Tattoos: What You Need to Know Before You Commit to Ink

Are you thinking about getting a tattoo? You’re in good company. A 2016 Harris Poll revealed that 3 in 10 Americans have at least one tattoo. It has become more popular, accepted, and mainstream as a form of self-expression, art, and cultural identity.

Tattooing has been around for thousands of years in different cultures, used for religious or spiritual purposes, representation of social status or membership in a group, or even as a form of medicinal treatment. In the United States, tattoos gained popularity in the punk and heavy metal era in the 1980s and 1990s. Fast forward a couple of decades, with advances in tattooing technology and the rise of social media, tattoos have become more accessible and customizable than ever before.

However, with increased tattooing also came a rise in some participants regretting their decision. In the identical Harris Poll, a quarter of people with a tattoo regret getting it and have considered having it removed at some point in their lives. This number is expected to increase with new and improved tattoo removal technologies.

Braden Candela, MD, assistant professor of dermatology at the Columbia University Vagelos College of Physicians and Surgeons, suggests a few things to consider, such as risks and possible complications, including:

• Infection if the proper hygiene and aftercare are not followed. Signs of infection may include redness, swelling, worsening pain, pus, and fever.
• Allergic reactions to the ink used in tattoos leading to itching, swelling, and tattoo distortion.
• Exaggerated wound healing responses such as hypertrophic scarring, keloids, and granulomas, which are firm raised bumps that can form in and around the tattoo.
• Bloodborne diseases such as hepatitis B and C, HIV, and tetanus if the tattoo artist does not use sterile equipment.
• MRI complications where patients with tattoo dye and ink have burning and swelling at the site of the tattoo. This is often due to metallic components in darker ink colors.
• Fading and distortion over time, particularly if exposed to sunlight or not correctly cared for.
• Psychological effects such as regret or anxiety.

If you decide to go ahead, here are ways to minimize the risks:

• Choose a reputable tattoo artist and studio.
• Carefully choose the design. Light colors like white, yellow, and pink can be the hardest to remove with a laser.
• Follow proper aftercare instructions.
• Be aware of any signs of infection or other complications.

What if I want to get my tattoo removed?

If you wind up with tattoo regret, you are not without options. Tattoos can be removed in several ways:

• The current standard of care is laser removal. This involves selectively targeting and heating tattoo pigment, causing the skin cells to break apart. This allows the body’s lymphatic system to carry away the tattoo pigment. It can take multiple sessions and can be costly. Multicolored tattoos can take more than 10 sessions to remove.
• Dermabrasion involves scraping off the skin’s top layers, which can leave some scarring and is less effective than laser treatments.
• Surgical removal involves cutting out the top layer of skin and can also create scarring.

If you have any concerns or questions about getting or removing a tattoo, make an appointment with a board-certified dermatologist. We are here to help without judgment, bias, or criticism.