Tattoos and body piercings

Who has

  • According to a 2004 survey of 500 people between the ages of 18 and 50, 24 percent reported having a tattoo and 14 percent had a body piercing in a location other than the ear lobe.1 Thirty-four percent had ear lobe piercings.2
  • By the age of 18 years, thirty percent of those pierced had their first body piercing and 16 percent of those tattooed had their first tattoo.3
  • Seventeen percent of those with tattoos had considered getting the tattoo removed, but none of the respondents had done that. Five percent had had a tattoo covered.


  • Tattoo pigments may contain industrial organic pigments, including azo and polycyclic compounds, sandalwood and brazilwood, as well as aluminum, cadium, calcium, copper, iron, phosphorus, silica, sulphur, titanium dioxide and barium sulphate, each of which may be the cause of a skin reaction like a rash or be toxic.
  • Home applied tattoos are often black and carbon based, deriving from India ink, charcoal, soot and mascara.
  • Tattoos can be removed, although results may vary depending on the inks used and the depth of the tattoo. Dark blue, red, some lighter blues and green inks all respond well to laser treatment, but the best candidates for tattoo removal are people with light skin who have a black ink tattoo.
  • Lasers may be able to remove the tattoo without scarring, but may require several treatments. Other options include dermabrasion and surgical removal. A dermatologist can determine which method is best.

Body piercings

  • Common reactions to piercings include infection and metal allergy.

What consumers should look for

Although almost every state has regulations for the proper sanitation of tattoo parlors and establishments that offer piercing services, a consumer should look for the following to minimize infection risk:

  • An autoclave. An autoclave, or heat sterilization machine, should be used to sterilize all nondisposable equipment after each customer. Instruments and supplies that cannot be sterilized with an autoclave should be disinfected with a commercial disinfectant or bleach solution after each use. These include drawer handles, tables and sinks.
  • Fresh equipment. An unused, sterile needle should be used for all piercings. If you're getting a tattoo, watch the tattoo artist and make sure he or she removes the needles and tubes from sealed packages before starting work. Any pigments, trays and containers should be unused as well.
  • Gloves. The piercer or tattoo artist must wash his or her hands and put on a fresh pair of surgical gloves for each procedure. The piercer or tattoo artist should change those gloves if he or she needs to touch anything else, such as the telephone, during the procedure.
  • No piercing gun. Don't receive a piercing from a piercing gun unless the part of the gun that touches the skin is sterile and has never been used before. Many of these devices cannot be autoclaved, which may increase your risk of infection.
  • Appropriate hypoallergenic jewelry. Metal jewelry containing nickel, cobalt or white gold can often cause allergic reactions. Look for surgical-grade stainless steel, titanium, 14- or 18-karat yellow gold, or a metal called niobium.

1,2,3 Laumann A, Derick A. Tattoos and body piercings in the United States: A national data set, J Am Acad Dermatol 2006;55:413-421.

See your dermatologist if you have questions about tattoos or body piercings.

Dermatology A to Z