Originally Published: January 12, 2014 6:01 a.m.
The art of tattooing originated during the Neolithic Age, some 5,300 years ago. First documented on the "Iceman," tattoos are worn for religious, aesthetic, tribal, and medicinal reasons. There has been a definite evolution of purpose and materials used to produce tattoos, which has morphed the way tattoos are being used today.
Tattoos can be simple or elaborate designs but have always maintained a uniqueness to them, as every tattoo represents a special meaning to the owner. Tattoos today are generally a decorative form of permanent expression.
Tattoo inks have also gone through an evolution. The earliest tattoo inks were mostly made of natural dyes from plants. For dark or black-pigmented colors, soot was most commonly introduced into the pricked skin. Today's inks are composed of a conglomeration of different chemicals and dyes that can be highly toxic, yet little regulation exists for the protection of the consumer. The FDA does not require ingredient disclosure of the inks used, so the tattoo inks can potentially contain a wide variety of ingredients. Some are known to be mutagenic, teratogenic and carcinogenic.
Metallic salts including arsenic, mercury, aluminum and cadmium, organic dyes and even plastics are suspended in solution for tattooing. Many permanent ink pigments are the same as those found in automobile and industrial paints and are known cancer-causing substances. Specific colors, like red, orange, yellow and white are well known for producing health risks. The inks - spontaneously or after laser treatment - can break down and disperse throughout the body, causing allergic reactions and possibly cancer, which can take decades to develop.
In addition, these inks can become contaminated with harmful viruses like HIV, Hepatitis B and C or bacteria like non-tuberculosis mycobacteria, which causes lung diseases, joint infections and eye problems as well as other organ problems. Most of the time, these are difficult to diagnosis and often require treatments of six months or longer.
Temporary henna tattoos originally were made from a flowering plant; however, most brands on the market now include coal tar dye, p-phenylenediamine (PPD), to darken the tattoo and make it last longer. PPD is known to cause serious skin reactions including blistering, redness, light sensitivity and permanent scarring. The last two years has seen increasing numbers of emergency room visits for children who have received temporary tattoos.
Despite the risks, 36 percent of Americans, between the ages of 20-29 get at least one tattoo. As they age, the tattoo changes shape and becomes skewed, leading to "tattoo regret." Therefore, many times these tattoos are removed. Removal of tattoos by nonprofessionals can lead to keloid scarring since abrasive sanding of the skin is usually employed using salt, lemon juice, bleach and other caustic substances.
The safest and most popular form of removal is laser tattoo removal, which can eradicate the tattoo completely without scarring. A Q-switched 1064 nm laser is usually employed for this purpose. Many unscrupulous salons will use a long pulsed 1064 nm hair removal laser for clearing tattoos, but this results in a significant risk of scarring due to the amount of heat delivered to the skin. A laser tattoo treatment takes about 15 minutes and must be repeated every two to three months. Some colors, like dark pigments, respond better to treatment than others. Most black tattoos require 10-20 treatments for complete elimination. More treatments are required for other colors.
Before choosing a tattoo, weigh carefully the health risks and the cost of removal, which can be considerable. Getting a tattoo during pregnancy is not advised due to potential harm to the fetus. Patients taking blood-thinning medications, those who are ill, or those under the influence of alcohol should not get tattoos. Diabetics should ask their doctor before getting tattoos since their risk of infection is increased.
Robin Fleck, M.D., is a board-certified dermatologist and internist. She is founder and medical director of Vein Specialties and Body Oasis Medical Spa, and is the director of Southwest Skin and Cancer Institute. Send questions via www.rejuvadoc.com.