Be Body-Art Smart

Casey Lewis, known to many in Sacramento as Inkdup, has a story to go with every one of the tattoos on his body. He’s got a lot of tattoos, so that means lots of stories. “Everything has some sort of reasoning behind it,” says the 38-year-old drummer. While he has faced his share of judgmental looks and wry comments, Lewis sees his tattoos—both the process of getting them as well as living with them—as a spiritual, therapeutic experience that helps him deal with the ups and downs of life. “I don’t go see a shrink. I see my tattoo artist,” he says.

If tattoos are indeed a new form of therapy, then it’s thanks in part to the success of reality shows such as “Miami Ink” and “L.A. Ink” in the mid-2000s, which gave behind-the-scenes insights into the lives of tattoo artists as well as their craft. In any event, tattoos are more mainstream and less associated with subculture than before: A 2013 Pew Research Center study found that 45 million Americans have at least one tattoo, and we spend more than $1.65 billion every year on tattoos. Tattoos representing personal achievements or tributes to loved ones are found on people from all walks of life and professions, even if they sometimes remain hidden from view. And thanks to a combination of regulations, technological advances in tattoo equipment and the tattoo industry’s commitment to safety, getting a tattoo can be safer than ever—provided you do your homework.

KEEPING ARTISTS—AND CUSTOMERS—SAFE Federal standards and regulations developed by the National Institute of Occupational Safety and Health, as well as California’s Safe Body Art Act of 2012, created a major shift in the tattoo industry. Once reliant on self-regulation and reputation, now tattoo shops must be registered with the county in which they are located, and all artists must be licensed and vaccinated for hepatitis B. The requirements vary by county and municipality, but in Sacramento County, artists are required to take a blood-borne pathogens course every year in order to receive their license. Offered by county-approved instructors, the coursework covers the use of personal protective equipment, sources of cross-contamination, types of viruses and bacteria, and proper disposal of needles.

Suppliers of tattooing equipment have incorporated advances in packaging and sterilization techniques to ensure safety for both artists and their clients, as well as to be compliant with federal and state regulations. In years gone by, tattoo artists forged their own needles and sterilized them before use; now, needles are purchased premade for one-time use and come in sterile packaging. The ink and ink delivery systems have also evolved: Ink is presterilized, and the ink tubes used in the machine are individually wrapped in sterile packaging and are disposable. While the ink and pigments used in tattoos are subject to regulation by the U.S. Food and Drug Administration, they are not currently regulated. However, the FDA’s National Center for Toxicology Research is studying the chemical composition of tattoo ink and how the body metabolizes it, the short- and long-term safety of tattoo ink pigments, and the effects of light on tattoo inks. Experienced tattoo artists are aware of potential allergic reactions to ink, which frequently happens with inks containing red pigment. Over the course of his 15-year career, Sacramento tattoo artist Eric MacLachlan has seen only three allergic reactions. If a customer has previously had an allergic reaction to an ink, he does a spot test and waits at least two weeks for the area to heal.

Since the Safe Body Art Act was passed, even the process of becoming a tattoo artist has changed. MacLachlan was self-taught, buying his own equipment and practicing on friends until he had a portfolio of work that he used to land a job in a studio. Nowadays, apprenticeship with a licensed professional tattoo artist is the preferred route. Reputation still plays an important role, though it’s often more about customer service and relationships than anything else. West Sacramento resident Jodie L. Martinez got her first tattoo when her kids were young, and she made sure they understood the importance of finding a clean, reputable shop once they were old enough to get their own tattoos. “You don’t want to get something,” says the 42-year-old massage therapist, referring to illness or infection. MacLachlan relies on his personal relationships with his clients to help him provide a positive, safe experience. “While I’m tattooing, I find out about their lifestyle, [if they have] pets, and I can go over things,” he says, explaining how he advises clients to keep pets out of the bedroom while a tattoo is healing in order to eliminate potential sources of infection. 

Even with strict regulations, there are still shops with questionable practices—and those are the ones that even tattoo artists will avoid. “If you go into a shop and there are dogs or kids allowed, walk away,” says MacLachlan. There should be no drinking or drugs on the premises, including medical marijuana. Lewis, who managed a tattoo shop for a couple of years, says to make sure artists have cleaned and sanitized their workstations after they are done: Plastic wrap, ink caps or tubes—and especially needles—should be properly discarded, and the area should be properly cleaned.

THE IMPORTANCE OF AFTERCARE Once the tattoo is complete, it’s up to the customer to ensure the area heals properly. Despite having 10 tattoos, Martinez doesn’t rely on her memory when it comes to aftercare. “I always follow the instructions of the shop—they give you a sheet with what to do,” she says. With very little real estate left on his body, Lewis has noticed a difference in the healing process based on his own behaviors: “If I wasn’t as diligent about aftercare with one [tattoo] than another, I would kick myself: Why didn’t I take better care?” Some basic guidelines to follow include:

• Don’t immerse the tattoo—no baths, hot tubs, pools.

• Avoid exposing the tattoo to direct sunlight.

• Wear clean, loose clothing, even while sleeping.

• Keep the tattoo covered while exercising.

• Wash hands thoroughly before applying moisturizing ointment to tattoo.

• Avoid perfume and scented products.

For larger pieces, such as a sleeve or back tattoo, the artist will space out the work of outlining and filling a tattoo over an extended period, giving the body time to heal between sessions. Martinez’s sleeve-in-progress is taking time for financial as well as health reasons. “Great ink isn’t cheap,” she says.

ERASING THE INK Sometimes the tattoo you loved at 25 is a tattoo you despise at 35—or your wrist tattoo isn’t acceptable in your workplace. Suzanne L. Kilmer, M.D., founder of Laser and Skin Surgery Center of Northern California, removes 200 to 400 tattoos a year, and she has heard a variety of reasons why patients want to get their tattoos removed. “The vast majority [of patients] are getting a job [where] the tattoo will be frowned on or not allowed,” she says. Sometimes it is a matter of style changes, or not wanting children to see tattoos as acceptable; in at least one instance, a tattoo was a reminder of an abusive relationship.

Tattoo-removal technology has come a long way from old methods that focused on removing layers of skin, often leaving scars behind. Different lasers are now used to remove tattoo ink, based on the ink’s color. Q-switched lasers emit short pulses of light into the area, shattering the ink into small particles that are removed from the body by its own natural filtration system. Kilmer’s research in the field of Q-switched lasers for tattoo removal has been instrumental in helping laser surgeons predict the best wavelength to use in removing a given tattoo ink color.

The removal of professional tattoos usually requires six to 10 laser treatments, spaced over the course of six to eight weeks. The number of treatments depends mainly on the ink: the amount and type used, as well as how deep it is in the skin. While many patients don’t need anesthesia, topical anesthetic creams can be used. Side effects are minimal, though occasionally pinpoint bleeding can happen. Post-treatment, an ointment, ice pack and dressing are applied to the area.

Coming Soon: An App for Tattoo Artists and Their Fans

Briana Aea may not have as many tattoos as some of her friends, but she’s passionate about supporting the artists who have created those tattoos. “People with tattoos usually have a story to tell behind their piece: They want to share why they got the work they did, and they want to brag about their artist,” she says. Five years ago, Aea came up with the concept for Ink Trail, a website and mobile app designed to connect tattoo artists with potential clients. “It’s Yelp for tattoo artists,” says Aea, who presented the concept at Hacker Lab’s Startup Weekend in July 2014. She sees Ink Trail as a way for artists to share their passion for tattooing and build their reputation while allowing potential clients to find artists in a particular area. The service would be exceptionally useful for folks who want to get tattoos while traveling. “There’s no way to connect with an artist if you’re just looking online at images of their work,” says Aea. “[Ink Trail] can help me build a relationship with an artist prior to going to a location that I want to commemorate with a tattoo.” Aea is currently looking for a programmer to write the code for the site and the app. To find out more, contact Aea on Twitter at @ink_trail.

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