Do potential patients regret getting their tattoo?

There are generally 4 reactions that potential patients have after getting a tattoo:

  1. Those who are happy with their tattoo but will not get any more
  2. Those who are happy with their tattoo(s) and want additional ones
  3. Those who regret their tattoo, but will continue to live with it.
  4. Those who regret their tattoo and consult a surgeon to remove it. Clearly, I get to see the latter group

What health risks do tattoos pose, if any?

There are numerous health risks associated with tattoos. The most important risk is the sterility of the needles and ink. Transmission of viral infections such as HIV, Hepatitis B and C are a cause for concern. All professional artists have medical grade sterilization procedures for their equipment and it is important to go to a reputable artist if you are considering a tattoo. Following a tattoo, local wound infections are possible, but quite uncommon. They are usually bacterial in origin. In some cases, re-activation of previous cold-sores or shingles may be caused by the trauma of the needle. In patients who are pre-disposed to poor scarring, both keloid and hypertrophic scarring may occur. Long-term health risks are rare, but tattooing over mole may make detection of cancerous change difficult to identify and recently an article in the plastic surgery literature has identified several cases of malignancy developing in the areas tattooed with red ink. I have personally seen the issues of scarring as noted above only.

How do you get tattooed without the risk of infection?

As noted above, going to a reputable artist is essential. These professionals also use medical grade skin disinfection and post-tattoo wound care. A prophylactic course of antivirals may be useful if you are a known cold-sore or shingles sufferer.

Are there any medical procedures that can affect or be affected by tattoos?

The white inks which contain titanium and the red inks which contain iron may be visible on CT or MRI scans, but the volume of ink is usually miniscule and not clinically relevant. Detection of malignant change in the tattooed skin may be very challenging. Some reconstructive procedures utilize adjacent skin and many patients request that their tattoos not be altered by such procedures, which may make the design challenging. When treating tattooed skin with some lasers, oxidization of the iron pigments may induce a colour change, which can subsequently be difficult or impossible to erase.

How do you remove tattoos?

There are only two effective way to remove a tattoo – laser and excisional surgery. Chemical peels, dermabrasion, and injection are usually associated with very poor results. Lasers may not be able to effectively remove all ink, or all colours – results vary according to the amount of ink, the colour of the ink, the depth of placement, the evenness of placement, the colour of the patient’s skin and the skill and equipment of the surgeon. Surgery always results in a scar which is permanent. The quality of the scar may be affected by many of the above factors.  Laser may result in thermal burns in the shape of the tattoo – which are also permanent. There absolutely no way to remove a tattoo without scar.