring and, in some cases, a darkening of the tattoo ink can occur, according to dermatologists. Dermatologists have observed severe medical complications from tattoo pigments in the body, and have noted that people acquiring tattoos rarely assess health risks prior to receiving their tattoos. Over the years, the FDA has received hundreds of adverse event reports involving tattoos.

Physical consequences for others

Beyond the well-known risks for the individual with the tattoo, people should also recognize the chance that what they do to and put into their body will cause physical consequences for others.

In 2005, the Environmental Working Group (EWG) published a ground-breaking report called “Ten Americans”. It tested for 500 toxic chemicals to determine the toxic chemical burden of ten Americans. They found 300 toxic industrial chemicals in their blood, but what was so interesting is these exposures did not come from
• the air they breathed, even though there was mercury found in their blood, which is often found in air pollution.
• the water they drank, even though there were additives found in their blood, like perchlorate, which is a rocket fuel component.
• the personal care products that they used, even though there were chemicals like parabens and phthalates found in their blood.
These ten Americans were newborn babies. This proves that toxic pollution does cross the umbilical cord and placenta, causing a toxic burden in the blood of unborn babies. What you expose your body to before and when you are pregnant - ends up in your baby!

I ask every expectant mother or woman planning to get pregnant, to take a serious look at what she eats, drinks, the synthetics in the clothing she wears, the products she uses on her skin and hair (cosmetics, deodorant, perfume, dyes, permanents, lotions, soaps, shampoo, tattoos even), medications, habits, what chemicals are used to clean her clothes (detergents, fabric softeners, dry cleaning, spot removers), what chemicals she uses to clean her home (bleach, oven cleaner, air fresheners) and the environment they are exposed to (tobacco smoke, exhaust, fuels, etc). It’s time that we as women and the caregivers of our families, commit to being focused on those things that really matter; being a nurturer and focusing on our home and family.

We need to think about how what we do each day really does affect our health and the health of the next generation in some very serious and long lasting ways, and on so many levels. We need to operate on the “precautionary principle”, which is basically the same as the “Better safe than sorry” approach.

Our Bodies Are God’s Temple

As a Christian, I studied my bible and read it daily. I’d choose a topic and learn all I could about what God says about that one thing. I wanted to understand what God expected of me as a person, woman, wife, mother and friend. I also wanted to know what He had to say about food and the body, because my perception of food and my body had been warped. It is no secret that our culture is obsessed with physical appearance. Many Christians focus on spiritual growth and maturity, but rarely give any thought to their bodies because, after all, we will get a new body in heaven - right. I did think of my body as the “temple of the Holy Spirit” and so I didn’t put drugs or alcohol in it, and I didn’t smoke. I didn’t tattoo it either, because I equate that to graffiti on the walls of the Holy of Holies in the old testament temple.

Your body is meant to be the temple of God. This may be a touchy subject, but I would be remiss if I didn’t share this thought with you. What would God think of someone who sprayed graffiti on the walls of the Holy of Holies in His temple in Jerusalem? That’s exactly how He feels about your body! Some people think, “My body is mine to do with as I please”. But Gods perspective is very different.

God created the body, so it belongs to Him. It also belongs to God, because He sent Jesus to redeem it (body, mind and spirit). Value is all about perception. Something is only worth what someone is willing to pay for it. You and I are very expensive, because Jesus paid the highest price (His life) to redeem us (1 Corinthians 6:19-20). If you want to know how valuable you are to God, just look at the cross. If I am worth dying for, than I am worth caring for. God cares for me, so I need to care for myself. That way, I can have the energy and clear mind to serve God and others. My body is on loan, like a tool, to use while I am here on earth. He expects me to care for it and use it to do His work. Think of your body as one of the “talents” (Matthew 25:15-28) He has given you and one day He will expect an account for how you used it. This life is preparation for the next life. If I can’t be trusted to manage earthly possessions; time, money, talents, opportunities, mental and physical abilities - how can God trust me with heavenly riches. I can’t expect God to bless me with heavenly riches, if I don’t manage my earthly responsibilities well. God is watching all of us, to see how well we manage what He has given us. Do we make the most of what we receive or do we squander it?

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