Parents worry about the medical concerns relating to tattoos and tattoo removal. Your Teen sought advice from the experts: Dr. Amy Hehr Kassouf, University Dermatologists and Dr. Joan Tamburro, University Hospitals Rainbow Babies & Children’s Hospital.

What is a tattoo?

Dr. Kassouf:  A tattoo is a permanent design made by inserting tiny needles filled with pigments into the skin’s middle layer. During the procedure, needles connected to tubes of dye force the ink droplets under the skin repeatedly. Each needle contains the correct droplet size and density so the ink stays permanent.

What are the potential health risks of a tattoo?

Dr. Kassouf: Hepatitis B is the most common health risk. It is most likely found in places where instruments are not properly sterilized.  Other risks include bacterial skin infections and allergic reactions.

Dr. Tamburro:  Scarring and infections are the most common health risks. Also, I am very concerned for children with heart ailments and compromised immune systems.  These parents must discuss the serious risks with their teen’s doctor.

What causes an allergic reaction to a tattoo?

Dr. Kassouf:  In some cases, people can have an allergy to certain droplets of the pigments used in tattoos. Tattoo dyes, particularly red dye, can cause an allergic reaction or granulomas (bumps on the skin around the tattoo ink). The skin will become inflamed, and hives can form. Depending on the size of the tattoo and the severity of reaction, a laser may be used to break up the tattoo, or it may have to be surgically removed.

What are the signs of infection from a tattoo?

Dr. Tamburro: Typical signs of an infection, include: warmth, redness, crusting, swelling, pus-like drainage or pain at the tattoo site.

What should teens do if they think they may have an infection?

Dr. Kassouf: See a doctor immediately.  Depending on the severity of the infection, they will most likely be prescribed a topical or oral antibiotic.  Also, the site will have to cleansed and dressed regularly.

Which areas of the body are more prone to infection from tattoos?

Dr. Kassouf: All tattoos are prone to infection before they are completely healed.  Areas with friction are slower to heal, thus increasing the risk of scarring or inflammatory response. There is a correlation between placement on the body and healing; the lower a tattoo is placed on the body, the slower the rate of healing.  For example, a tattoo on an ankle takes longer to heal than a tattoo on a shoulder.

What questions should be asked before choosing a tattoo studio?

Dr. Kassouf: Obviously, the studio must look clean and professional with properly trained employees.  Ask questions about the following: equipment sterilization, (all non-disposable equipment should be heat sterilized or disinfected with a commercial disinfectant), ink type (avoid arsenic-based ink) and the policy regarding follow-up.

What advice would you give to parents?

Dr. Kassouf: Parents should share their opinions with their teens.  Ask them why they want a tattoo and whether they understand the implications. Most teens do not “think beyond 18,” so they cannot imagine how a permanent tattoo might look many years from now.   Parents should make sure that their teen has researched the process and understands the risks before making a decision.

Dr. Tamburro: I think that there is very limited information for parents concerning tattooing. This article is a great starting point.

Dr. Amy Hehr Kassouf, MD, FAAD of University Dermatologists, Inc.

Dr. Joan Tamburro, University Hospitals Rainbow Babies & Children’s Hospital, Pediatric Dermatologist.

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