Tattoos

1
Tattoos Body Piercings
2
Tattoo History

• The word tattoo comes from the Tahitian tatu
  which means to mark something.
• Originally called painting or staining
• Believed that the first known tattoo dates back
  to 4,000 B.C. (body of man, skin bears cross
  behind one knee and a series of lines above the
  kidneys)
• Egyptian and Nubian mummies (practiced around
  2000 B.C.)
• Ancient Greeks used Tattooing for communication
  among spies
• Ancient Romans used tattoos to mark criminals and
  slaves.

(Philippine Man)
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Tattoo History cont.

• 1700 Japan - escalated the tattoo to an aesthetic
  art form.
• - At that time, only royalty were allowed to
  wear ornate clothing, so as a result of this the
  middle class adorned themselves with elaborate
  full body tattoos.
• Ancient Japanese also marked criminals
• - 1st offense marked w/ line across
  
  forehead
• 2nd was marked by adding an arch
• 3rd marked by another line
• Together the marks formed the Japanese character
  for dog.

(2500 year old Pazyryk mummies)
4
Modern Tattooing

• Today, tattoos are created by injecting ink into
  the skin. Injection is done by a needle attached
  to a hand-held tool. The tool moves the needle up
  and down at a rate of several hundred vibrations
  per minute and penetrates the skin by about one
  millimeter.
• What you see when you look at a tattoo is the ink
  that's left in the skin after the tattooing. The
  ink is not in the epidermis, which is the layer
  of skin that we see and the skin that gets
  replaced constantly, but instead intermingles
  with cells in the dermis and shows through the
  epidermis.
• The cells of the dermis are remarkably stable, so
  the tattoo's ink will last, with minor fading and
  dispersion, for your entire life!

5
Body Piercing History

• 700 A.D., the Mayans practiced ear, lip, cheek
  and Nasal Piercing
• Prehistoric times (Aleut and Eskimo cultures of
  Alaska), lip piercing done
• Considered sign of womanhood
• Used stone, glass, bone, wood and ivory (later
  metal)
• 1983, USA man, first documented tongue piercing.
• First documented case of Naval piercing done in
  20th century (although there are unverified
  claims of ancient Egyptian origin.)

6
Psychosocial Issues

• Elisa Ornelas, LMSW

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Medical Issues

• Related to Hemophilia
• Related to other Health Concerns

8
Hemophilia Issues (Tattooing)

• Bleeding can be an issue
• - Only a superficial puncture with needle, no
  risk for muscular bleeding
• Hepatitis C HIV
• - Is this really an issue?

Magician David Blane
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Tattooing Hepatitis C

• Editorial of Research Study done by Dr. Robert
  Haley (epidemiologist Univ. of TX Southwestern
  Medical Center at Dallas) cited in Dermatology
  Nursing, August 2001, by Rachel Franz, BSN, RN
• Study found 1 in 9 risk of Hep C infection, in
  people who had tattoo done at comm. Parlor than
  those who didnt have tattoo.
• 626 patients studied, 113 had tattoo. 22 w/
  tattoo had Hep C.(52 (33)of these patients who
  had acquired tattoo in comm. Parlor had Hepatitis
  C)
• Only 3.5 of these patients without tattoo had
  Hep C. (Few tattoo assoc infections could be
  traced to injection-drug use, transfusions or
  other known risks.
• People w/ several tattoos or complex / lg tattoos
  had increased risk of Hep C.
• People with white, yellow, orange or red pigments
  in their tattoos were more likely to have Hep C
  than those w/ only black pigment.(char. Of tattoo
  done in commercial parlor)
• Most importantly, commercially acquired tattoos
  accounted for more than twice as many hep C
  infections as injection-drug use. This meant
  that it may have been the largest single
  contributor to the nationwide epidemic of this
  form of hepatitis.

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Tattooing Hep C cont.

• From the CDCs Website on Hepatitis C
  Epidemiology Transmission Modes
  www.cdc.gov/ncidod/diseases/hepatitis/c_training/e
  du/1/epidem-trans-5.htm
• Website states, No data exist in the U.S.
  indicating that persons with exposures to
  tattooing and body piercing alone are at
  increased risk of HCV infection.
• INTERESTING, the prior study presented was from
  August 2001, and this quote was from the CDCs
  website as of January 5, 2004.

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Body Piercing and Hemophilia

• Risk of Bleeding
• Damage to Teeth Gums
• General Infection
• HIV Hepatitis C risk

12
Body Piercing Risk of Bleeding

• Definitely upon review of the types of
  piercings that are being done now, the one that I
  found most disturbing was that of the UVULA
  (thats right, in the throat)
• Risk of bleeding not so large when associated
  with ear or nose piercing.
• Risk of bleeding would likely be increased when
  you think about piercings in the tongue, uvula,
  belly button, nipples, or genitals.

13
Damage to teeth gums

• Tongue piercing may be damaging to teeth and gums
• From website dentalimplants-usa.com they
  state that a new study showed that extended wear
  of barbell-type (most common tongue jewelry) can
  cause receding gums and chipped teeth
• Study showed that the type of damage caused
  varied according to the length of the barbell
  stem
• ½ of participants who had worm either long or
  short barbells for 4 or lt yrs had chipped teeth
  (short barbells more likely to cause tooth
  chipping, d/t it being easier to position between
  teeth.)
• Study also found receding gums, which can lead to
  tooth loss, in 35 of those who had pierced
  tongues for 4 yrs or lt and in 50 who had worn
  long-stemmed barbells for 2 yrs or lt.
  (long-stemmed barbells are more likely to reach
  and damage the gums.

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General problems w/ Piercing

• Worst case scenario, gangrene develops and your
  tongue falls off (or more vital organs)
• Infection from body piercing common
• Allergic reaction to metal that is used
• 1 in 10 will have a bleeding complication
• 1 in 15 will have a large scar or reaction at the
  site
• Possibility of TOXIC SHOCK SYNDROME
• Nerve damage can occur if nerve is pierced (I.e.
  eyebrow piercing or piercing to bridge of nose)

15
Piercings Hepatitis C

• Cited from Bandolier Internet Journal, March
  2003, 109-2. Body Piercing Prevalence and
  risks.
• Systematic lit review of 12 studies, 3 in USA, 4
  in Italy and the remainder in Taiwan, Korea,
  Thailand and Africa (subject size from 110 to
  13,000.)
• 9 of the studies, including all US and Italy
  studies found body piercing to be a risk factor
• More recent study in USA, looking at risk factors
  for acquisition of Hepatitis C(148 pts 88 men,
  60 women)

Figure 2 Associations between hepatitis C
infection and known risk behaviours
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Healing Times for Piercing

• Taken from the TDH Website (www.vh.org/pediatric
  /patient/dermatology/tattoo/)
• Ear lobe 6 to 8 wks
• Ear Cartilage 4 mos to 1 yr
• Eyebrow 6 to 8 wks
• Nostril 2 to 4 mos
• Nasal Septum 6 to 8 mos
• Nasal bridge 8 to 10 wks
• Tongue 4 wks
• Lip 2 to 3 mos
• Nipple 3 to 6 mos
• Naval 4 mos to 1 yr
• Female Genitalia 4 to 10

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Whats our Role?

• Educate
• RE risk of viral bacterial infections
• Risk of bleeding with body piercings
• If theyre going to have a piercing, then tell
  them to give factor first (because theyll
  probably do it anyway
• Its their body and they can do what they want
  with it, but they have to be responsible for it
  also.