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Complications with tattoos and piercings

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  • Are tattoos and piercings recommended from a medical perspective?
  • How dangerous are tattoo inks?
  • What direct complications can arise from tattoos?
  • What direct complications can occur with piercings?
  • What happens if a piercing tears off?
  • Can you be allergic to tattoos or piercings?
  • Are there any skin conditions that mean you should avoid tattoos or piercings?
  • How should you care for freshly done tattoos and piercings?
  • What should you consider when choosing a tattoo or piercing studio?

Whether it's a sin of youth, a spontaneous holiday souvenir or a long-held wish: tattoos and piercings are still popular. According to a survey by the opinion research institute YouGov, 17 percent of Germans have one or more tattoos. There are no concrete figures for piercings in Germany; according to a British study, around 10 percent of all respondents there are pierced, and in the group of 16 to 24 year old women even over 46 percent are pierced, although ear piercings are not considered piercings in this definition.

Body jewelry is often an expression of one's own individuality – but under certain circumstances it can also pose a health risk. Expert Dr. med. Friederike Wagner explains. She is a specialist in dermatology and allergology and head of laser medicine at Dermatologikum Hamburg.

Are tattoos and piercings recommended from a medical perspective?

“I don’t want to demonize anything,” says Dr. med. Friederike Wagner, “If a piercing has been done well and cared for and you don't develop an allergy, there's nothing wrong with it. With tattoos, however, it's less transparent: What exactly are you putting under your skin and into your body? You know that “There are substances in the paints that can be carcinogenic, but there is still no clear information about the quantities in which this is the case. But there are certainly ingredients in them that are not exactly beneficial to health.”

How dangerous are tattoo inks?

“We know that the ink is deposited in the lymph nodes. A large part of the ink is removed by the immune system, which is why a tattoo changes color over time. It has not yet been determined whether the ingredients are actually carcinogenic,” says she Expert.

One thing is certain: a tattoo, whether using needles, mircroblading or other methods, penetrates the skin barrier and the mixtures used end up in the body. They consist of dyes, solvents, stabilizers, wetting agents, pH regulators, plasticizers, preservatives and thickeners; according to the EU report, a total of over 100 dyes and 100 additives. Since January 2022, the EU has changed the requirements for tattoo studios, and since January 2023, further color pigments have been banned. These specifications primarily concern colorful tattoo inks.

What direct complications can arise from tattoos?

According to the EU report, most tattoo complications are initial difficulties in the healing process. An acute bacterial infection can also occur in up to five percent of all cases.

This finding is consistent with the practical experience of Dr. Wagner: “At least I rarely see real complications; in a few cases there are allergies to the ingredients in the colors, sometimes acute wound infections after piercing. The biggest complication with tattoos is something completely different: when people no longer like it at some point.” According to YouGov analysis, one in five tattooed men regret their tattoo.

While tattoo removal is possible, it is expensive, time-consuming, and painful. In addition, difficulties can arise, the expert knows: “Especially with permanent make-up, which is also a tattoo, people are not properly informed. During the removal process, the pigments often turn a shade of green: those affected have to Then you have to live with green eyebrows for a long time, which of course isn't so nice.”

What direct complications can occur with piercings?

The situation is similar with piercings: “Sometimes people with allergies to certain metal alloys. Infections arise much more frequently, due to the ring, the measure, due to a lack of hygiene. This is the classic example of complications that arise from piercings,” says she Expert.

A tricky area for piercings is the ear cartilage, which can potentially be damaged: “The piercer has to really make sure to hit the right spot. A piercing that only goes through the skin is much less complicated.” In short, complications from piercings depend on the location of the piercing, the material, the professionalism of the procedure and the hygiene of the piercing itself and the aftercare. According to a Bremen study, 28 percent of those surveyed reported complications during the healing process.

What happens if a piercing tears off?

The piercing gets caught in your clothes while changing and it hurts: with a bit of bad luck, the skin can quickly tear. If a piercing tears off completely, the expert recommends seeking medical help. “If it tears properly, it won't grow back on its own, then it has to be stitched up. Smaller wounds heal on their own. You can also notice that when you have fresh ears pierced: At the beginning it's important to wear the plug because Otherwise the holes will grow over again. If the hole is older, the canal is lined with skin and will no longer grow over.”

The healing ability of the skin is also used when someone no longer feels like having their ears pierced: “Then the hole is cut out a little and then grows back on its own or you can easily sew it up.”

Can you be allergic to tattoos or piercings?

“An allergy is caused by contact. This means that either a second contact or long-term contact with the allergen is required. Especially if you wear the piercing on a part of your body where you sweat a lot, the metals can come out,” explains Dr. Wagner. An allergy to certain metal alloys can only develop after years. “It's the same with tattoos, this also applies to the removal: Whenever we remove a tattoo, we first treat a sample area with the laser and wait four to six weeks to see the body's reaction. Because we release the dye again and out of the cells and the body comes into contact with it for the second time. An allergy can develop, especially with certain pigments, for example in red tattoo ink.”

Are there any skin conditions that mean you should avoid tattoos or piercings?

“There are some skin diseases for which tattoos are not advisable. In patients with psoriasis or lichen planus, for example, the Köbner phenomenon can occur: here the psoriasis can be triggered by an injury, including tattoos or piercings “, explains the dermatologist. Anyone who suffers from a skin disease should therefore speak to their doctor beforehand about their body jewelry plans.

How should you care for freshly done tattoos and piercings?

“The piercing is initially a fresh wound, the skin is pierced. There are germs on the skin per se, which can easily collect in such a wound. That's why you have to make sure that the area and the plug or ring are good at the beginning disinfect regularly,” explains dermatologist Dr. Wagner.

Sprays that are easy to use are particularly suitable for disinfecting. You should clean wounds and jewelry at least twice a day – and of course make sure your hands are clean. Piercings in the mouth area are a special case: Here you should clean your mouth with an antibacterial mouthwash after every meal.

Even with tattoos, proper care ensures that the wound heals well and the tattoo remains beautiful. At the beginning it is important to keep the area clean and from the fourth day onwards to treat it regularly with wound and healing ointment. Very important for healed tattoos: sun protection! “The dark pigment absorbs more UV radiation, which means there is a risk of getting sunburned more easily and this also increases the risk of skin cancer. And of course the tattoo also fades due to the sun’s rays,” says Dr. Wagner.

What should you consider when choosing a tattoo or piercing studio?

Since most complications with tattoos or piercings arise from bacterial infections, hygiene naturally plays a major role, and not just in aftercare. The piercing itself must be carried out in a sterile manner in the studio. So when choosing a studio, pay attention to cleanliness and professionalism. It is also helpful to read online experiences or reviews to find good studios. A good indicator of a professional studio: You will be informed about possible risks and your questions, for example about the colors used and their ingredients or the correct aftercare, will be answered competently. Your first tattoo? You should definitely pay attention to this!

Tattoos and piercings are beautiful, but they also have a certain risk potential. If you have already decided on new body jewelry, the most important thing is to be careful when choosing a studio and taking proper care of it.

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