Do your homework before deciding on body art

Cheaper might not be a bargain when it comes to tattoos and permanent makeup!

As you’re making holiday wish lists and searching for the best deals, here’s a health tip: Cheaper might not be a bargain when it comes to tattoos and permanent makeup.

Aside from the potential for goof-ups permanently inked into your skin, going to a sketchy tattoo artist or unregulated studio puts consumers at risk for contracting infections, diseases and even superbugs like methicillin-resistant Staphylococcus aureus, also known as MRSA, according to the U.S. Food and Drug Administration (FDA).

The agency, which issued a nationwide alert about tainted tattoo ink last summer, urges consumers who are considering body art to make informed decisions by doing their homework and being aware of the risks involved.

Kentucky requires tattoo studios to be certified by local health departments, which involves inspections and a $100 annual fee. Tattoo artists are required to register with local health departments and pay a $20 annual fee. In addition, those getting inked must show proof of age and a photo ID, and have a signed, notarized parental consent form if under 18 years old.

Why the precautions? Consider some of the tattoo-related health issues that have come up in recent years to understand why it’s important to go to a licensed facility, and hire a trained and licensed artist who uses properly maintained inks and equipment.

  • In 2012, there was a MRSA infection outbreak in New York, Washington, Iowa and Colorado, reported in the Journal of the American Medical Association. MRSA is a hard-to-treat bug that can quickly devastate a person’s skin and organs. The 22 infected with the fast-growing bacteria all had been recently tattooed. Their conditions ranged from mild rashes to severe abscesses that required surgery and several months of antibiotic therapy. Based on symptoms, dozens more cases were investigated, but testing proved inconclusive for the bacteria.
  • A 2004-2005 MRSA outbreak in Ohio, Kentucky and Vermont involved 34 people with fresh tattoos, plus 10 people who had been in close contact with someone who recently had been tattooed, according to the U.S. Centers for Disease Control (CDC). Except for one of the patients who also had hepatitis C, no underlying diseases or risk factors were identified. Symptoms began to show up four to 22 days after the patients were tattooed, and most had mild to moderate infections, ranging from cellulitis and small pustules to large abscesses that required surgical incision, drainage and antibiotic treatment. Four of the people infected needed to be hospitalized because they required intravenous medications to prevent pneumonia and necrotizing fasciitis, a serious bacterial infection, according to a CDC report.
  • Two 2009 cases in Washington involved tattoos infected with a bacteria normally seen only in people with poor immune systems. The journal Emerging Infectious Diseases reported that both otherwise healthy individuals had been inked at the same shop and developed identical symptoms, including pustules around their new tattoos. One person’s tests proved inconclusive. The other’s tattoo was infected with Mycobacterium haemophilum, which can be tricky to treat, just like its tuberculosis-causing relative. The man’s lesions took nearly a year to fully heal. Because M. haemophilum doesn’t normally cause the type of pustules seen in this case, investigators said the man’s condition may have stemmed from being infected via tattoo needle.

Another outbreak of M. haemophilum was reported among 12 Swiss women who had their eyebrows tattooed as permanent makeup. In addition to lengthy antibiotic treatment, 10 of them needed surgery, according to the CDC.

Bacterial endocarditis, a potentially deadly infection of the heart’s inner linings or heart valves, could be a risk for some people who have heart conditions. If you’ve ever been advised to take antibiotics before invasive procedures such as dental extractions, you may want to discuss tattoo safety precautions with your doctor.

“Tattooing poses a risk of infection to anyone, but the risk is particularly high for those with pre-existing heart or circulatory disease, diabetes or compromised immune systems,” Linda Katz, director of the FDA’s Office of Cosmetics and Colors, said in a release.

Investigators suspect some of the infections have come from tattoo artists diluting ink with nonsterile water, or from needles or other equipment that were not properly sanitized.

The process of tattooing, in which one or more needles pierce the top layer of skin repeatedly to carry tiny dye droplets into the different levels of the skin, causes a small amount of bleeding and swelling. It’s normal for the tattooed area to swell slightly and ooze small amounts of blood for up to 24 hours. Anything more than that — redness, weeping wounds, blemishes, blisters, excessive pain at the site, fever, shaking, chills or sweats — could signal an infection requiring immediate antibiotic treatment, according to the FDA.

Not all bad reactions happen right away, notes the FDA, which reports that it has heard of bad reactions to tattoo inks years after procedures.

Health officials, including the CDC, the FDA and insurance giant Kaiser Permanente, offer these suggestions for those considering tattoos or permanent makeup:

  • Don’t get a tattoo while under the influence of alcohol or drugs.
  • Get a tetanus shot before tattooing, if you have not had one in the past 10 years.
  • Investigate the artist and studio. Ask about their cleaning methods and safety records. Make sure the artist washes his or her hands before putting on gloves, which should be fresh for each procedure and changed after answering the phone or touching other nonsterile items during procedures.
  • Think ahead. Dark blue, black and red are the easiest dyes to remove with lasers, and bright colors, such as light blue, green and yellow, are hard to remove.
  • Don’t get a tattoo if you’ve ever had an allergic reaction to tattoo dye, henna or hair dye.
  • Check with your city or county health department to find out if there have been any complaints about the studio or artist you’re considering.
  • Carefully consider where on your body you want to tattoo. Some placements or styles could limit future opportunities. And remember that weight gain — including pregnancy weight gain — might distort or otherwise affect a tattoo’s appearance.


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