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    Talking about tattoos

    Tattoo-associated skin complications are on the rise.


    ConsumerReports.org reported in 2008 that tattoos had become mainstream. More than one-third of US adults aged younger than 35 years have at least 1 tattoo, according to the article.1

    The part of that statistic that most concerns pediatricians is that tattooing can result in complications, ranging from localized inflammatory skin eruptions to sometimes life-threatening infections and hepatitis. Some teenagers are at higher risk for complications than others.

    Pediatricians who recognize and diagnose tattoo complications early on can help to prevent morbidity—even mortality. Pediatricians also can help by counseling their teenaged patients about potential dangers before children go under the needle.2

    Physician awareness, surveillance, and action are needed, especially when one considers: “There is no standard regulation for training or licensing, no requirements for inspection, record-keeping, informed consent, or oversight for compliance and complications,” according to ConsumerReports.org.1

    A problematic process

    It’s no wonder that tattooing can result in skin and other health problems. Permanent tattooing involves making ink-filled injections into the dermis.3

    The inks injected often consist of products that shouldn’t be put into the body. Among those: azo pigments, which contain impurities and are manufactured for use as printing inks and automobile paint.1 “Alarmingly, in tattooing, hundreds of milligrams are injected directly into the skin,” according to ConsumerReports.org.

    Even the water used in the tattoo ink or to dilute it is a potential health concern. Tattoo artists have been known to use distilled or reverse osmosis water to create or dilute tattoo ink products, which could expose adolescents and others to germs and infection.4

    Cases in point

    Researchers published a study in 2013 on increasing reports of cutaneous inoculation of nontuberculous (atypical) mycobacteria (NTM) during the tattooing process.5 The 3 NTM skin infections reported in the study prompted the government to conduct an epidemiologic investigation.

    Researchers in the study interviewed tattoo artists involved in the NTM cases about their practices, ink procurement, use, and other symptomatic clients. They uncovered 31 cases of suspected or confirmed NTM inoculation from tattooing and concluded the problem stemmed from a bottle of gray-wash ink used on the tattoos.5

    Lisette Hilton
    Lisette Hilton is president of Words Come Alive, based in Boca Raton, Florida.


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