Not too long ago, most Americans associated tattoos with sailors, bikers and sideshow artists. But tattoos have become more popular in recent years, and the people who get them are as diverse as the styles and designs they choose. And some people who would never think of tattooing pictures or symbols onto their bodies use permanent makeup — a type of tattoo — to emphasize their eyes and lips. Artists create tattoos by injecting ink into a person’s skin. To do this, they use an electrically powered tattoo machine that resembles (and sounds like) a dental drill. The machine moves a solid needle up and down to puncture the skin between 50 and 3,000 times per minute. The needle penetrates the skin by about a millimeter and deposits a drop of insoluble ink into the skin with each puncture.
A tattoo machine creates a puncture wound every time it injects a drop of ink into the skin. Since any puncture wound has the potential for infection and disease transmission, much of the application process focuses on safety. Tattoo artists use sterilization, disposable materials and hand sanitation to protect themselves and their clients. To eliminate the possibility of contamination, most tattoo materials, including inks, ink cups, gloves and needles, are single use. Many single-use items arrive in sterile packaging, which the artist opens in front of the customer just before beginning work.
Time and Money
A small tattoo — under one inch — should cost from $50 to $100. Custom tattoos and larger designs are more expensive, and elaborate pieces can require multiple sessions. Prices for elaborate designs are whatever the market will bear, according to tattoo artists.
Reusable materials, such as the needle bar and tube, are sterilized before every use. The only acceptable sterilization method is an autoclave — a heat/steam/pressure unit often used in hospitals. Most units run a 55-minute cycle from a cold start, and they kill every organism on the equipment. To do this, an autoclave uses time, temperature and pressure in one of two combinations:
- A temperature of 250° F (121° C) under 10 pounds of pressure for 30 minutes
- A temperature of 270° F (132° C) under 15 pounds of pressure for 15 minutes
Prior to sterilizing the equipment, the artist cleans each item and places it in a special pouch. An indicator strip on the pouch changes color when the items inside are sterile.Early ToolsEarly tattooing methods used picks, rakes, combs and chisels to cut or puncture the skin before adding pigment. Some Arctic and Sub-arctic tribes created tattoos by pulling a thread coated with soot thorough the skin.
Before working on customers, tattoo artists wash and inspect their hands for cuts and abrasions. Then, they should do the following:
- Disinfect the work area with an EPA-approved viricide.
- Place plastic bags on spray bottles to prevent cross-contamination.
- Explain the sterilization process to the client.
- Remove all equipment from sterile packaging in front of the client.
- Shave and disinfect (with a mixture of water and antiseptic soap) the area to be tattooed.
Creating a Tattoo
Some Americans with tattoos say they feel sexier (34%) and more attractive (26%). Many who don’t have tattoos, however, think people who do have them are less attractive (42%), more rebellious (57%) and less intelligent (31%). [Source: Harris Interactive]
People describe the sensation of getting a tattoo as similar to bee stings, sunburn or being pinched. Some say they experience a slight tickling or “pins and needles.” Individual pain tolerance, the size and type of tattoo, and the skill of the artist all contribute to the amount of pain. Location also makes a difference — skin that rests right over a bone is more sensitive.
Clients work with artists to create custom tattoo designs, or they chose images from flash, which are tattoo designs displayed in the shop. The artist draws or stencils the design onto the person’s skin, since the skin can stretch while the artist uses the tattoo machine. The artist must also know how deeply the needles need to pierce the skin throughout the process. Punctures that are too deep cause excessive pain and bleeding, and ones that are too shallow cause uneven lines.
The tattoo itself involves several steps:
- Outlining, or black work: Using a single-tipped needle and a thin ink, the artist creates a permanent line over the stencil. Most start at the bottom of the right side and work up (lefties generally start on the left side) so they don’t smear the stencil when cleaning excess ink from the permanent line.
- Shading: After cleaning the area with soap and water, the artist uses a thicker ink and a variety of needles to create an even, solid line. Improper technique during this step can cause shadowed lines, excessive pain and delayed healing.
- Color: The artist cleans the tattoo and then overlaps each line of color to ensure solid, even hues with no holidays — uneven areas where color has lifted out during healing or where the artist missed a section of skin.
- Final cleaning and bandaging: After using a disposable towel to remove any blood and plasma, the artist covers the tattoo with a sterile bandage. Some bleeding always occurs during tattooing, but most stops within a few minutes.
Health RisksExtreme TattoosSome people choose to use their entire body as a canvas. Others use tattoos and surgeries to shift their appearance from human to animal. One example is Stalking Cat Dennis Avner.
Since tattoos involve needles and blood, they carry several risks. These include transmission of diseases like hepatitis, tuberculosis and possibly HIV. When [Source: Harris Interactive] follow all the correct sterilization and sanitation procedures, risks for disease transmission are relatively low. According to the Centers for Disease Control and Prevention (CDC), there has not been a documented case of HIV transmission from a tattoo. However, doctors warn that non-sterile tattooing practices can lead to the transmission of syphilis, hepatitis B and other infectious organisms.Infections can occur in new tattoos, especially without appropriate aftercare. Some people also experience allergic reactions to tattoo inks. Although the pigments used may have U.S. Food and Drug Administration (FDA) approval for other purposes, the FDA does not regulate tattoo inks. Finally, some people experience pain or burning during magnetic resonance imaging (MRI) examinations because of metallic pigments. Some doctors have also reported interference and distorted MRI images from permanent makeup pigments.
In addition, most states place restrictions on whether people who have tattoos can donate blood. Because of the danger of hepatitis, the American Red Cross will not accept blood from someone who has been tattooed in the past year unless the tattoo parlor is state-regulated. Most states do not regulate tattoo parlors. [Source: American Red Cross]
Tattoo professionals use rules known as universal precautions to prevent the spread of illnesses during tattooing. These precautions are part of the Bloodborne Pathogens Rule issued by the U.S. Environmental Protection Agency (EPA). The same rules apply to hospitals and doctors’ offices. The CDC is a good resource for information about universal precautions.
Other than the use of universal precautions and laws requiring minors to have parental permission, few regulations cover tattooing.
Licensing usually involves completing a health department course on infectious [Source: Harris Interactive] and passing an exam, but no governing body inspects tattoo businesses. Laws allow anyone to buy a machine, get a license and start tattooing whether or not they have any artistic ability — a situation that professional tattoo artists object to — so it’s a good idea to do your homework before rolling up your sleeve.
Here are some basic steps for choosing a safe tattoo parlor:
- Look around to see if the studio is clean and professional.
- Ask questions: Is there an autoclave? Are the needles and other materials single-use? Are EPA-approved disinfectants used? Do the tattoo artists wear gloves? Professional artists won’t mind the questions.
- Watch the artist and pay attention to health and safety precautions.
- Watch the artist open all needles before beginning work.
- Ask about the staff’s professional memberships. These are not required, but artists who participate may have the most current information about trends, innovations and safety issues.