by Dr. Hotosa Ebrahimzadeh

In times past tattooing has been used as a rite of passage, a mark of status and rank, the symbol of religious and spiritual devotion, to brand outcasts and criminals, or merely for decoration. 

Over time, the art of tattooing has found its place amid a multitude of cultures, representing an endless array of meanings. It is a craft that is, and has been, practiced in every corner of the globe. The forms of tattooing are as endless as their meanings. Some are created with ink or ash rubbed into open cuts. Others are elaborate tracings sliced onto the skin. Burns or branding even fall into the larger umbrella of body art, and tattoos can be found on humans and animals, for definition or decoration.

The Ainu, indigenous people of Japan wore facial tattoos. Tribal groups in the Phillipines, Borneo and Africa used it as a means of distinction. In Cambodia and Thailand there are tattoos branded for protection. History even contains several stories of people marked by tattoos against their will, like animals branded for distinction. The best known is the ka-tzetnik identification system for Jews in part of the concentration camps during the Holocaust. European sailors were known to tattoo the crucifixion on their backs to prevent flogging , as it was a crime to deface an image of Christ. 

Tattoos Today 

In modern times, people have crafted the art of tattooing to such detail that any color and design imagined is possible. Tattooing has even found itself in the realm of cosmetics, with a process that is now known as ‘permanent makeup’. Tattoos enhance eyebrows, add liner to lips or eyes and even create beauty moles with colors that are intended to resemble actual makeup! One thing that remains constant when tattooing, is the need to protect yourself in the process and maintenance of your tattoo.

Protection Procedures

The modern process of tattooing works like this: a tattoo machine creates a puncture wound in the skin. The machine moves a solid needle up and down puncturing the skin between 50 to 3,000 times per minute, each and every time injecting a drop of ink. With each penetration, the needle enters the skin by about a millimeter and deposits a drop of ink into the second layer of skin, the dermis. The cells of the dermis layer are much more stable than the top layer of skin, the epidermis, so the tattoo ink will stay in place on that layer. When you are looking at a person’s tattoo, you are in fact seeing it through the outer layer of skin. 

With such a permanent endeavor, there are a variety of ways to keep both yourself and your tattoo healthy. As a series of thousands of puncture wounds, a tattoo has the potential for infection as well as disease transmission. The use of unsterilized equipment can cause infections that can be transmitted through the process, causing Herpes simplex virus, tetanus, staph, fungal infections, as well as some forms of hepatitis and HIV. There have been, up until this time, no reported cases of HIV transmission in the United States via a commercially applied tattooing process, however, measures should absolutely be taken to minimize all other risks of infection. Having an up-to-date tetanus booster can prevent the risk of tetanus. Also, it is heavily recommended that alcohol not be consumed either before or after obtaining a tattoo. Alcohol thins the blood and thus causes more bleeding during the process, increasing the possibility of infection. It should be noted that in order to eliminate contamination, most tattooing materials such as inks, ink cups, gloves and needles should be for single use only.

Caring for new tattoos involves a variety of options. It is often recommended to keep the sensitive and damaged skin cells both out of sun and water. Many tattoo artists recommend keeping the artwork covered anywhere from the first few hours to a full day. It is generally advisable not to remove the scab that forms after a tattoo. As long as infection is avoided, a properly crafted tattoo will heal over time leaving the owner with its mark forever, and with whatever meaning was intended.

Are Tattoos Forever?

In the United States, it is thought that close to 75% of all tattoos crafted include names, initials or dates. There may come a time when the wearer of those names or initials will ask: is this permanent? The answer nowadays is: not necessarily. It is possible - to a varying degree - to remove tattoos. The cost of removing them (as well as the pain involved) will often be more than the initial expense of applying them. 

Lasers are the most commonly used method for tattoo removal. They react with the ink in the tattoo, breaking it down. When broken down, the skin more easily absorbs the ink. It mimics the process of fading that would have occurred naturally over time with exposure to the sun. Repeated visits are often required to remove even the smallest of tattoos. The removal does not eliminate all of the color, and may even result in some additional permanent scarring. 

An additional option to tattoo removal is the cover up technique. The initial tattoo can be covered up by a larger and more thickly applied tattoo, so that the original image will be gone completely, leaving in its place a new work. Lasers can be used even before the cover up tattoo to break down the old tattoo and lighten the area before the new one is applied. b