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PubMed1983

Regression of cetacean tattoo lesions concurrent with conversion of precipitin antibody against a poxvirus.

Tattoo lesions linked to the cetacean poxvirus of bottlenose dolphins regressed without treatment. Two types of regression were observed: (1) The tattoo lesions became raised and blanched, then disappeared along with sloughing skin. (2) When an incision was made through a tattoo lesion, the tattoo disappeared in a zone around the incision. Poxviruses removed from the raised, blanched skin lesions and from typical tattoo lesions were reacted with dolphin serums and examined by immunoelectron microscopy. Antibody was not detected against either of these poxvirus preparations when the dolphins had only typical tattoo lesions. However, after the raised, blanched lesions appeared, serums obtained during the acute or convalescent stages were positive for the poxvirus separated from the lesions. Regression of the typical tattoo lesions was concurrent with antibody conversion.

Animals↗
PubMed2003

The tattooing paradox: are studies of acute hepatitis adequate to identify routes of transmission of subclinical hepatitis C infection?

BACKGROUND: The Hepatitis Branch of the Centers for Disease Control and Prevention does not recommend routine regulation and inspection of tattoo parlors because surveillance of hepatitis C virus (HCV)-positive acute hepatitis cases rarely identifies tattooing in the incubation period. However, the majority of seroepidemiological studies agree that tattooing is a strong, independent risk factor for subclinical HCV seropositivity. We postulated that this paradox might be explained if transmission of HCV by tattooing generally caused subclinical HCV seropositivity without the acute hepatitis syndrome. METHODS: We reanalyzed data from a prior seroepidemiological study of 626 consecutive patients who were unaware of their HCV serologic status and whose risk factors were ascertained by interview of an internist. Separate multiple logistic regression models were developed to predict a history of the acute hepatitis syndrome and HCV seropositivity. RESULTS: A history of injection-drug use was strongly associated with both HCV seropositivity (adjusted odds ratio [AOR], 7.2; 95% confidence interval [CI], 3.1-16.5) and a history of acute hepatitis (AOR, 5.9; 95% CI, 2.5-13.8), whereas having a commercially applied tattoo was strongly associated with HCV seropositivity (AOR, 6.5; 95% CI, 2.9-14.4) but not with a history of acute hepatitis (AOR, 1.2; 95% CI, 0.5-3.3). CONCLUSIONS: Intravenous injection of relatively large quantities of innocula of HCV may be more likely to result in the relatively rare acute HCV hepatitis syndrome, whereas intradermal exposure to small quantities of innocula may cause only subclinical HCV infections. If so, public policy on regulation and inspection of tattoo parlors should be determined by seroepidemiological studies rather than by the Sentinel Counties Study of acute hepatitis cases.

Acute Disease↗
PubMed2006

Labor analgesia for the parturient with lumbar tattoos: what does an obstetrician need to know?

Tattoos-ancient forms of permanent body ornamentation (body art) have today become popular fashion accessories worldwide. More than 50% of all tattoos are being done on women. In the recent years body tattooing in unconventional sites (e.g. lumbar and/or sacral area, lower abdomen, breast, and buttocks) has gained increasing popularity among young women (including in pregnancy). Although, the potential hazards of regional anesthesia in patients with lumbar tattoos remain controversial it may seem prudent to avoid a hollow needle insertion (possible tissue entrapment in its bore as the needle passes to the deeper structures) through a tattoo for neuraxial blocks. This author is not aware of any other review articles in English literature discussing implications, and complications of labor analgesia in parturients presenting with lumbar tattoos.

Analgesia, Epidural↗
PubMed2006

Biocidal activity of a bioactive glass-protected, preservative-free tattooing solution.

BACKGROUND: The number of people obtaining a tattoo has increased markedly in recent years Tattooing is known to present a risk of transfer of bacterial/fungal pathogens and possibly also viral pathogens. Colorants used for tattooing purposes can be heavily contaminated with bacteria, thus presenting a risk for infections. Concerted efforts are being made to remove this threat, including the production and use of cleaner dyes and pigments with enhanced antimicrobial properties. METHODS: Challenge tests were used to assess the survival characteristics of bacteria, bacterial endospores, fungal hyphae/spores, and bacteriophage in tattooing colorants. RESULTS: Bacteria were able to grow to high numbers in some colorants. A recently marketed, preservative-free colorant was shown to have a good hygienic quality and rapidly inactivated added bacteria and fungal spores. Activity against bacterial endospores was also demonstrated. Bacteriophage survived in the product during the 28-day test period. CONCLUSION: The present study is the first to document the survival characteristics of vegetative bacteria and endospores, fungi, and bacteriophage (as virus surrogate) in tattooing solutions. The results of the present study readily explain the previously reported high numbers of bacteria in some tattooing colorants. A preservative-free colorant, which was designed in response to recent recommendations of the European Council with respect to chemical content, was also adequately self-preserving with respect to bacterial and fungal growth.

Anti-Infective Agents↗
PubMed2006

Tattooing of the nipple-areola complex: review of outcome in 40 patients.

Reconstruction of a pigmented nipple-areola complex (NAC) is one of the final steps in rehabilitating patients following mastectomy. We report the results of 40 consecutive patients who had NAC tattooing done by the same surgeon. Assessments were made both subjectively using a questionnaire, and objectively by using a computer software programme (Adobe Photoshop) to analyse the colour of the NACs. Follow up ranged between six and 24 months (mean 14 months). One patient suffered an infection, and was the only one to need repeat tattooing in our series. Thirty-seven patients (92%) reported some colour fading which ranged between 5% and 80% (mean 32%). A grade of good or very good was given by 33 patients (82%) for colour match, by 36 patients (90%) for over all satisfaction, and by 34 patients (85%) for enhancement in body image. An analysis of the colours of the tattooed and unoperated NACs by the software programme showed that they were similar to a value that ranged from 78% to 97% (mean 91%). Tattooing is a simple and safe procedure, and despite some colour asymmetry it still has a high satisfaction rate. It significantly improves patient's perception of body image. An objective assessment of tattooing using a computer software programme can be a useful tool in reviewing the outcome. Video clips (1-5) are included with the paper for demonstration of the tattooing technique (re-arranged from the video presented with the paper at BAPS).

Adult↗
PubMed2006

Tattoos and body piercings in the United States: a national data set.

BACKGROUND: Little is known about the prevalence and consequences of body art application. OBJECTIVE: Our aim was to provide US tattooing and body piercing prevalence, societal distribution, and medical and social consequence data. METHODS: Random digit dialing technology was used to obtain a national probability sample of 253 women and 247 men who were 18 to 50 years of age. RESULTS: Of our respondents, 24% had tattoos and 14% had body piercings. Tattooing was equally common in both sexes, but body piercing was more common among women. Other associations were a lack of religious affiliation, extended jail time, previous drinking, and recreational drug use. Local medical complications, including broken teeth, were present in one third of those with body piercings. The prevalence of jewelry allergy increased with the number of piercings. Of those with tattoos, 17% were considering removal but none had had a tattoo removed. LIMITATIONS: This was a self-reported data set with a 33% response rate. CONCLUSION: Tattooing and body piercing are associated with risk-taking activities. Body piercing has a high incidence of medical complications.

Adult↗
PubMed2006

Body of evidence: tattoos, body piercing, and eating disorder symptoms among adolescents.

OBJECTIVE: Tattoos and body piercing have been linked to risk-taking behaviors, including disordered eating, but the findings have come from selected samples that were at greater risk for bias due to comorbidity. This study set out to explore concurrently the prevalence of tattoos and body piercing, and eating disorder symptoms in a representative adolescent sample of a community in Sardinia, a major island in Italy. METHODS: A community sample of 828 students (female, 535; male, 282; mean age=17.5+/-1.4 years) among those attending high school in the district of Cagliari, Italy, were invited to take the Eating Attitudes Test, the Bulimic Investigatory Test of Edinburgh, and the Body Attitudes Test, alongside a short questionnaire aimed at evaluating their resorting to body modification practices, including tattooing and body piercing. RESULTS: Females scored higher than males at all eating disorder inventories. More males than females admitted the use of tattoos (14.5% vs. 5.4%), whereas the reverse was found for body piercing (18.4% vs. 21.3%). Tattoos among females and body piercing in both genders were statistically associated with eating disorder measures related to bulimia symptoms. On the whole, the degree of association was modest. CONCLUSIONS: Tattoos and body piecing should be seen as desires to show a subject's identity rather than as a marker of psychopathology. Greater health education, however, is needed in the wake of the growing popularity of these body modification practices.

Adolescent↗
PubMed1998

India ink tattooing in the esophagus.

BACKGROUND: Precise endoscopic measurement of esophageal landmarks is difficult and inaccurate because of the ability of the esophagus to lengthen and foreshorten. METHODS: Nineteen patients enrolled to date in a study of Barrett's esophagus had an India ink tattoo placed at the most proximal level of the squamocolumnar junction and were examined endoscopically at 3, 9, 15, 24, and 36 months. RESULTS: Eighteen of nineteen patients (94.7%) were judged to have a good to excellent tattoo persistence at 3 months. One of the 19 patients (5.3%) had poor tattoo persistence and was retattooed at the 3-month interval. Eventually, 15 of the 15 patients (100%) who remained in the study had a good or excellent tattoo persistence at 36 months. There were no complications related to India ink tattooing including chest pain, bleeding, or perforation. At follow-up endoscopy, no ulcers, inflammation, break in the mucosa, or pain were noted. CONCLUSION: India ink tattooing in the esophagus is safe and persistent and may be used as an effective method for longitudinal follow-up of lesions in the esophagus.

Aged↗
PubMed1999

A clinical and histologic prospective controlled comparative study of the picosecond titanium:sapphire (795 nm) laser versus the Q-switched alexandrite (752 nm) laser for removing tattoo pigment.

BACKGROUND: Theory predicts that picosecond lasers should be more effective than the currently available nanosecond lasers in removing tattoo ink. In addition to thermal confinement, such pulse widths cause optimal photomechanical disruption of the target. OBJECTIVE: This study compared the efficacy of the picosecond titanium:sapphire (795 nm, 500 psec) laser and the Q-switched alexandrite (752 nm, 50 nsec) laser in the treatment of tattooed guinea pigs. METHODS: Six albino guinea pigs, each with 6 uniformly 1 cm circular black tattoos, were treated. Three of the tattoos were divided into 2; one half was treated with the titanium:sapphire laser and the other half with the alexandrite laser. Fluences used for both lasers were 6.11, 4.24, and 2.39 J/cm2 with spot sizes of 1.25, 1.5, and 2 mm, respectively. The remaining spots served as control. Clinical evaluation and biopsies were performed at baseline and at 11 and 16 weeks after a single laser treatment. RESULTS: Greater clearance of tattoo was observed in titanium:sapphire laser-treated areas in 2 of the 4 surviving guinea pigs. In some areas total clearing was observed after the single titanium:sapphire laser treatment. Clearing improved with higher fluences. No scarring was present. Histologic results showed similar findings. CONCLUSION: Our findings suggest that the picosecond titanium:sapphire laser is more effective than the Q-switched alexandrite laser in removing tattoo pigment and may be of significant clinical utility.

Animals↗
PubMed2005

Tattoos, incarceration and hepatitis B and C among street-recruited injection drug users in New Mexico, USA: update.

To the Editor:In a previous report [1], we described significant risks for hepatitis B (HBV) and hepatitis C (HCV) positivity associated with receipt of tattoos, particularly while incarcerated, among a street-recruited population of injection drug users (IDUs) in New Mexico, United States from 1995 to 1997. Another recent report in this Journal, based on a study conducted on prisoners in Australia, found tattooing in prison to be an independent risk for HCV [2]. Another report also described a strong association between tattoos and HCV, but found the strongest association to be with commercial tattooing venues [3]. That study found the risk associated with receipt of tattoos in prison elevated, but not statistically significant. That same report reviewed other articles and found a significant risk for HCV infection associated with tattoos in six out of eight studies that had data available. Further, a recent U.S. Centers for Disease Control and Prevention (CDC) document summarized the literature on risks for hepatitis infections in correctional settings and developed extensive control guidelines [4].

Hepatitis B↗
PubMed1999

Tattoo allergy in patients receiving adjuvant radiotherapy for breast cancer.

Tattooing is routinely employed prior to radiotherapy treatment but allergies to tattoos are rare. New information on the incidence of tattoo allergy at St George Hospital is presented with details of two clinical cases. The literature on tattoo allergy has been unable to estimate the incidence of allergic reaction to tattoos because the total number of patients treated is unknown and not all patients were followed up. Our radiation oncology population for the first time has provided a known denominator, but wide confidence intervals prevent an accurate estimate of the incidence. Salient issues about tattoo allergy are highlighted based on a review of the published literature from 1966 to 1998.

Adult↗
PubMed2002

Multiple color changes following laser therapy of cosmetic tattoos.

OBJECTIVE: To emphasize the wisdom of small test areas when treating cosmetic tattoos and the need for multiple laser systems. METHODS: A 48-year-old woman requested removal of permanent makeup (cosmetic tattoos) of her eyebrows and around her lips. Physical examination revealed a brown tattoo of both eyebrows and dark red lip liner around both lips. A test area was performed on the red tattoo of the lips. A frequency-doubled Nd:YAG laser (532 nm, 2.0 J/cm2, 2 mm spot size) was used for the lip area, while the same laser at 1064 nm, 3.9 J cm2, 2 mm spot size was utilized for the eyebrows. The lip area immediately turned black. The patient returned for follow-up 1 month later; the black ink on the lip was treated with the same laser at 1064 nm, 3 mm spot size, 4.2 J/cm2, with satisfactory resolution in two monthly treatments. Both brown eyebrow turned bright orange and were treated with 532 nm, 3 mm, 3.0 J/cm2. One month later the eyebrows were a mixture of yellow ink and dark green. The yellow area was treated with 532 nm, 3 mm, 2.3 J/cm2, while the dark green was treated with the 1064 nm, 3 mm spot size, 4.2 J/cm2. One month later little improvement was noted, so Q-switched ruby laser at 694 nm, 6 mm spot size, 16 J/cm2 was utilized. An additional four monthly treatments were given utilizing a combination of both ruby and 532 nm ND:YAG lasers for green and yellow pigment, respectively. RESULTS: Significant but incomplete resolution of the tattoo ink was achieved. CONCLUSION: Multiple laser systems are needed to remove cosmetic tattoos. Test areas must be done before treatment.

Eyebrows↗
PubMed2002

Areolar cosmetic tattoo ink darkening: a complication of Q-switched alexandrite laser treatment.

BACKGROUND AND OBJECTIVE: Medical tattooing of the areola is widely performed in Korea. However, cosmetic tattoos containing flesh-tone, purple-red, and yellow dyes are sometimes resistant to Q-switched laser and may even become darker. METHOD: Two Korean women in their 30s who had a mastectomy got light brown to red areolar medical tattoos but they were not satisfied with the shape and size of the tattoos. They underwent Q-switched alexandrite laser treatment with a 3 mm collimated beam at fluences of 7.5-8 J/cm2 in order to trim the irregular contour and reduce the diameter of the tattoos. RESULTS: Within 5 minutes a dark gray to black discoloration of the treated area was evident and remained dark for 6 weeks. Improvement was not noted after two further Q-switched Nd:YAG laser treatments. CONCLUSION: Medical areolar tattoos should be approached with extra caution when attempting their removal with high-energy pulsed lasers such as Q-switched alexandrite laser and a small test site should be performed prior to treatment.

Adult↗
PubMed2002

Treatment of an amalgam tattoo with a Q-switched alexandrite (755 nm) laser.

BACKGROUND: Amalgam tattoos result from deposition of metallic particles (eg, silver, mercury, copper, zinc, and tin) into the oral mucosa. Their clinical and histologic appearance is similar to that of decorative tattoos. OBJECTIVE: To describe the successful use of a Q-switched alexandrite laser for removal of an amalgam tattoo. MATERIALS AND METHODS: An amalgam tattoo on the buccal mucosa and gingiva was treated with a QS 755 nm alexandrite laser. Three treatments were delivered at 8-week time intervals (average fluence = 6.8 J/cm2). RESULTS: Significant lightening of the tattoo was achieved after each of the three treatments without adverse sequelae. CONCLUSION: Q-switched alexandrite laser irradiation can safely and effectively eradicate amalgam tattoos.

Adult↗
PubMed2006

[Prevalence, sociodemography, mental health and gender differences of tattooing and body piercing].

OBJECTIVE: To obtain representative data on incidence and psychological background of tattooing and body piercing. METHOD: Prevalence of tattooing and body piercing is derived from a representative survey (N = 2043, age 14-93 years). Data are evaluated with respect to mental health (GHQ), Beck Depression Inventory (BDI) and sensation-seeking (AISS). RESULTS: The total prevalence of tattoo and piercing is 8.5 % and 6.8 %, respectively. In the age 14-44 15 % are tattooed and 14 % are pierced. Unemployment and lack of partnership correlate positively with body modifications. Tattooing correlates with the perception of reduced mental health and both, tattooing and body piercing correlate highly with increased "Sensation-Seeking" behaviour. DISCUSSION: Gender specific investigations show a differentiated picture background for body modifications.

Adolescent↗
PubMed2001

Tattoo removal by grafting enzymatically separated epidermis.

A novel method of tattoo removal in which the enzymatically separated epidermis of an excised tattoo was grafted in situ was applied to 3 patients. Unlike the conventional skin-grafting procedure, this method resulted in the complete obliteration of the tattoos without donor site scars. In 1990, Hosokawa and colleagues first reported a technique similar to the one described, but the enzymatic process required surgery to be performed over two consecutive days and, thus, it did not become an established procedure. A modification of Hosokawa's method enabled the authors to reduce the enzymatic processing time to an hour using Dispase. The thinning of the tattooed skin using a Paget's-type dermatome before its exposure to an enzymatic solution facilitated the enzyme's infiltration of the basal layer of the epidermis. Hence, the time taken for the epidermis to separate from the tattooed skin was markedly shortened. Although laser removal continues to be the optimal treatment method, skin grafting or other abrasive procedures, including dermabrasion and cryosurgery, are still necessary for those patients who want complete tattoo obliteration over a shorter time frame and at less expense. In these patients the authors recommend that their procedure be offered as an alternative treatment to laser removal.

Adult↗
PubMed1998

Lamellar intrastromal corneal tattoo for treating iris defects (artificial iris)

PURPOSE: Defects in the iris are associated with clinically significant optical anomalies, such as glare and peripheral light scatter; however, current artificial-iris technology remains inadequate. The purpose of this study was to explore the practicality of a lamellar intrastromal tattoo technique as a treatment modality to correct optical and cosmetic defects resulting from simulated iris abnormalities in eye-bank eyes. METHODS: Simulated iris defects (abnormally large pupil, sector iridectomy, iridodialysis, and aniridia) were produced in a series of eye-bank eyes. Depending on the simulated iris defect, one or two lamellar channel(s) were created at 50% depth of the cornea via a peripheral incision (1.8 mm) with specialized proprietary instruments (KeraVision, Inc., Fremont, CA, U.S.A.). Commercially available tattoo pigment was inserted through the lamellar channel(s) and blended into the defective region of the iris. RESULTS: The tattoo treatment was relatively simple to perform. Tattoo pigment was inserted uniformly through the small incision, and adequate color blending to match the recipient iris was achieved. The intrastromal tattoo effectively obscured light. CONCLUSION: The lamellar intrastromal tattoo technique appeared to be efficacious for treating different types of iris defects in eye-bank eyes. Further investigation of this technique in nonsighted patient eyes is warranted.

Corneal Stroma↗
PubMed1987

The office treatment of tattoos: a simple and effective method.

A simplified method for the treatment of tattoos is described. The method is based on an older method called the "French method" known to tattoo artists. The treatment consists of superficial dermabrasion of the skin followed by application of a tannic acid solution which is then "rubbed" into the skin by the dermabrasion wheel. The treatment site is then "painted" with a silver nitrate stick. A heavy eschar forms which separates in approximately 2 to 3 weeks. The method incorporates the use of equipment that is present in the usual plastic surgical office. The method has produced excellent improvement in tattoos, with obliteration of the tattoo in the majority of cases. This report covers 85 patients with 207 tattoos treated over an 11-year period. The method is presented as a treatment of tattoos that are too large for simple excision. Details of the treatment are presented.

Cicatrix↗