So, you’re considering getting a tattoo. Maybe you’ve looked at every Instagram hashtag showcasing tiny tats. Perhaps you’re finally completing that sleeve. No matter the case, you should ask your tattoo artist, your dermatologist, your primary care doctor, and yourself the following questions before going under the needle.
Ask your tattoo artist:
1. Can you tell me about the ingredients in the ink you’d use for my tattoo?
Tattoo ink, which isn’t currently regulated by the U.S. Food and Drug Administration (FDA), is made up of colorants (pigments that provide color) and carriers (also called diluents, these liquids are used to transfer colorants from the needle to your skin).
As the FDA notes, there’s a huge variety of colorants and carriers out there. Some colorants are completely unfit for injecting into your skin. (Colorants that can double as car paint, anyone?) And some carriers, even distilled water, can increase your risk of infection.
So, to avoid allergic reactions, infections, and potentially hazardous substances, ask your prospective tattoo artist about the ingredients in the ink they’d use on you, Mario Barth, a tattoo artist for nearly four decades and owner of tattoo ink manufacturer Intenze Products Inc., tells SELF. They should be able to give you a solid overview at the very least. If not, that’s a potential red flag.
Even if your tattoo artist seems totally on top of it, consider asking for the brand of ink they’d use for your tattoo (including specific colors), then researching all the ingredients on your own. Some ink manufacturers post Material Safety Data Sheets (MSDS) online that include product ingredients, potential hazards, and toxicological and regulatory information. (As an example, here is Intenze’s database.) You can also double-check that none of the ink’s ingredients are in the Agency for Toxic Substances and Disease Registry’s Toxic Substances Portal.
2. Can I watch you work?
For each client, your artist should open a new set of needles, place ink into new containers or trays, wear gloves while tattooing, and replace those gloves with a new pair after each break to reduce the risk of infection, the Mayo Clinic says. They should also use a heat sterilization machine (autoclave) to clean any non-disposable tools and manually disinfect items like sinks every time they use them.
Even if your tattoo artist ticks all these boxes, you should make sure they’re fully licensed, which brings us to…
3. Are you a licensed tattoo artist?
Licensing differs from state to state, the Mayo Clinic explains. Do some research to find out your local regulations.
Though this varies based on location, an artist being licensed typically means they’ve been trained in (and passed an exam on) various aspects of responsible tattooing, like how best to prevent bloodborne infections, how to provide first aid if necessary, and how to properly sterilize their tools. They’ll also need to renew this license every so often (typically every few years) so this knowledge is fresh in their minds.
Ask your tattoo artist or dermatologist…
1. What are the signs that I’m having a bad reaction to the tattoo?
In some unfortunate circumstances, your skin can react badly to the intrusion.
One potential issue is contact dermatitis, an itchy rash that can happen due to an allergy. When it comes to tattoos, this happens most frequently in response to red, green, yellow, and blue ink, according to the Mayo Clinic. This reaction can happen immediately, but weirdly enough, sometimes it can take years of exposure to the ink for your skin to freak out.
If you have sensitive skin that often breaks out in irritation and rashes, whether to cosmetics, jewelry, or substances like pollen and dust, that’s a sign you may respond negatively to tattoo ink, David Erstein, M.D., a board-certified allergist-immunologist in New York City, tells SELF. Same goes if you have chronic inflammatory skin conditions like psoriasis, Michi Shinohara, M.D., a board-certified physician at the Dermatology Clinic at the University of Washington Medical Center Roosevelt, tells SELF. If you have any reason to believe your skin might not handle a tattoo well, Dr. Shinohara suggests talking it through with your dermatologist.
Another possible reaction is keloids, which are raised scars that grow past the bounds of the original injury, according to the American Academy of Dermatology (AAD). Certain factors predispose you to keloids, like being a person of color and having a family history of these scars, the AAD explains. Again, talk to your dermatologist pre-tattoo if you’re concerned about this; the AAD notes that wearing special pressure-providing garments can possibly prevent keloids.
2. Can you perform a patch test?
Your tattoo artist may be able to do a patch test if either of you suspect you may have an allergy to the ink, Barth says. This involves taping a “patch” of ink onto a small area atop your skin (typically your back) for 48 hours and monitoring your skin for up to a week for signs of contact dermatitis such as severe itching, irritation, and blistering, Dr. Shinohara explains.
If your tattoo shop doesn’t perform patch tests, ask your artist for ink samples to bring to a dermatologist who does. Visit the American Contact Dermatitis Society’s directory(ACDS) website to locate one in your area. If you have known allergies, Dr. Shinohara recommends telling your artist or dermatologist before undergoing the patch test so you can try to avoid those ingredients.
Ask your primary care doctor…
1. Am I already vaccinated against hepatitis B?
Getting tattooed with needles or equipment that aren’t sterile can lead to various infections like a bacterial Staphylococcus aureus infection, hepatitis B, and hepatitis C. (It’s theoretically possible to get HIV this way, but the CDC notes that there are no reported cases of this happening in the United States.) Out of these illnesses, hepatitis B is the only one with a vaccine.
“Some physicians recommend completing hepatitis B immunizations before tattooing,” Dr. Erstein says. Hepatitis B is a pathogen that causes a liver infection, the CDC explains. It can range from a short, mild illness (known as acute hepatitis B) to a more serious, chronic infection that can potentially lead to liver damage, cirrhosis (severe liver scarring), liver cancer, and even death, according to the CDC. (Acute hepatitis B only evolves into the chronic form in about 5 percent of adults, according to the CDC.)
Hepatitis B can spread through bodily fluids, like if you get pricked with a needle that still contains blood from a person who has the illness. You’re probably already protected, since the vaccine, which consists of three to four shots over six months, is recommended for newborns, the CDC explains. But if you didn’t complete the vaccination when you were young, you may want to consider doing so before getting a tattoo. (Realistically, even if you don’t, going to a licensed tattoo artist who follows proper sterilization procedures should keep you safe.)
1. Do I feel a connection with this tattoo artist?
Have a discussion with them about what you’d like tattooed and why, where you’d like it placed, and any additional questions or concerns you may have. Then ask for their opinion. If their response makes you uncomfortable, figure out why before taking next steps.
It’s one thing if your potential tattoo artist tells you disappointing news, like that a tattoo in a certain area might fade really quickly or hurt more than you might expect. But if you feel disrespected, pressured, or unsafe, you may want to find someone else. “[Your artist] puts a mark on you for the rest of your life,” Barth says. “You should have some form of personal connection.”
2. Will I regret this in 10, 20, 30+ years?
“The top reason that patients want their tattoo [removed] is simply regret,” Michele Green, M.D., a board-certified cosmetic and medical dermatologist in New York City who has specialized in laser tattoo removal for over 15 years, tells SELF. Sometimes a tattoo won’t reflect you as you age. Or maybe you’ll love the tattoo but hate that it’s harder to hide than originally anticipated.
Only you know if you would always treasure a tattoo as a marker of how you felt at one point in life or if you’d want it removed. Since tattoo removal can be wildly painful and cause scarring or infection (and may not even fully erase the tattoo), it’s usually just easier to avoid it.
3. Am I prepared for the aftercare?
Taking care of your tattoo properly is crucial for reducing your chances of a negative reaction such as an infection and making your tattoo look as good as possible for as long as possible, Barth says.
Aftercare recommendations vary between tattoo artists and shops, but in general, the Mayo Clinic says that for around two weeks, you’ll need to keep the area clean, moisturize it frequently, avoid exposing it to the sun, avoid submerging it in water, and avoid any clothing that might stick to the tattoo. You should also resist the siren song of scabs begging you to pick at them. If you don’t think you’re up for this level of aftercare, you may want to reconsider getting inked.