<p>@pugmadkate, that is EXACTLY what I was trying to say about the pain, thank you</p>
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<p>Wait, I thought all those injections you were getting for your hamstring injury would make a tattoo needle seem harmless!</p>
<p>^^ I know. A new tattoo would be much more “elective” though!</p>
<p>I had an interesting conversation about tattoos with my husband; my take was that people would regret a tattoo years later–“it’s like putting on a shirt at 18 that you can’t take off at 40.” His take was that someone might well regret NOT getting a tattoo later just as well. “I wish I’d gotten that tattoo when I was 18; it would help me keep my younger self fresh in my mind.”</p>
<p>Neither of us has a tattoo, FWIW.</p>
<p>In general my philosophy is in agreement with Mrs Patrick Campbell: ‘I don’t care what people do, as long as they don’t do it in the streets and frighten the horses’.</p>
<p>If an individual is of age and sober, is made acquainted with the risks, and wants a tattoo, then that is an individual choice. If the tattoo is visible and affects the individual’s prospect’s for employment, then that is a consequence that should have been anticipated.</p>
<p>As a physician I have a duty to warn against choices that carry medical risks. I have taken an oath that states that ‘I will prevent diseases whenever I can, for prevention is preferable to cure’. I have therefore advised against cartilage piercing, as any knowledgeable physician would, and against piercings that carry similar risks.</p>
<p>I included tattooing because there are real risks associated with the practice that I thought young people, my particular charges, should be aware of, and because of the comments I have received from employers at such events as Rotary meetings. I know that many people have small tattoos that are meaningful to them. I also know that many young people get tattoos as an impulsive act, often under the influence of alcohol or drugs.</p>
<p>I anticipated most of the responses that my post received but was surprised that tattooing became the primary focus. It is clearly a subject that arouses strong opinions. I had hoped that more physicians would comment upon and support my major point with regard to piercings, but I am content to know that I may have played some role in preventing even one person from suffering the consequences of a piercing gone wrong.</p>
<p>To the person who commented that life involves risks I can only say that you are right but obviously have not seen very many consequences of risky behaviour: you have not seen, for example, a young man who survived a fiery auto accident with his face burned beyond recognition, or a baby born to a drug-addicted mother, or a young mother who has passed a sexually transmitted disease to her infant, or a young man with Hepatitis B contracted after a home tattooing session using a guitar string. I spared you the graphic details because I knew they would not alter the view of young people for whom an element of risk is an attractive feature.</p>
<p>I stand by everything in my original post: there are risks that our sons and daughters should be aware of when they are making decisions that can affect their health.</p>
<p>To the person who commented that life involves risks I can only say that you are right but obviously have not seen very many consequences of risky behaviour: you have not seen, for example, a young man who survived a fiery auto accident with his face burned beyond recognition, or a baby born to a drug-addicted mother, or a young mother who has passed a sexually transmitted disease to her infant, or a young man with Hepatitis B contracted after a home tattooing session using a guitar string. I spared you the graphic details because I knew they would not alter the view of young people for whom an element of risk is an attractive feature.</p>
<p>I think the poster was referring to " calculated risk", not something that was done under the influence of substances &/or without any forethought or consideration.</p>
<p>I must respectfully disagree. I don’t think he meant that, and he certainly didn’t say that.</p>
<p>I guess we aren’t talking about the same poster.
Hep B doesn’t scare me though, I already have had it & I don’t use needles, or have a tattoo, or exchange body fluids with anyone outside my family ( who happen to be negative).
I do go to the dentist & I have worked with preschoolers including one who had a liver transplant ( no idea of his current health).
So where did the Hep B come from?</p>
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<p>I am confident that you speak out on message boards, warning women about the choice to get pregnant. Many, many medical risks there. In addition, my seatbelt has a high chance of bruising me during an accident, though it may save my life. Even piercing the lobes of my ears could lead to infection so therefore, it’s important that I am warned about that, correct?</p>
<p>In other words, there is nothing that anyone can do to, on, or for their body that does not carry some level of medical risk. Whether the risk is acceptable or not of course depends on what safeguards you take to prevent against the risk, how likely it is that the risk will occur, and what consequences you will face if the risk comes to pass and how you will address those.</p>
<p>For example in a cartilage piercing scenario, you can safeguard against the risk of infection by insisting on 1) a licensed facility where disposable sterile equipment is used where possible, and where impossible, all equipment is sterilized using appropriate sterilization procedures, such as autoclaves, (and it’s important to note that no cases of HIV have ever been reported due to a body piercing or tattoo when done at a licensed shop) 2) insisting on a sterile hollow needle piercing, as opposed to a gun piercing, which carries a much lower risk of infection, 3) insisting on either a stainless steel (assuming no allergy to nickel as most people know if they are allergic to nickel by the time they get a cartilage piercing) or other appropriate metal suspension ball hoop earring rather than a stud which leads to lower infection, 4) following appropriate aftercare including cleaning and not removing the earring before healing (the AMA recommends 3 weeks, most piercers recommend longer). By safeguarding against the risk, you do play a role in preventing the risk. However, it is of course still possible that the risk (infection) will happen, in which case, if you seek appropriate medical interventions early on, the risk of that infection turning serious are minimal.</p>
<p>In other words, like anything else, it’s important to evaluate the risks of what you are doing and determine if that risk level is acceptable to you. My guess is when I get pregnant, that will be far more medically risky to me (and just as elective) as my cartilage piercing. However, after evaluating the risks, I’m comfortable with it because I believe the “reward” so to speak is worth it.</p>
<p>Yes. Your articulate and knowledgable reply does not in any way diminish the importance of my post. I do wonder, however, why you are so angry. My personal view is that the ‘rewards’, as you choose to call a human child, of pregnancy, are rather different than the gratifications of piercing as bodily ornamentation. The phrase ‘like anything else’ suggests a rather naive relativism.</p>
<p>All I have said is that a young person should be aware of the risks and complications associated with certain particular decisions.</p>
<p>Irishdoctor, while we probably would disagree on some matters as I like tattoos. pierced my own cartilage when I was 12 (yes, I know it was a bad idea), and am in general more of the opinion that the human body should be allowed to take care of itself… I sincerely appreciate this post and conversation. I know too many people who have gotten awful infections, diseases, scars, badly healed sites, or just plain crappy quality work from badly done and poorly regulated tattoos and piercings. Especially considering how easy it is to mitigate the risks if one is well aware of them, thank you for informing people. And thank you for your work as a pediatrician.</p>
<p>Thank you for your kind words. I very much appreciate them.</p>
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<p>^^This summarizes exactly what I thought about the latest post by 2plus2.</p>
<p>2plus2 appears to be on the same page as Irishdoctor, acknowledging the risks associated with getting a tattoo and even outlining how one can minimize said risks. Let me just point that examples that 2plus2 used cannot be compared to tattooing - neither getting pregnant (or even pregnancy itself) nor getting a whiplash from a seatbelt can be classified as an elective medical procedure.</p>
<p>2plus2, since you seems to know a lot about the ins and outs of tattoo business, let me ask you a few questions and make a few points.</p>
<ol>
<li>You state," …it’s important to note that no cases of HIV have ever been reported due to a body piercing or tattoo when done at a licensed shop…" When one makes such sweeping statements, it is critically important to support them with references from peer-reviewed publications in reputable scientific journals. I’d like you to provide a few references.</li>
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<p>Additionally, HIV is not the only pathogen that can be transmitted through blood contact. Hepatitis B and Hepatitis C can be just as scary; the disease can lie dormant and then manifest itself as untreatable liver cancer, such as hepatocellular carcinoma (which IS a death sentence).</p>
<ol>
<li><p>I like that you listed a few steps that one can do to minimize exposure to blood-borne pathogens, however, I doubt that a rebellious teen hell-bent on getting a tattoo would walk into a tattoo shop with such a checklist in hand. If only the parents would drill the list of these risks into their teens’ heads instead of simply saying, “we will disown you if you get a tattoo”!</p></li>
<li><p>Licensed vs unlicensed. Risks of contracting an infectious disease if one undergoes the procedure in a licensed shop do go down, however, they are still significantly higher than risks associated with similar procedures (shots, sutures, etc.) done at a medical clinic, because medical clinics are held to much higher standards. Let’s take needles. A manufacturer of hypodermic needles has to clear its product through the so-called 510(k) approval process (clinical trial equivalent for medical devices) under the watchful eye of the FDA. The manufacturer has to prove that it adheres to a set of very stringent QC/QA and manufacturing controls. Who oversees the manufacturing process of disposable and resusable instruments used in tattoo shops?</p></li>
<li><p>Inks and dyes. As far as I know, neither falls under the FDA jurisdiction. Who then oversees and analyzes these injectables making sure that there are no toxic metals and contaminants in the dyes that go into the skin?</p></li>
<li><p>The FDA put up a very informative page on tattoos:</p></li>
</ol>
<p>[Think</a> Before You Ink: Are Tattoos Safe?](<a href=“http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048919.htm]Think”>Think Before You Ink: Tattoo Safety | FDA)</p>
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<p>TRUE STORY: I was trying to help a young male RN get a new job. A friend was hiring and I got him an interview. He was granted a 2nd interview as well. After the 2nd interview, both of the staff agreed that he was very qualified and had a lot of relevant and interesting job experiences. Nonetheless, he was turned down because the job involves him going out in the community, working with clients and seeing a lot of doctors and other medical personnel. He had large gauges – one in each earlobe. He also wore large sparkley studs in his ears. They both thought the appearance was NOT a good fit. This was one of the main reasons he was not offered a job. 
I don’t think he was ever told that this was the reason.</p>
<p>Aside from the medical issues, which concern me as a physician as well, I just feel that the ‘self expression’ argument is flawed. The person who is ‘expressing themself’ with a tattoo as a 19 person is not the same person they will be as a 38 year old or a 57 year old. There are ample ways to express who you are- through hair, clothing, lifestyle choices, etc… which do not define you in perpetuity. </p>
<p>True story. My mother was very ladylike in a conventional way. She died at a young age and about 2 years later, when he was in his early 60’s my father remarried. I took my young sons to meet his new wife and when we met them in the airport, my sons’ gaze went right to the tiny heart tattoo on her right chest and the clover (or something like it)on her ankle. My son, never at a loss for words, was quick to note ‘She is nothing like a Bubbie…’</p>
<p>Six years ago my then 15 year old daughter got a small piercing in her nose. We went to my brother-in-law’s house for a holiday dinner soon afterward. He told her that if she got one more piercing she was not welcome in his home, and we haven’t gone back since.</p>
<p>Pierced kid has a 3.94 cumulative GPA in Physician Assistant program after the first semester of grad studies (and three years undergrad), has been a leader in the spiritual life programs at school, and an RA. The school bans unnaturally colored hair and nail polish, but has no problem with her nose stud. And our family doctor has already promised to take her on for her residency in family medicine.</p>
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<p>The FDA DOES regulate the inks and dyes as cosmetics. Not too sure about the needles, though many manufacturers of tattoo needles also produce the needles and guns used in piercings and there is no Hepatitis pandemics among babies with piercings or in general.</p>
<p>I think this quote from the previous FDA link says it all… “However, because of other public health priorities and a previous lack of evidence of safety concerns, FDA has not traditionally regulated tattoo inks or the pigments used in them.”</p>
<p>Plus, being FDA approved, regulated or overseen is not = to being safe. </p>
<p>[FDA</a> Mistakes](<a href=“http://lmgtfy.com/?q=fda+mistakes]FDA”>http://lmgtfy.com/?q=fda+mistakes)</p>
<p>I’d say while there are risks with tattoos and piercings they are not severe risks. Yes you can get hepC or hiv from a dirty needle in a tattoo parlor. You can get the same thing in a medical facility, and that’s not to mention the ever increasing rates of nosocomial infections in medical centers.</p>
<p><a href=“http://lmgtfy.com/?q=va+infects+hiv[/url]”>http://lmgtfy.com/?q=va+infects+hiv</a>
<a href=“http://lmgtfy.com/?q=the-gruesome-math-of-hospital-infections[/url]”>http://lmgtfy.com/?q=the-gruesome-math-of-hospital-infections</a></p>
<p>You have a higher risk of contracting an illness AND dying after receiving a medical procedure than you do of contracting an illness after getting a tattoo.</p>
<p>There are many reasons why the FDA would not regulate tattoo inks and such, but I will not discuss them here because it will turn the thread towards politics rather quickly (you mentioned cosmetics, so I assume you can make the links on your own). Let’s just say that the powerful cosmetics industry lobby has something to do with it. It is also easy to find the FDA-bashing articles all over the web, since the consumers have the sentiment that the agency is not doing enough, and the pharmaceutical industry thinks it is being too strict. Here is a really well-written opinion article by a seasoned biotech professional:</p>
<p>[Why</a> Do I Love Drug Regulation? Simple: It Keeps Us Safe | Xconomy](<a href=“Informa Connect - Know more, do more, be more.”>Informa Connect - Know more, do more, be more.)</p>
<p>As an educated person, you should be aware that “Previous lack of evidence” does not equate with “safe”. All it means that no one has performed a comprehensive, multiyear study with adequate controls. I can tell you why it has not been done: since inks and pigments and mehods of their delivery vary so much, it is impossible to design such a study.</p>
<p>xSlacker, your argument about the higher risks of dying from an infection at a medical facility does not hold water. If you are going to make a comparison, please compare apples to apples. You compared a healthy population of mostly younger teens to a cohort of sick, generally older people undergoing more than a minimally invasive procedure. Additionally, there is a reason why the public is so aware of HAI: hospitals in many states are required to report infection rates. What about tattoo shops?</p>
<p>Busenburner is right. If you feel you must some personal statement of artistic “self-expression,” do it with your hair and not your skin. That way when your body and/or your artistic tastes change you won’t be stuck with your previous mistake.</p>