To tattoo, or not to tattoo; think before you doby Michael BakerPublic Relations In a matter of months, tattoos could become much more visible in South Carolina. Gov. Mark Sanford signed a bill in June to legalize tattooing throughout the state, and now the bill’s enactment awaits the creation of state health regulations. Once the state cements its tattooing guidelines, the practice seems certain to be a popular industry. With the abundance of market-friendly college students, cities such as Charleston could experience an influx of parlors. But for those who eagerly anticipate the opportunity to add a bit of body art, it’s important to understand the facts, risks, benefits, and consequences of getting a tattoo. As a dermatological surgeon at MUSC, Joel Cook, M.D., has cared for patients with various tattoo-related health issues. To understand the basic process of tattooing, he said, one must understand how the body’s immune system works. “Let’s say you get a cut on your finger and bacteria get inside,” he explained. “The immune system sends cells to consume the bacteria and prevent infection. The process works because the bacteria are smaller than the cells attacking them.” However, tattooing circumvents the cellular-directed consumption (phagocytosis) based on the physics of particle size. “To create a tattoo, a motor-driven electric needle injects ink globules just under the skin, about one or two millimeters beneath the surface,” he said. “But the ink globules are larger than the cells dispatched by the immune system. It’s physically impossible for the cells to consume something larger than they are, so the tattoo stays permanently.” For a person with consistent tastes, the permanence presents no problem, but studies show that half of all people who get tattoos regret the decision. “People don’t understand,” Cook said. “It takes 10 minutes and $50 to get a tattoo, and two years and $2,000 to take it off.” The latter portion of his statement surprises many people. Indeed, the removal process is complex and lengthy, consisting of many treatment sessions spread throughout many months. First, the dermatological surgeon uses a laser to fracture the globules of tattoo ink into smaller pieces. The immune system then sends cells to consume these more manageable fragments. Still, one treatment rarely removes the entire tattoo. “In a way, it’s like sculpting out of rock,” Cook explained. “You can’t just tap the rock once and create something meaningful. You have to keep chiseling away, breaking pieces off the main body. It’s similar with tattoos.” Each treatment leaves an abrasion on the patient’s skin, which must be cleaned with soap and water and protected with antibiotic ointment. Pain usually isn’t the largest hurdle, though. Cook said the discomfort of removing a tattoo generally equals the pain of acquiring it, and patients receive local anesthesia to make the laser procedure more comfortable. The larger obstacle is the lengthy period of time over which the removal takes place. “Each treatment takes about two weeks to heal, and then the patient waits four to six weeks for the next treatment session,” he said. “It usually requires six to 10 treatments to finish the process.” Depending on the tattoo’s size and intricacy, a patient may need as few as one treatment or as many as 20. Even after the treatments, traces of the tattoo still linger in the skin, but most aren’t noticeable without close scrutiny. “The tattoo is never 100 percent gone, but from four or five feet away, it’s extremely hard to see,” Cook said. What he finds most disconcerting are the inherent health risks of getting a tattoo. Statistics show that people with tattoos are twice as likely to test positively for hepatitis C, a potentially fatal disease. Some people experience an allergic reaction to the ink, especially with shades of red, and develop symptoms ranging from localized itching to persistent sores to a full-body rash. “Right now, there’s no FDA regulation regarding what goes into the ink,” Cook said. For people giving serious consideration to getting a tattoo, he suggests a temporary alternative before making a final decision. Henna tattoos use a strong paint that lasts approximately two weeks before fading away. It allows curious individuals to get accustomed to the presence of a tattoo before taking permanent action. Whether a person gets—and keeps—a tattoo ultimately depends on his or her discretion. But based on his experience and on advice from patients going through the removal process, Cook has a few tips. “Always go to a regulated tattoo parlor,” he asserted. “Make sure the artist wears gloves, uses sterile needles that are opened in front of you, and uses sterilized instruments. “And a good tattoo artist will never work on an underaged or intoxicated person,” he concluded. “Remember, you don’t really know anything about these artists when you walk in the door.” Cook also suggested tattoos incorporating only one color (preferably black)—fancier tattoos are harder to remove. Sorority and fraternity letters or tattoos that symbolize a dated period of your life are also a bad idea. “Never get anyone’s name put on your body,” he said. “You may love them today, but life can change.” Ultimately, Cook sees promise in the new law. “People have tattooed in South Carolina for a long time,” he said. “In fact, about half of the tattoos I’ve removed were done within the state. “I think tattoo legalization is a good thing for South Carolina, because
the state can finally regulate the health issues that come with it.”
Friday, July 16, 2004
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