According to Dr. Roy Geronemus, most people make the decision to get a tattoo on a whim, with very few giving it careful thought or reflection. Therefore, it’s not surprising that many of them seek to have it removed. According to the American Society of Dermatologic Surgery, laser tattoo removal procedures rose 27% between 2001 and 2003.
Getting a tattoo removed is “laborious, time consuming and costly in some cases, depending on the type of tattoo,” warned Geronemus, who is president of the American Society for Laser Medicine and Surgery and director of the Laser & Skin Surgery Center of New York in New York City.
Geronemus is also a member of the American Society of Dermatologic Surgery.
If you absolutely have to have a tattoo, he said, there are several things to consider beforehand.
“The most important thing to think about is one’s own personal safety when having a tattoo placed. Make sure the establishment applying the tattoo is reputable and provides a sterile technique in the application of the ink,” Geronemus said.
This means making sure that the needle that is being used is sterile - clearly not used on someone else - and that the tattoo artist does not “double-dip” - dipping the needle it into one jar of ink that is used for more than one patient.
“There have been reports linking double-dipping to hepatitis and this is actually what closed the tattoo parlors in New York City in the 1960s,” said Geronemus. “More recently there have been reports of Hepatitis C with the placement of tattoos and that could lead to a debilitating illness.”
Causes, incidence, and risk factors
Hepatitis C infection is caused by hepatitis C virus (HCV). Persons who may be at risk for hepatitis C are those who:
- Received a blood transfusion prior to July 1992
- Received blood, blood products, or solid organs from a donor who has hepatitis C
- Injected street drugs or shared a needle with someone who has hepatitis C
- Have been on long-term kidney dialysis
- Have had frequent workplace contact with blood (for instance, as a healthcare worker)
- Have had sex with multiple partners
- Have had sex with a person who has hepatitis C
- Shared personal items, such as toothbrushes and razors, with someone who has hepatitis C
- Were born to hepatitis C infected mother
The prevalence of hepatitis C infection is approximately 4 million people in the United States or about 1 in 70 to 100 people. Other hepatitis virus infections include Hepatitis A and Hepatitis A.
More information: Hepatitis C
Tattoo seekers should also know that there is “very little regulation” over what can be used for tattoos. “The FDA does not necessarily enforce what pigments are safe and can be applied to the skin,” Geronemus warned.
It’s also a good idea to plan for the future when getting a tattoo. Many employers frown on visible tattoos in the workplace, so think small and concealable when getting a tattoo, he said.
Still not willing to skip the “I love Jill” tattoo? Then Geronemus has another piece of advice. “Consider the color of ink that is placed in your skin. Many people don’t consider the fact that someday they may want to get rid of it and the best way to get a tattoo off is if the tattoo is black,” he said.
Multicolor tattoos and fluorescent color tattoos are more difficult to get out, and all of this becomes more complicated with people of color. People with darker skin have more difficulty getting their tattoos removed because their natural pigmentation interferes with the laser light.
Finally, find someone who is trained with the use of lasers and has the appropriate laser for your color tattoo and for your skin color, Geronemus advises. “For instance, if someone comes in for a red tattoo or a black tattoo, I’d use a completely different laser.”
Revision date: June 18, 2011
Last revised: by Janet A. Staessen, MD, PhD