It's inevitable that my columns are often a product of personal experience - typically regarding my three daughters. So far, today's topic has not affected my life at home, but I'll bet that it has had an impact on many of you! The subject is tattoos. Personally, I want to be prepared when the question comes my way. You should be too.Just a generation or so ago, most Americans associated tattoos with sailors, bikers and sideshow artists. They have become far more popular with the mainstream in recent years, and those who get them are as diverse as are the styles and designs they choose. Tattoos are even used as very long-lasting makeup. A tattoo can be acquired in a matter of hours, but it is a permanent statement. Take steps to protect yourself from possible risks, in order to ensure that what seems like a cool idea at the moment does not become a source of regret down the road. A tattoo is a permanent mark or design made on the skin by having pigment inserted through pricks into the skin's outer layer, the epidermis. The tattoo artist uses a hand-held machine that behaves much like a sewing machine, with one or more needles piercing the skin repeatedly at a rate of 50 to 3,000 times per minute. With every puncture, the needles insert tiny ink droplets into the dermis, the second layer of skin. Cells in the dermis are far more stable than cells of the epidermis, so the tattoo ink stays in place. The procedure, which is done without anesthetic and may take several hours, causes a small amount of bleeding and pain that ranges from slight to significant. This process has not changed since its invention by Samuel O'Reilly in the late 1800's. The physical risks of getting a tattoo are related to problems that arise when you puncture the skin. The tattoo machine creates an open wound every time it injects a drop of ink. •Tattoo dyes (red in particular) can cause an allergic reaction in the form of an itchy rash at the tattoo site. This rash can even occur years after getting the tattoo because the body may take that long to develop an allergy to the chemical. •Skin infections can develop if the needle or needles that breach the skin are contaminated with bacteria, or if the open skin later gets exposed to bacteria. The result will be a red, swollen, tender lesion. •Granulomas can develop around the tattoo (more often when red dye is used). This results in raised areas with overgrowths of scar tissue, known as keloids. •The tattoo may become swollen during magnetic resonance imaging (MRI) due to metallic pigments. Tattoos can also interfere with getting a proper image. •Blood-borne diseases are easily the most serious complications from getting a tattoo. If equipment is contaminated with infected blood, numerous diseases can be contracted, including Staphylococcus Aureus (including MRSA), Hepatitis B, Hepatitis C, Tuberculosis, and HIV. (The Center for Disease Control (CDC) does not have a documented case of HIV to date from a tattoo, but reporting is imperfect and the risk is real.) What about the emotional risks? Ask yourself this question: Would you want your rock group passion or romantic interest from three years ago, or 10 years ago, on your body today? When you put permanent art on your skin, it is, for all intents and purposes, permanent. The lengthy and expensive process of removing a tattoo is not completely effective. Do not seek a tattoo while under the influence of social/peer pressure, alcohol, or drugs. Tattoos are removed using several different methods: laser removal, excision or dermabrasion. The cost varies for each technique. Laser tattoo removal is the most common method and usually the best. Costs range from $200 to $500 per session. Multiply that by the five to twenty sessions it takes to remove a tattoo! If you want a tattoo, what can you do to protect yourself? Go to a reputable tattoo studio. Regulations and licensing standards vary from state to state. Check with the local health department to see what the standards are in a given city. The tattoo artist should wear gloves, wash his or her hands, and change gloves with each new procedure and person. The tattoo artist needs proper sterile equipment. Watch that the artist removes needles, tubes, pigment trays and containers from sealed packages. Non-disposable equipment is to be sterilized before each new customer. Instruments that cannot be sterilized must be disinfected with a commercial disinfectant or bleach solution. So, what is my closing advice to you today regarding tattoos? As a parent…the answer is NO!!! But as your local medical columnist, my parting words are…think long and hard about it, make sure it is something that you'll want to see on your skin in 30 years, and if you must, go to a reputable artist. (Sigh) Good health to you all! Dr. Alan Frischer is former chief of staff and current chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

********** Published: June 24, 2010 - Volume 9 - Issue 10