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Friday, August 28, 2015

Got Tats? What Ya Gonna Do When Your Kids Want Them?

Tattoos, tattoos, tattoos -- they are everywhere in every style depicting seemingly anything imaginable while proudly proclaiming the "body art" sensation. A 2012 Harris Poll found that 21 percent of Americans (one in five) has a tattoo, up from 14 percent in 2008.

Yet, how about tattoo remorse? In the poll, 86 percent of people claimed to not regret the tattoo, yet, according to another study reported by The Huffington Post in 2012, close to one-third of people who have gotten a tattoo regret it.

In fact, tattoo removal, both painful and expensive, is becoming commonplace. Laser tattoo removal procedures increased 32 percent from 2011 to 2012 according to one survey, with "employment" often cited as the reason. And although tattoo removal involves many months of laser treatments tailored to the wavelength of the pigments, chemists from several laboratories, including the government's National Center for Toxicological Research, said the fading tattoo becomes more like a toxic chemical dump. The laser removal process, which demolishes the pigment by scorching it with heat, triggers chemical reactions that generate carcinogenic and mutation-inducing breakdown products, which are then absorbed by the body.

And the bigger the tattoo, the greater the toxic release. This can only make one wonder whether it's better to let the sleeping paint lie, walled off by the body's own protective devices.

(Michael Yaremchuk, M.D., Chief of Craniofacial Surgery, Massachusetts General Hospital. "Beyond Tattoo Regret: The Public Health Dangers of Ink. Huff Post "Healthy Living."
March 07, 2013)
  
(Bernadine Healy, M.D. "The Dangerous Art of the Tattoo. U.S. World and Health News.
                                                                       July 25, 2008)

My question is despite the popularity of tattooing, what will parents say to the younger generation when their offspring demands to be inked with tattoos similar to Mommy's and Daddy's? Even with the "safeguard" of modern tattoo removal technology, scar tissue takes the place of the "removed" ink. Are parents willing to condone the practice for their loved ones?


The risks of getting a tattoo -- stigma, social embarrassment, job-related restrictions, and medical problems -- must be weighed carefully as people decide whether any gain exceeds the exposure to harm.

The health risks alone may be the most powerful argument against tattooing. Even though tattoos are increasing in popularity and taboos against them are decreasing, these factors do not mean that tattoos are extremely safe even for those who visit a well-respected tattoo artist in a sterile setting.

A 2012 New England Journal of Medicine article looks at the public health issues resulting from nontuberculous Mycobacteria (NTM), a bacterial infection caused by contaminated tattoo ink -- ink that was contaminated before distribution to the parlors. The research stated that "even if a person receives a tattoo at a tattoo parlor that maintains the highest standards of hygienic practice, there remains a risk of infection from the use of contaminated ink. People who get tattoos must be made aware of this risk and should seek medical attention if lesions consisting of red papules or a diffuse macular rash develop at the tattoo site."

According to the FDA, efforts to identify these cases nationwide revealed that there were outbreaks of tattoo ink–related nontuberculous mycobacterial infections that were associated with multiple brands of ink, occurred in other states, and involved multiple species of mycobacteria (e.g., chelonae, fortuitum, and abscessus).  have been linked to four brands of ink.

The FDA found 19 cases of skin infections in New York State that were traced to the same pre-mixed (tap water or distilled water) and tattoo ink mixtures. In addition to the cluster in New York, cases were confirmed in Colorado, Washington, and Iowa.

The FDA concluded: "M. chelonae, one of several disease-causing NTM species, can cause lung disease, joint infection, eye problems and other organ infections."

(Pamela M. LeBlanc, M.P.H., Katherine A. Hollinger, D.V.M., M.P.H., and Karl C. Klontz, M.D., M.P.H. "Tattoo Ink–Related Infections -- Awareness, Diagnosis, Reporting, and Prevention.N Engl J Med. September 13, 2012.)


The infection caused by Mycobacterium chelonae, which is related to the same germs that cause leprosy and tuberculosis usually don’t cause a problem for people with strong immune systems.
But, injecting the ink under the skin to make a tattoo bypasses many of body’s natural defenses and can allow these germs to set up shop. Once established, mycobacterial infections are stubborn. They often require months of treatment with antibiotics to clear.

Linda Katz, director of the Office of Cosmetics and Colors at the Food and Drug Administration, said people should be aware that the FDA has never approved a color or pigment for injection into the skin. Many colors are approved for other uses, such as automobile paint or printer’s ink. Inks don’t have to be tested for safety or purity before they’re sold to consumers. Katz warned: “Tattooing poses a risk of infection to anyone, but the risk is particularly high for those with pre-existing heart or circulatory disease, diabetes or compromised immune systems.”

Delaware Valley College chemistry Professor Ronald Petruso has found what he says are potentially carcinogenic substances manufactured solely for car paint in a yellow-orange pigment he tested. And traces of lead turned up in ink samples analyzed by a Northern Arizona University colleague, Jani Ingram.

"It just boggles my mind that the federal government has never set regulations for anything like this," Petruso says. Experts believe these materials are being mixed into ink because they endure. "Look at your car—the color is there for 20 years," says Wolfgang Bäumler, assistant professor of experimental dermatology at the University of Regensburg in Germany. His own study of some 40 inks revealed that most contained potentially hazardous chemicals.

(Lindsay Lyon. "If You're Considering a Tattoo, Read This." U.S. News and World Report.
April 15, 2008.)

Allergic reactions have occurred with some of the many metals put into tattoo inks. Nickel being one of the most common metal allergies. Others have reacted to the mercury in red cinnabar, to cobalt blue, and to cadmium sulfite when used as a yellow pigment. Some inks were found to have high levels of lead, some contained lithium, and the blue inks were full of copper.

Henna tattoos that contain the dark brown dye para-phenylenediamine (PPD) can cause a delayed allergic reaction and subsequent PPD hyper-sensitization that may permanently prohibit one from using sulfa drugs, PABA sunscreens, benzocaine and other anesthetics, and hair dyes. Fragrance sensitization may occur, and in some cases, the reaction will include skin necrosis, scarring, and hypo-pigmentation. Analysis of henna dye used on persons who reported allergic reactions has shown the presence of toxic chemicals from hair and textile dyes, in addition to PPD.

(Julie Genser. "The Truth About Tattoos: Health Risks, Toxicity and More." Natural News.
 September 28, 2007.)

University of Bradford researchers using an atomic force microscope (AFM) that allows them to examine skin with tattoos at the nano-level (the first to use an AFM to examine tattoos) found evidence that suggests the tattoo process remodels collagen (your body's main connective tissue).

One nanometer is one-billionth of a meter, which is a measure so small it's absolutely useless as a reference point. To get some idea of just how small these particles are, consider that a human blood cell is 8,000 nanometers, and a human hair is 80,000 nanometers wide.

Nanoparticles from tattoo ink were found to exist in both the collagenous network of the skin as well as around blood vessels. This suggests that the ink particles are leaving the surface of your skin and traveling elsewhere in your body, where they could potentially enter organs and other tissues.

(Joseph M. Mercola."Nanoparticles in Tattoos May Cause Cancer." Mercola.com.
November 20, 2013.)


This is problematic because tattoo inks are largely unregulated and known to contain cancer-causing compounds. The researchers believe the issue could become a significant public health concern given the rise in tattooing in the last decade, noting:

"We need to do more work, but there is no question that these substances can be toxic. It takes a long time for the multi-step nature of cancer to show its face and I don't think we should wait to see if there is anything wrong with these ingredients."

And, while, so far, incidences of skin cancer appearing on tattooed skin has been considered coincidental, it is largely unknown whether the inks may be contributing to cancers, or other health problems, elsewhere in the body. It's known, for instance, that some tattoo pigment may migrate from your skin into your body's lymph nodes. According to Dr. Samuel Epstein, a well-respected professional in cancer prevention:

"… the evidence which we've accumulated so far, is largely restricted to the fact that they (nanoparticles) get into your bloodstream and reach organs throughout your body. And as far as the brain is concerned, we have actual evidence of entry into the brain and producing toxic effects -- lesions, small lesions, toxic effects in the brain."

(Joseph M. Mercola."Nanoparticles in Tattoos May Cause Cancer." Mercola.com.
November 20, 2013.)

Evidence suggests that some nanoparticles may induce toxic effects in the brain and cause nerve damage, and some may also be carcinogenic. In 2011, a study in The British Journal of Dermatology revealed that nanoparticles are indeed found in tattoo inks, with black pigments containing the smallest particles (white pigments had the largest particles and colored pigments were in between).

(T. Høgsberg, K. Loeschner, D. Löf, and J. Serup. "Tattoo inks in general usage contain nanoparticles." British Journal of Dermatology. November 24, 2011.)

Since black ink, which is common in nearly every tattoo, may contain a significant amount of nanoparticles, it is likely that such toxins could find easy entrance into the bloodstream, perhaps worsening their effects. Writing in Experimental Dermatology, researchers highlighted the dangerous potential of tattoo inks (particularly black) even beyond nanoparticles:

"Black tattoo inks are usually based on soot, are not regulated and may contain hazardous polycyclic aromatic hydrocarbons (PAHs). Part of PAHs possibly stay lifelong in skin, absorb UV radiation and generate singlet oxygen, which may affect skin integrity."

(Cameron Kennedy. "Sarcoidosis presenting in tattoos." Clinical and Experimental Dermatology. April 27, 2006.)

Kristina Chiprean, Director of the McLaughlin Health Center said ...

“Because tattoos weren’t as popular 30 years ago as they are today, it isn’t as easy to monitor the effects. Watching people who are 20 now over the next 50 years, that’s when we’re really going to figure out the long term effects of tattoo ink.

“Often times a tattoo gets infected because bacteria moves through the holes in the skin, not from an allergic reaction to the ink,” Chiprean said. “What people don’t realize is that skin is our largest organ, and by putting holes in it we open ourselves up to invasive bacteria.”

(Catie Clark. "Black tattoo ink may carry long-term health risks." theonlinerocket.com. September 21, 2012.)

The Friends of the Earth – a global network of grassroots groups – is among those now calling for proper regulation of tattoo inks amidst the new findings that they may contribute to cancer. In the meantime, it may be wise to "think before you ink," as the FDA recommends, at least until further research is completed (and remember that permanent makeup is also a form of tattoo).

And, The Kids?

I've heard it said that "one person's art is another person's graffiti. The permanence of tattoos is overwhelming to many who consider that their tattoos may be considered by others as beautiful "body art" or as "tramp stamps." Youthful decisions about fads and risks often come back to bite the integrity of parents who preach "Do what I say, not what I do."

I believe a timely discussion about the health risks of tattoos is necessary in proactive parenting. Perhaps a thorough review of the research will convince many young tattoo enthusiasts that skin is more beautiful, and exceeding more healthy, without ink. For those parents who are looking for a lesson plan to help them explain all about tattoos, here is a site to click for one such aid:

"Health Risks Of Body Art"http://www.discoveryeducation.com/teachers/free-lesson-plans/health-risks-of-body-art.cfm

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