What is a tattoo / what is tattooing ?
A tattoo is a process by which pigments are deposited underneath the top layer of the skin to a depth of 1 or 2 mm below the surface and the pigments stay there forever and retain their colour .
Should I be getting a tattoo ?
There is no harm in getting a tattoo for various reasons that are strictly personal to everyone provided the person is aware of its consequences and the fact that what is once created , it cannot be undone .
What are the risks involved ?
Wherever a needle is involved there will be pain of the procedure itself . As there are different coloured inks used , some people might develop an allergic reaction to it . There have been some severe infections reported from New Zealand after ritual tattooing from Samoan ta tatau artists ; but these are rare complications . One must always be awake to the probability of infection if they develop fever or redness at the site of tattooing .
Are they permanent ?
There are macrophages â these are special cells underneath the skin that are a part of our immune system ; they absorb these pigments and they stay underneath the epidermis in the second layer of the skin â the dermis . That is how the tattoo remains permanent .
What are the options for tattoo removal ?
There are lasers available that can specifically target certain pigments under the skin and help to make the tattoo faint and with multiple sessions of lasers the tattoo can gradually fade away . But some traces of pigment do remain and there will be some amount of scarring .
Do they need surgical removal ?
Yes in certain situations ; complete removal will be required for certain personal, religious, social and occupational constraints . These are few examples :
- For the purpose of a religious pilgrimage such as Haj
- A tattoo created in the past that is a cause of distress in the present such as for relationships or romantic involvement
- Someone who has secured employment to the paramilitary forces â they request the employee to get the tattoo removed surgically .
- Childhood branding or tattooing done without the childâs consent and he or she wants it removed .
What are the surgical options available ?
Plastic surgery is a vast speciality of surgery that gives us abundant options for tattoo removal such as
Shaving with a dermatome and resurfacing the area with a skin graft
Local tissue re arrangement and suturing the skin edges for smaller tattoos
Surgical excision and re surfacing using skin grafts
Local flaps wherever the defect is large and requires resurfacing .
What precautions are to be taken while getting a tattoo ?
Hygiene at the tattoo studio
Look at the needles and equipment and ensure its being used for the first time and it is well sterilised
The experience of the tattoo artist .
Catastrophe: A Samoan tattooing ritual resulted in severe sepsis because the legs were tattooed after the perianal region causing in the infection to be seeded to the legs . This underlines the importance of hygiene while undergoing any form og tattooing .
What is a Medical Tattoo ?
Some areas like the scalp can be tattooed with small fine needles that are motorised and they can create an effect of the presence of hair and can be used to conceal baldness . It is called as Scalp Micropigmentation .
Ref: Kerure AS, Marwah M, Wagh ND, Udare S. Micropigmentation. Indian Dermatol Online J. 2023 Aug 29;14(5):605-610. doi: 10.4103/idoj.idoj_767_21. PMID: 37727553; PMCID: PMC10506827.
Take Home Message : Make up your mind before getting a tattoo ; get it from an experienced and trained artist or dermatographer . Medical tattoos can be done well by dermatologists . For tattoo removal or any reactions or complications of tattoo, consult your nearest plastic surgeon . Be mindful of the hygiene aspect while getting a tattoo .
Courtesy: Dr V Manjunath (Plastic Surgeon), one can reach out to him at vmanjunath985@gmail.com for queries or consultations regarding tattoo removal.