Skin tattoo

1.

Introduction

The word Tattoo has its origin in the Tahitian language and carries the meaning a drawing in the
skin (Bogdan-Alleman and Goldberg,2011,p.98).But this is not to say that the practice of tattooing
ones body originated from the Tahitian people. Throughout the history, tattooing has been practiced by
various cultures and physical evidence of the practice predates the human written history. Residues of
red ochre pigment used in the ancient tattooing process have been found in the cave of Arcy-sur-Cure
in Burgundy, France and radiocarbon dating estimates them to be around 35,000 years old. In 1991,
scientists found hard evidence of body tattooing being practiced in the ancient time when they
discovered a tattooed body of a Bronze Age Hunter which is estimated to be 5000 years old at the
border of Italy and Austria(Bogdan-Alleman and Goldberg,2011,p.98) .
2.

Types of Tattoo

In general tattoo can be divided into permanent tattoo and non-permanent tattoo. Permanent tattoo is a
tattoo where dye/ink pigment is inserted into the skin layer whereas for non-permanent tattoo, the
dye/ink pigment is applied on the skin i.e. non-invasive to the body. FDA (2012) listed two types of
non-permanent tattoo namely Henna (Mehndi) tattoo and sticker type temporary tattoo. Getting a
Henna (Mehndi) tattoo involves the use of a natural plant dye called henna or mehndi to stain the skin
and does not involves the use of needle. The colour usually will last for two to three weeks. Sticker
type tattoo is done by transferring the non-permanent tattoo design from a piece of paper (the transfer
sheet) to the surface of the human skin (FDA,2012). The discussion in this paper will however only
relate to the permanent tattoo type. Permanent tattoo can basically be divided into two types i.e. the
tattoo proper and Permanent Make-UP (PMU). The tattoo proper is tattoo which is obtained through the
permanent embedding of pigments into the skin (Muller,2004,p.3) whereas permanent make-up is the
term given to a range of cosmetic procedures which rely mainly on the principles of tattooing and it
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ranges from changing the placement of or filling out of the eyebrows, eyeliner, eyelash enhancement,
lip liner and full colour. Permanent make-up can reshape and frame the targeted features of a human
body (normally facial features) for example, for permanent make-up on lips, it can give the person an
appearance of a plumper lips and correct irregular lip lines (Twiggs,2006,p.4).
3.

The Procedure of Tattooing

The technique of cosmetic tattooing or technically referred to as micropigmentation, basically involves

the application of tiny droplet of tattoo ink into the superficial layer of the dermis using a traditional
tattoo device or a modern tattoo pen with an oscillating needle which due to hygienic
concern,preferentially should be disposable (De Cuyper and Cotapos,2010,p.58).

Fig.1 : How Tattooing is done (source : www.howstuffworks.com)

The level of permanency differs between the two in that the permanent make-up may fade after a few
years. This is due to the fact that cosmetic tattoos is done by limiting the implantation/application of the
tattoo ink to the superficial layer of the dermis i.e. at the epidermal-dermal junction or in the dermal
pars papillare whereas for conventional permanent decorative tattoos, the ink pigment is applied in the
mid-dermis layer of the skin (De Cuyper and Cotapos,2010,p.54). Before starting the procedure, the
intended area of the skin where the tattoo will be made is cleaned and disinfected. The performer must
wear clean gloves during the procedure. Local anesthetic cream is sometimes applied in order to make
the procedure less uncomfortable. To prevent contamination, only single-use ink container are advised
to be used and the brand/make of the ink identified in case of allergic reaction or some correction need
to be made post-procedure (De Cuyper and Cotapos,2010,p.54). Immediately after the procedure of
tattooing, Vaseline or an antibiotic ointment is mostly applied on the tattooed area as post-procedure
after care. Tattooing should only be performed by qualified personnel i.e. either by experienced
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beautician with advanced training in case of cosmetic tattoos or by the established practitioner for the
traditional tattoos (De Cuyper and Cotapos,2010,p.54).

4.

The Risks involved in Getting a Tattoo

According to the United States Food and Drug Administration (USFDA,2012), the procedure involved
in getting a tattoo exposed the person being tattooed to several health risks, for examples :
i.

Infections due to improperly sterilized tattoo needle. According to Bogdan-Alleman and

Goldberg (2011,p.100) , infection is the top complication related to tattooing and the most
common infections is due to bacteria (mainly Staphylococcus and Streptococus), viruses
(hepatitis B and C and HIV) and fungal infections.

ii.

The second most common complication after infection is an inflammatory response to the
pigment,

usually

manifesting

as

granulomatous

reaction

(Bogdan-Alleman

and

Goldberg,2011,p.100).
iii.

Allergic reactions to the dye/pigment used in the tattooing process. According to the FDA
(2012) in one reported case involving a particular brand of tattoo dye, over a hundred reports of
allergic reaction to the dye carried by the brand concerned resulted in the company which owns
the brand to recall its product. Mercury (red) and cadmium (yellow) pigments are particularly
likely to induce allergic reactions to the person getting the tattoo, though there have also been
reports of allergic reactions to chromium (green), cobalt (blue) and beige tattoo dye BogdanAlleman and Goldberg,2011,p.100).

iv.

People with tattoo may have swelling or burning feeling in the tattoo when they undergo the
Magnetic Resonance Imaging (MRI) procedure due to the existence of metal based compound
in the tattoo dye. This however happens only rarely and the effect is not permanent (FDA,
2012)
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5.

Tattoo Removal

The risks involved in getting a tattoo is not limited only to the time of getting the skin tattooed but also
when the person decide to remove the tattoo. Although it is true that tattoos can be removed, the
process is expensive, painful and does not leave the skin with flawless appearance, furthermore some
tattoo ink are moredifficult to remove than other (Sawyer,2007,p.31) Nowadays, tattoo is invariably
removed by using laser treatment. In laser treatment, laser light is targeted to the tattoo ink throughout
the skin. This will cause the tattoo ink pigment particles to heat up and fragment into smaller pieces.
This snaller pieces are then removed by normal body process (i.e. absorbed by the integumentary
system) (Tay and Chan,2011,p.60).
6.

Conclusion

Having a tattoo is an important decision to make considering the irreversible effect it has on skin as
discussed above (i.e. it can never be completely removed). Taking care of the skin does not only means
taking care of the hygienic aspect of it (i.e. cleaning our skin by using soap, facial wash etc) but at a
more philosophical level, it also means not to tamper with its original condition by introducing a
foreign colour pigment/dye to its multi-layers composition. Although people who get tattoo might at
first feel exhilarated by having them, many choose to have them removed later, most commonly for
social reasons. As such because of the risks involves during the process of drawing the tattoo on the
body and also because of the impossibility of its full removal, this paper strongly advise against making
a tattoo unless it is a religious or cultural requirements.

References
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Karger AG
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and Permanent Make-Up.Berlin,Germany : Springer-Verlag
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Rosen Publishing Group
Tay, Y.K. & Chan, Y.C. (2011).Textbook of Laser and Light Dermatology in the Asian Skin. Singapore
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USFDA.(2012,

May

18).

Tattoos

and

permanent

make-up.

Retrieved

http://www.fda.gov/ForConsumers/ByAudience/ForWomen/ucm118568.htm
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