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Removal of tattoos was studied in the guinea pig. Professional tattoos were made, and two different solutions of tannic acid were injected intradermally into the tattoos four times. The macroscopic end result was formation of a slight fibrosis with little visible pigment. Histologic examination after treatment showed a moderate fibrosis with little visible pigment situated deeper in the dermis than in the untreated tattoo.
Cutaneous reactions to red tattoo pigment occurred in two patients who developed erythema, swelling, and severe pruritus in the area of red coloration within their tattoos. Carbon dioxide (CO2) laser vaporization of the red portions of the tattoos led to complete resolution of symptoms with an excellent cosmetic result and preservation of the tattoo design. A step-by-step guide to the use of the CO2 laser for this treatment is described.
The Q-switched ruby laser was used to treat 101 amateur and 62 professional tattoos in 80 patients over a period of 22 months. Using a 5- to 8-mm spot size and energy fluences of 2-4 joules/cm2, an average of three retreatments resulted in complete pigment removal in four, nearly complete pigment removal in 84, significant pigment removal in 11, and minimal pigment removal in two amateur tattoos. Using identical parameters for professional tattoos, there was complete pigment removal in two, nearly complete pigment removal in five, significant pigment removal in 18, minimal pigment removal in 25, and very little pigment removal in 12. Professional tattoos with red, yellow, and green pigments faded, but required multiple retreatments. While transient hypopigmentation occurred in many patients, skin texture and hair growth returned to normal in all cases and no hypertrophic scarring was seen.
BACKGROUND: The desire to remove tattoos has probably been around as long as their existence. Recent technological advances in lasers have finally made it possible to remove tattoos without leaving an equally undesirable scar. OBJECTIVE: The purpose of this article is to review the use of the Q-switched ruby (694 nm) and the Q-switched Nd:YAG (532 and 1064 nm) lasers for effective removal of tattoo ink, with cosmetically appealing results. RESULTS: The Q-switched ruby laser (694 nm) effectively removes blue-black and green ink, may treat other colors less efficiently, and is frequently associated with transient pigmentary changes, including rare depigmentation. The Q-switched Nd:YAG laser at 1064 nm quickly removes black ink, as well as other colors less efficiently; pigmentary changes are much less frequent, correlating with its lower absorption by melanin. The 532-nm wavelength treats red ink effectively, but also leads to temporary hypopigmentation. Transient textural changes may be noted at all three wavelengths discussed, but scarring is rare. CONCLUSIONS: Q-switched lasers can remove tattoos without residual scarring. Efficacy of ink removal is dependent on the wavelength used for the targeted pigment.
The Q-switched ruby laser is effective in the treatment of amateur tattoos and other pigmented lesions. Previous studies have shown that, though amateur tattoos usually respond well, professional tattoos show greater resistance to clearing. Our study evaluates the treatment of 20 patients with 28 professional (blue, green, black) tattoos by a Q-switched ruby laser with a 28-ns pulse width, and using high energy fluences up to 10 J/cm2. Responses proved to be good to excellent among these patients, who needed fewer treatments than previously reported.
Flesh-colored tattoos darken with traditional tattoo removal lasers. An alternative method was tried. A pulsed carbon dioxide laser was used to remove a facial iron oxide flesh-colored tattoo. It resulted in significant clearing without scarring or textural changes. This is a significant improvement over other reported laser treatments. If this laser is used to remove tattoos elsewhere on skin other than the face, an increased risk of scarring may occur.
Tattooing is an act of permanent marking of the skin with indelible patterns by pricking and inserting pigments. Langerhans cells (LCS) are dendritic cells normally present in suprabasal layers of the epidermis of the skin. To assess whether there were any effects caused by the tattooing on Langerhans cell population and cutaneous nerves, skin from affected areas (n = 15) was compared with controls (n = 10). Frozen sections were immunostained with antisera to S-100. No discernible change either in distribution or in number of Langerhans cells and nerves was seen upon comparison with control skin taken from different areas, but all of the specimens taken from affected areas had a significant increase in the number of Langerhans cells (p < 0.001) even after several years of tattooing with no change in the cutaneous nerves. Thus, the study shows persistent stimulation of Langerhans cell population in tattooed skin.
Though tattooing has been practiced by various cultures for centuries, this art form has undergone dramatic changes the past few decades. Today, tattoos appeal to diverse populations and mainstream culture. The proliferation of tattooing prompted increased concern for safety and awareness of hazardous conditions. Transmission of infectious diseases, such as hepatitis B and C, and theoretically, HIV, can occur when proper sterilization and safety procedures are not followed. While there are many populations at risk, a critical at-risk group is adolescents. Tattooing among adolescents is a risk-taking behavior that warrants the attention of health education in assisting adolescents in becoming informed decision-makers. Teaching and advocacy strategies are suggested, and roles for school health personnel are presented.
Tattooing and body piercing are increasing, especially among college students. A study of 766 tattooed and/or body-pierced college students in 18 universities across the United States and one in Australia was conducted to discover the demographic characteristics, motivational factors, and health concerns. The traditional college time of 18 to 22 years of age (69%) was when they obtained their tattoo (73%) and/or body piercing (63%). More frequent health problems and impulsive decision making were noted for those with body piercing when compared to those tattooed. Three cases of hepatitis were reported. Health professionals should openly discuss body art with students, convey a nonjudgmental attitude, and assist with informed decision-making information to either reduce risks or dissuade. Open communication and applicable health education will be very important.
This journal presented the first nursing information on adolescents and tattooing 6 years ago, and 5 years ago, information was provided about body piercing. These were published to help school nurses assist adolescents become informed decision makers. Another purpose was to prevent risks and, if possible, help dissuade adolescents from tattooing and body piercing. Continuing this theme, the latest information and trends are reported and discussed, and new information on scarification and branding is presented. If an adolescent wants some form of body art (tattooing, body piercing, or branding), they will often obtain it regardless of regulations, risks, or money. School nurses can take a powerful, proactive role by sharing applicable information, realistic concerns, and care instructions about tattooing, body piercing, and branding. Specific information, risks, and care about each form of procedure is presented. A convenient reference table is available for nurses and students. Additionally, nursing actions are suggested including making changes in health policies regarding body art on a local and state level.
The purpose of this report is to describe the management of gingival vitiligo in a black female. This patient was referred by her psychiatrist to the Mount Sinai Hospital Dental Department (Toronto) for assessment of progressive loss in gingival pigmentation. According to her psychiatrist this loss of pigmentation, which the patient indicated may be considered in Africa as a hallmark of HIV infection, was a significant exogenous factor in relation to the patient's ongoing clinical depression. After obtaining informed consent, a modification of a tattooing method used for skin was applied to the patient's attached gingival tissues. Test sites were tattooed prior to performing full gingival tattooing under local anaesthesia. The results demonstrate that it was possible to restore this patient's gingival pigmentation in a highly esthetically acceptable manner. The resulting coloration was reminiscent of the patient's natural pigmentation that had been lost ostensibly because of her systemic disorder. Our findings also showed that the artificial pigmentation established via the tattoo method was stable 4 months postoperatively and continues to be stable, as expected. A profound improvement in the patient's mood was noted.
BACKGROUND: Gingival pigmentation is a common finding, may be of endogenous or exogenous origin, and can have diagnostic significance. Diffuse gingival pigmentation may be physiologic in nature or can be due to environmental factors, drugs, endocrine disorders, or genetic conditions. We present four cases of diffuse gingival pigmentation due to traditional gingival tattooing and review the literature on this practice. METHODS: Four black females (aged 19 to 56 years) of West African origin (Mauritania and Senegal), representing three different ethnic groups (Fulani, Mandinka, and Soninke) presented with various chief complaints. All exhibited diffuse pigmentation of the maxillary vestibular gingiva extending to the second premolar areas, without any associated radiographic abnormalities. The color ranged from intense blue gray to light gray or grayish pink. One case was biopsied for histopathologic evaluation. RESULTS: Questioning revealed that the women had had one or more sessions of traditional gingival tattooing. In one case, the procedure was performed in a dental office. The color range appeared to depend on the time that elapsed since the last procedure. The biopsy exhibited dense fibrous connective tissue containing aggregates of foreign material consistent with a foreign body tattoo. CONCLUSIONS: Gingival tattooing, a cultural practice prevalent in certain African ethnic groups, results in diffuse pigmentation. Outside of Africa, it may be misinterpreted as racial pigmentation or pose a diagnostic puzzle. The color and distribution pattern of diffuse gingival pigmentation often are quite suggestive, and the clinical diagnosis should be confirmed by patient history. In selected cases, biopsy may be necessary to exclude other diagnostic considerations.
To determine whether a history of blood transfusion, tattooing, and acupuncture is associated with an increased risk of hepatitis B surface antigenaemia, a study of 6,328 Chinese men between 35 and 65 years of age was undertaken in Singapore. The age-adjusted odds ratios were 1.44 (95% CI: 1.14, 1.83) for blood transfusion, 1.14 (95% CI: 0.80, 1.63) for tattooing, and 0.88 (95% CI: 0.71, 1.11) for acupuncture. Using no history of any of the three percutaneous procedures as reference, the age-adjusted odds ratio for blood transfusion only was 1.40, 95% CI: 1.07, 1.84, and for blood transfusion plus tattooing was 2.59, 95% CI: 1.18, 5.70. The proportion of HBsAg positive cases attributable to blood transfusion and tattooing, as measured by the population attributable risk, are 4.1 and 0.7 per cent, respectively.
This study examined the effects of tattooing on perception of a male's and a female's credibility and attractiveness. 74 undergraduates viewed a photograph of a tattooed or nontattooed male or female model and then rated dimensions of the models' credibility and attractiveness. Analysis indicated that, although the models' attractiveness ratings were not affected by having a tattoo, their credibility ratings were generally lower when wearing a tattoo than when not wearing one.
This research examined the association of having a tattoo and engaging in premarital sexual intercourse. Data gathered from a convenience sample of 450 college students indicated that tattooed respondents were substantively and significantly more likely to be sexually active than nontattooed college students. Tattooed men became sexually active at a significantly earlier age than nontattooed men but no such difference was found between tattooed and nontattooed college women.
The study investigated the social background and current social stability of 45 tattooed males. Tattooed subjects compared to non-tattooed controls were more likely to report leaving home and school early, to report spending a period in a boys' institution and in prison, and showed greater current instability with regard to accommodation and employment. Tattoos were significantly associated with a current diagnosis of personality disorder and alcoholism and past treatment for drug abuse and parasuicide.
Tattooing and body piercing are now worldwide fashion crazes. The health risks associated with these procedures are as yet unclear. This article examines the prevalence of body decoration and the associated health risks within the Australian population using a random sample survey of individuals aged 14 years and over, collected between June and September 1998 (n = 10,030). The results show that one in 10 people have had a tattoo at some point in their lives and 8 per cent some form of body piercing, excluding ear piercing. Men are more likely than women to report tattooing, while females are more likely to report body and ear piercing. Some 10 per cent of respondents report drinking alcohol or using other drugs when the procedures were undertaken. The prevalence of tattooing and body piercing is considerably higher among injecting drug users. Although the rates of transmission of bloodborne disease due to body decoration are believed to be low, the strong association with youth and with injecting drug use suggests considerable potential for transmission.
Four patients developed contact dermatitis to black henna tattoos on holiday in the Middle East and Asia. Two to ten days after skin painting an itchy, reddish swelling developed at the site of the tattoo exactly following its sharply demarcated borders. Histological investigation of the lesions revealed spongiotic dermatitis with dense lymphohistiocytic infiltrates. Patch testing in all patients showed a strong reaction to p-phenylenediamine (PPD). The other tests, including standard series and henna powder, were all negative. Healing time after application of topical class III and IV steroids was prolonged. These reports show an impressive side effect of temporary tattoos with possible long-term damage. Rather than henna, the causative agent in the pastes used for temporary tattoos appears to be PPD, a widely used dye that is added to the pastes in high concentrations to produce a darker shade. The growing incidence of this complication requires close observation, while practitioners should be aware of this sensitisation and of possible subsequent allergic reactions, especially after hair colouring with dyes based on PPD.