The truth about tattoos

If you haven't noticed, tattoos are popular. A survey for Fosters in 2010 found 39% of UK adults already have a tattoo and another 32% were considering getting one. Before you ink, learn more about tattoos – why people get them, the health risks involved, and your removal options if you change your mind.

Types: Amateur tattoos

Amateur tattoos are made by individuals or their friends using DIY kits or improvised materials. They lack the artistry of professional tattoos. Because such tattoos are often done under unsanitary conditions with unusual pigments, there is a much higher risk of infection.

Types: Cultural tattoos

Cultural tattoos are applied via traditional methods to members of certain ethnic groups. They may serve ritual, societal or cosmetic functions.

Types: Professional tattoos

Professional tattoos are applied by registered artists using a tattoo machine – or "tattoo gun."

Types: Cosmetic tattoos

Tattoos may be used as "permanent" make-up, such as eye and lip liner, lipstick, blush, eyebrows or hair imitation. Because tattoos fade over time, the procedure must occasionally be repeated to keep colours fresh.

Types: Medical tattoos

Medical tattoos are not decorative, but are placed for medical reasons:

• Patients with medical conditions or chronic diseases, such as diabetes, may use a tattoo to alert health care workers in case of an emergency.
• Doctors may use tattoos to mark specific sites for repeated application of radiotherapy.
• After breast reconstruction surgery, a tattoo may be used to simulate the nipple. This use may also be considered a cosmetic tattoo.

Types: Traumatic tattoos

Traumatic tattoos occur during injuries, when dirt or other materials get imbedded in the skin. Examples include "road rash" from bike accidents or "pencil-point" tattoos (like the one shown here) from pencil punctures.

Why get a tattoo?

There are two basic, very different reasons why people get tattoos: to demonstrate individuality and uniqueness, or to show membership in a group. Should you get one? Things to consider include: down the road, you may not want it -- bodies at 60 look different to bodies at 30. Also, some people still have preconceived notions about people who get tattoos, and if you are looking for a job, you may not get it.

Safe tattooing: Choosing a studio

If you're going to get a tattoo, remember that getting a permanent tattoo is an invasive procedure that requires breaking the skin and coming into contact with blood and body fluids. In the UK tattooists have to be registered with their local council. Make sure the studio is as clean as a clinic. (Hint: check the toilet. If it's dirty, leave immediately.) Check the tattoo area: look for a separate area for tattooing with a clean, hard surface and no random items contaminating the work area. It is illegal to give tattoos to under 18s.

Safe tattooing tips

• Don't drink alcohol or take medication (especially aspirin) the night before or while getting a tattoo.
• Don't get a tattoo if you're unwell.
• Make sure all needles are removed from a sterile single-use package before use.
• Make sure the studio has sterilisation equipment to clean instruments after each use.
• Make sure the artist washes his hands and puts on sterile gloves.
• Make sure the work area is clean and clear of non sterile objects (water bottles, purses, wallets, etc.)
• Get a list of the specific pigments used, including colour, manufacturer's name, and batch number.
• After getting a tattoo, carefully follow healing instructions - including any recommended use of antibiotic ointment.

Tattoo risks: Infection

Whatever type of tattoo you get, there are risks involved. The most serious risks are life-threatening infections, such as HIV or hepatitis B or C, from unclean needles. Other infections, such as impetigo or MRSA (shown here) or deep-skin infection cellulitis may develop.

Tattoo risks: Allergic reaction

Some people develop allergic reactions to tattoo pigments - especially red pigments. The woman in this picture developed an allergic reaction to the red pigment used in her cosmetic lipstick tattoo. Tissue injury and inflammatory reactions to dyes or metals into the skin can occur. Occasionally a contact dermatitis can happen.

Tattoo removal

Tattoos can be removed. Sometimes, particularly if the tattoo was done only in black, the results can be quite good. Often the skin cannot be restored to its original colour or quality. Generally, the NHS will not carry out tattoo removal, unless the mental health of a patient is at risk, so the procedures would have to be paid for privately.

Tattoo removal techniques

There are three basic techniques: cutting away the tattooed skin, dermabrasion (rubbing away the tattooed skin with an abrasive device), or laser removal. The British Association of Dermatologists says several laser sessions may be needed, even for small tattoos. The tattoo shown here was removed via laser; the scar below it was left from dermabrasion removal. Some colour inks are harder to remove than others and repeated visits are required; permanent tattoos may never be gone entirely.

Tattoo removal: What to expect

Different lasers are used on different tattoo colours to break down the pigment into small particles that can be eliminated from the body. Immediately after treatment, the skin under the tattoo may whiten. More normal skin colour usually appears in time.

Tattoo removal risks: Allergic reactions

Lasers break down tattoo pigments, raising the possibility of allergic reactions. In the heart tattoo shown here, each of several different laser treatments caused the same blistering reaction. Fortunately, the blisters got better with routine skin care.

Tattoo removal risks: Scarring

Not every tattoo comes off perfectly. This picture shows scarring caused by attempting to remove it with a laser treatment.

Even temporary tattoos have risks

A popular alternative to permanent tattoos is temporary tattooing with henna-based ink painted on the skin. However, as this picture shows, even these tattoos can cause allergic reactions. Environmental health officers say to stay away from "black henna" temporary tattoos, often sold in seaside resorts. These can contain harmful chemicals.

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