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    Effects of body modification are more than just skin deep

    Like it or not, teenagers and young adults are embracing body modification, making it more commonplace and accepted than in previous generations, where tattoos and piercing were mostly seen in high-risk groups.

    With increased acceptance comes increased prevalence, and parents and pediatricians should know how, where, and why teenagers are choosing body modification.

    Cora Collette Breuner, MD, MPH, FAAP, a pediatrician specializing in adolescent health and chair of the American Academy of Pediatrics (AAP) Committee on Adolescence, helped craft the Academy’s first-ever guidance on body modification. She says parents and pediatricians have to be educated when it comes to knowing the rules and regulations of body modification in their state, as well as the risks and complications of such procedures, so they can guide adolescents in their decision making.

    More: Talking about tattoos

    “Our hope from the AAP and from the Committee on Adolescence is that pediatricians and other healthcare providers will learn how to guide their young adults on making a decision about body modification,” Breuner says. “An informed young adult is one who can make a decision that [he or she] hopefully can make which will not lead to a complication and definitely lead to no regret.”

    Previous reports on body modifications have focused on high-risk and at-risk teenagers, but tattooing and piercing are no longer seen as activities limited to high-risk populations. More and more adults and teenagers have tattoos and body piercings, with a 2010 report estimating that 38% of persons aged 18 to 29 years had at least 1 tattoo and 23% had piercings in places other than the earlobe. The mainstream nature of piercings and tattoos today has not removed the risk associated with them, however, and pediatricians and parents should be aware of the possible medical complications and safety issues.

    Body modification is increasing in popularity, according to the report, which cited a 2016 Harris poll estimating that the popularity of tattoos was up 20% since 2012. Few adults polled about their tattoos regret getting them, with most revealing that it makes them feel rebellious, strong, attractive, or spiritual. As far as popularity among teenagers goes, the report cites 1 study conducted across 8 states that found that 10% of high school students already had tattoos and 55% had an interest in getting one. Other polls place prevalence of tattoos in the 12-to-22-years age group at 10% to 23%, and body piercing in places other than the earlobe at 27% to 42%.

    College students also favor body modification, with 23% having tattoos and 51% reporting body piercings, according to the report. Male athletes were more likely than nonathletes to have tattoos, and piercing was more common among women, the committee states. In terms of what types of piercings are popular, upper ear cartilage piercing (53%) was the most common visible piercing, followed by the navel (38%) and tongue (13%). About 9% of college students reported having nipple or genital piercings.

    Whereas tattooing and piercing used to be associated with high-risk groups engaged in drug and alcohol use, violence, or self-harm, this is not the case today, the researchers say. However, pediatricians are still advised to conduct careful psychosocial assessments with teenagers to help decrease high-risk behaviors through targeted behavioral interventions. Body modification is not the same as nonsuicidal self-injury (NSSI), the report clarifies, which is often impulsive or compulsive and associated with mental health disorders.

    NEXT: The risks of tattoos and piercings

    Rachael Zimlich, RN
    Rachael Zimlich is a freelance writer in Cleveland, Ohio. She writes regularly for Contemporary Pediatrics, Managed Healthcare ...

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