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Health risks, medical complications and negative social implications associated with adolescent tattoo and body piercing practices
Abstract
Tattoos and body piercing as expressions of individuality, group affiliation or belonging, resistance and control have become a normal and popular practice among adolescents. These practices have potential infectious and non-infectious health risks, medical complications and negative social consequences. Long-term effects cannot be predicted. Exposure to tattoo and body piercing through environmental and cultural influences can encourage participation in body art practices, sometimes without awareness of the risks involved. Adolescents who are not aware of associated risks and how these practices can affect them directly are not afforded the right to make knowledgeable and informed decisions about their bodies. Documented cases of complications associated with tattoos and body piercing substantiate the need to develop non-judgemental information networks and programmes for adolescents.
... Getting a tattoo is a risk-taking activity that has potential medical, physical, and social implications (Vanston & Scott 2008). The prevailing literature has defined tattoos as deviant, a "set of complementary group practices coalescing 538261S GOXXX10.1177/2158244014538261SAGE ...
... Negative effects of having a tattoo include social stigma and discrimination (Goffman, 1963;Vanston & Scott, 2008). Intolerance of persons with visible tattoos remains prevalent in the workplace (Benton & DeRosa, 2002) and in the society at large (John Roberts, 2012); however, tattoos as art may be protected by the First Amendment (Porter, 2012). ...
... Many Americans who do not have tattoos regard persons with tattoos as more rebellious (57%), less attractive (42%), less sexy (36%), and less intelligent (31%; Sever, 2003). Women with tattoos have been stereotyped as heavy drinkers, promiscuous, and unattractive (Vanston & Scott, 2008). ...
In anticipatory socialization, individuals adopt norms and behaviors of reference groups before transitioning into them. We hypothesized that non-tattooed students who desired a tattoo (1,364 “wannabes”) would report attitudes and behaviors between those of students who already had tattoos (429 tattooed) and respondents who neither had a tattoo nor wanted one (816 resistant students) in Grades 7 to 12 in an entire school district in Colorado. Tattooed respondents reported the lowest school attitudes and educational aspirations, and the most weapons possession, substance use, and delinquent behaviors. Resistant students reported the most prosocial attitudes and behaviors. Consistent with anticipatory socialization toward a more antisocial, tattooed reference group, wannabes reported attitudes and behaviors between resistant and tattooed students. A majority of respondents want a tattoo, so we recommend that school health curricula address health and stigma issues associated with tattoos.
... This includes practices such as body piercing, scarification, or branding (e.g. Armstrong, 2005;Vanston and Scott, 2008;Iftekhar and Zhitny, 2020), which are distinct from tattooing practices. Other themes of academic inquiry include prison tattooing (Hellard, Aitken and Hocking, 2007), mastectomy tattooing (Kruger, 2018), and tattooing for religious purposes (Scheinfeld, 2007). ...
... Tattooing has been examined from a scientific medical perspective (e.g. Mortimer, Chave and Johnston, 2003;Vanston and Scott, 2008;Bandodkar, Jia and Wang, 2015). As this is not directly relevant to the research this literature was not reviewed. ...
Academic focus on contemporary western tattooing is primarily from the disciplinary perspectives of the sciences, economics, history, and anthropology. With few exceptions, attention is placed on the modified body and the recipient of the tattoo rather than the tattoo producer or the processes of production. Though tattooing is an important creative industry, the occupational role of the tattooist and the processes and development of practice is yet to receive academic investigation from a practice-centred perspective. This has led to understanding of tattooing that is either absent entirely, partially informed, or flawed, from a range of perspectives.
This AHRC/NPIF funded research is conducted in partnership with Sunderland (England) based tattoo studio Triplesix Studios, where the researcher has worked as a tattooist. A multi-method methodology was created with practice at its core combined with a contextual overview and autoethnography to contribute insight into tattoo production, the role of the producer and stylistic development that is largely absent in academia. It is suggested that the processes of tattoo production are inherently collaborative between tattooist and client. The tattooist’s role is proposed as both material (provision of medium) and non-material (provision of service). The material facet of the tattooist’s role in the provision of the medium is presented as contingent in accordance with the tattoo brief. Autoethnographic accounts of tattooing practice are utilised to generate insight into the non-material facet of the tattooist’s role in the provision of service. Stylistic development with tattooing as a medium through practical investigation that is informed by design training is then presented, illuminating factors that affect the approach of the tattooist.
This is the first piece of research to be conducted using tattooing practice as a core methodological approach and demonstrates that understanding of contemporary western tattooing more broadly can be enriched as a result. Through the contribution of a novel methodology, frameworks and documentation offered by this research, it is proposed that tattooing may be better understood from the perspectives in which it has previously been studied and be introduced into broader arts and design scholarship.
... This could consequently hamper organisational productivity and growth. Additionally, although tattoos and body piercings are accepted as cultural norms in many western societies (Laumann and Derick, 2006;Vanston and Scott, 2008), in Nigeria, the societal perceptions of people with tattoos and body piercings are negative and could have a psychological impact on the bearers of tattoos and body piercings. Future research could examine the psychological and sociological impacts of these societal perceptions of people with tattoos and body piercings. ...
Drawing on 35 in-depth interviews, this article explores the perceptions of managers and employees concerning tattoos and body piercings in Nigeria. This study examines the underlying factors inherent in the comments of the participants. The study reveals a general negative perceptions on tattoos and body piercings, which are basically driven by ethical, religious, and cultural beliefs. Interestingly, the findings also reveal that tattoos and body piercings influence recruitment and selection decisions and could lead to summary dismissal of an employee. Contrary to popular opinion as well as other research findings that social acceptance of tattoos and body piercings is increasing, this study found that Nigerian employers and society generally stigmatise and prejudice against people with tattoos and unconventional body piercings.
... Although tattooing, for instance, is an established practice of asserting control over women and men of lower status in many criminal groups, getting tattoos is not only about being branded. Data show that youth of all genders acquire multiple tattoos at younger ages than older generations (Lauman and Derick, 2006;Vanston and Scott, 2008), and name tattoos are among the most common (Kluger, 2015). Including behaviours that are of valid concern with normative adolescent activities generates confusion and positions young girls themselves and girlhood as a distressing spectre that demands strict management by families, society, and even law enforcement. ...
... When body art is discussed provide it factually, to the point, and believable, then move on to the emphasis of your information, that is on empowerment and self-esteem; content that will be more important to help students respect themselves as they have more confidence about their self-worth and health decisions (Vanston & Scott, 2008). As a health class project, the school nurse could work with the students to help them develop their own decision-making examples that could be applied to many situations, including body art. ...
Using the major format identified for successful prevention and intervention work, five "W" questions: what, why, whom, where, and who, plus one: how, this article first summarizes the current body art literature. Then, educational strategies specifically regarding the topic of tattoos and body piercing are presented for school nurses. These strategies can be used to create applicable, realistic information for young students before they are faced with decisions related to body art. The school nurse might be the first and only credible source of information the students receive related to body art in an education/health environment. Curriculum emphasis is on the decision making leading up to the action, and the major purposes, rather than on the markings or jewelry associated with procurement. Reducing decisional conflict while promoting positive development in the areas of empowerment, self-esteem, and maturing can help achieve stronger informed decision making.
Purpose
This study draws on social stigma and prejudice to examine the perceptions and beliefs of managers and employees regarding visible tattoos and body piercings, as well as the impact they have on potential employment and human resource management in the global South, using Nigeria as the research context.
Design/methodology/approach
The study uses a qualitative research approach, drawing on data from 43 semi-structured interviews with employees and managers in Nigeria.
Findings
Contrary to the popular opinion that tattoos and body piercings are becoming more accepted and mainstream in society, this study finds that some Nigerian employers and employees may stigmatise and discriminate against people with visible tattoos and body piercings. The findings of this study suggest that beliefs about tattoos are predicated on ideologies as well as religious and sociocultural values, which then influence corporate values.
Research limitations/implications
The extent to which the findings of this research can be generalised is constrained by the limited sample and scope of the research.
Practical implications
Religious and sociocultural preconceptions about people with visible tattoos and body piercings have negative implications for the recruitment and employment of such people and could prevent organisations from hiring and keeping talented employees. This implies that talented employees might experience prejudice at job interviews, preventing them from gaining employment. Furthermore, stigmatising and discriminating against people with visible tattoos and body piercings may lead to the termination of employment of talented employees, which could negatively affect organisational productivity and growth.
Originality/value
This study provides an insight into the employment relations regarding tattoos and body piercing in Nigeria. The study highlights the need for mild beliefs and positive perceptions about people with visible tattoos and unconventional body piercings. There should be a general tolerance of the individual preference for body art and physical appearance, and this tolerance should be incorporated in organisational policies, which are enactments of corporate culture.
The relation between tattoos and drug use among respondents in general populations raises important questions about the etiology of a pattern of deviant behavior that declines in adulthood and is stronger in collective versus individually oriented cultures. Nineteen studies (N = 44,110) have a combined effect size using Cohen’s d of.51 (95% CI.44,.59). Adolescents from cultures characterized by a collective orientation have the largest combined effect size (d =.91; 95% CI.69, 1.12). Gender does not moderate the relation between tattoos and drug use. Results are interpreted using theories of maturation, strain, control, and labeling.
Tattooing, and more invasive procedures, with distortion or mutilation of body parts has been commonplace in some cultures for centuries. Body art is the term usually applied to tattooing and the wearing of jewellery in unconventional sites. In the developed world, body art has become popular, especially in adolescence as one means of self expression. Oral or facial piercings are now commonplace and therefore, dentists should be in a position to advise patients.
Body piercing appears to be gaining in popularity and social acceptance. With the increase in the number of piercings, it
is likely that health care providers may see an increase in the complications resulting from these piercings. These may include
the transmission of hepatitis viruses and bacteria at the time of the piercing or in the course of wound care. We review the
infectious complications that have resulted from body piercing and have been documented in the medical literature.
This descriptive, correlational study surveyed 79 pierced and/or tattooed participants to determine reasons why people pierce and tattoo their bodies and to assess participants' knowledge of health risks involved in body alteration procedures. Participants queried represented a wide age range-between 19 and 55. Results showed that participants perceived few health risks involving piercing and tattooing and desired additional piercings and/or tattoos. Individual expression was an important body alteration motivation for both piercing and tattooing. These findings underscore the importance of health care professionals' maintaining nonjudgmental attitudes about those who alter their bodies, there by facilitating important health education concerning related health risks. Suggestions for nursing applications are discussed.
To discuss the possible ramifications of neuraxial analgesia and anesthesia in women with tattoos involving their midline lumbar area.
Recently the authors have received requests for epidural anesthesia in three women with tattoos over the midline of their lumbar spine. In one patient the tattoo covered her entire back. In the other two, it was possible to locate a lumbar interspace that did not have tattoo pigment in the overlying skin. All three women received uneventful epidural analgesia. A Medline and EMBASE search for relevant publications using the keywords: epidural, spinal, tattoos, tattooing, complications did not find any reports of complications from inserting a needle through a tattoo. As none were found, the literature on tattoos and on coring with neuraxial anesthesia was reviewed to see if neuraxial anesthesia might be problematic if the needle passed through the tattoo. Coring is a complication of neuraxial anesthesia that may lead to epidermoid tumours in the subarachnoid space. Theoretically, a pigment-containing tissue core from a tattoo could be deposited into the epidural, subdural or subarachnoid spaces, leading to later neurological complications.
There is no information in the literature about possible risks from inserting needles through tattoos during the performance of neuraxial anesthesia. This report discusses the possible implications.
To describe the characteristics of body modification among adolescents and to determine whether adolescents who engage in body modification are more likely to screen positive for alcohol and other drug problems than those who do not.
Adolescents aged 14 to 18 years presenting to an urban adolescent clinic for routine health care completed a questionnaire about body modification and a substance use assessment battery that included the 17-item Problem Oriented Screening Instrument for Teenagers Alcohol/Drug Use and Abuse Scale (POSIT-ADS). Body modification was defined as piercings (other than one pair of bilateral earlobe piercings in females), tattoos, scarification, and branding. Problem substance use was defined as a POSIT-ADS score > or =1. Data were analyzed using logistic regression to determine whether the presence of body modification was an independent predictor of problem substance use.
The 210 participants had a mean (+/- SD) age of 16.0 (+/- 1.4) years and 63% were female. One hundred adolescents (48%) reported at least one body modification; girls were more likely than boys to have body modification (59% vs. 28%, p < or = .0005). Ninety (42%) reported piercings, 22 (10%) tattoos, 9 (4%) scarification, and 1 (< 1%) branding; 21 (10%) had more than one type of body modification. These were in a variety of locations, most commonly the ear and the nose (piercings) or the extremities (tattoos). One-third of the sample (33%) screened positive for problem substance use on the POSIT-ADS questionnaire. Controlling for age, adolescents with body modification had 3.1 times greater odds of problem substance use than those without body modification (95% CI 1.7, 5.8).
Body modification was associated with self-reported problem alcohol and other drug use among middle adolescents presenting for primary care. More research is needed to determine the clinical and sociocultural significance of body modification and its relationship to substance use in this population.
Tattoos are an increasingly prevalent form of self-expression, especially for adolescents. This study was conducted to determine health-risk behaviors associated with tattoos in young men and women entering military service.
We surveyed a cohort of 550 military recruits using a modification of the Youth Risk Behavioral Survey (YRBS), a validated instrument used to assess health risk behaviors in adolescents. All individuals entering basic training in the US Marine Corps or the US Air Force from June through September 1999 were eligible to participate. The primary outcome variables of interest were tobacco use, alcohol use, seatbelt use, suicidal behaviors, depression, and physical violence.
The survey response rate was 91% (n = 499 of 550). Overall, 27% of respondents had tattoos (n = 125) when entering military service. Women entering military service were more likely to have a tattoo than men. Controlling for age and gender, individuals with tattoos were more likely to smoke, drink heavily, use smokeless tobacco, and ride in a vehicle with someone who had been drinking than non-tattooed individuals.
In a population of military recruits, tattoos were associated with predictable adverse health-risk behaviors. This represents an important opportunity for targeted preventive counseling.
The popularity of tattooing, body piercing, and permanent cosmetics demands up-to-date state legislation. The objective of this article is to present a historical perspective and nationwide review of current state regulations for body art. Methods comprised Internet and telephone inquiries to state agencies. It was found that while 36 states have changed their body art legislation since 1998, the overall strength of the regulations varies widely. The author concludes that it is unrealistic, given the amount of body art performed in the United States, to prohibit body art, emphasize only business licensing, or have limited state regulations while local municipalities establish separate policies. Concerns remain about standard precautions, adequate documentation of complications, and lack of uniform regulations. Quality protection will mean taking a more comprehensive approach to effective regulations and enforcement.
The cases: Over a 2-year period, 6 women have come to our dermatology clinic with an allergic contact dermatitis to paraphenylendiamine (PPD) from hair dye after being previously sensitized to PPD from black henna tattoos. These patients, 14–38 years and previously healthy, all reported similar stories of developing erythema, edema and pruritus in some combination of their scalp, hairline, eyelids or cheeks, 1–2 days after having their hair dyed. All had previously had at least 1 black henna tattoo; 4 of them also reported having a previous local allergic reaction to a black henna tattoo.
When patch testing was performed to identify causative allergens, all 6 patients were found to have strong allergic reactions to PPD. Moreover, their skin reacted to other para-dyes, which can cross-react with PPD: specifically, paratoluenediamine, aminophenol and 2-nitro-4-phenylenediamine.
This study examined social and physical perceptions of blonde and brunette women with different degrees of tattooing. Eighty-four female and 76 male undergraduates rated a series of 16 female line drawings that varied in 2 levels of hair colour and 8 levels of tattooing. Ratings were made for physical attractiveness and sexual promiscuity, as well as estimates of the number of alcohol units consumed on a typical night out. Results showed that tattooed women were rated as less physically attractive, more sexually promiscuous and heavier drinkers than untattooed women, with more negative ratings with increasing number of tattoos. There were also weak interactions between body art and hair colour, with blonde women in general rated more negatively than brunettes. Results are discussed in terms of stereotypes about women who have tattoos and the effects of such stereotypes on well-being.
Tattooing has become a popular recreational practice among younger adults over the past decade. Although some of the pigments used in tattooing have been described, very little is known concerning the toxicology, phototoxicology or photochemistry of these pigments. Seven yellow tattoo inks were obtained from commercial sources and their pigments extracted, identified and quantitatively analyzed. The monoazo compound Pigment Yellow 74 (PY74; CI 11741) was found to be the major pigment in several of the tattoo inks. Solutions of commercial PY74 in tetrahydrofuran (THF) were deoxygenated using argon gas, and the photochemical reaction products were determined after exposure to simulated solar light generated by a filtered 6.5 kW xenon arc lamp. Spectrophotometric and high-pressure liquid chromatography (HPLC) analyses indicated that PY74 photodecomposed to multiple products that were isolated using a combination of silica chromatography and reversed-phase HPLC. Three of the major photodecomposition products were identified by nuclear magnetic resonance and mass spectrometry as N-(2methoxyphenyl)-3-oxobutanamide (o-acetoacetanisidide), 2-(hydroxyimine)-N-(2-methoxyphenyl)-3-oxobutanamide and N,N"-bis(2-methoxyphenyl)urea. These results demonstrate that PY74 is not photostable in THF and that photochemical lysis occurs at several sites in PY74 including the hydrazone and amide groups. The data also suggest that the use of PY74 in tattoo inks could potentially result in the formation of photolysis products, resulting in toxicity at the tattoo site after irradiation with sunlight or more intense light sources.
This article analyses the developing industry of body modification, in which cutting, tattooing and piercing are carried out in studios for profit. It seeks to offer a feminist understanding of this industry which places it on a continuum of harmful cultural practices that include self-mutilation in private, transsexual surgery, cosmetic surgery and other harmful western beauty practices. The ideology created by industry practitioners, that ‘body modification’ replicates the spiritual practices of other cultures, reclaims the body, or is transgressive, is supported by the use of postmodern feminist theory. These ideas are criticized here. On the contrary, it will be suggested that such harmful cultural practices of self-mutilation are sought, or carried out on, those groups who occupy a despised social status, such as women, lesbians and gay men, disabled people and women and men who have suffered sexual abuse in childhood or adulthood.
Background: Skin paints, traditionally performed with henna, are sometimes realized with hair-dyeing preparations like ‘black henna’ containing aromatic amines. Observations: Nine patients, 7 women and 2 men aged 9–41 years, had had skin painting with ‘black henna’. Six experienced acute manifestations: flare-up (1), eczema (1) or both (1), eczema after hair dyeing (1) or chemical burn (2). Two were symptom free. In 1, a positive p-phenylenediamine (PPD) patch test was explained by previous pseudo-tattooing. Patients positive for PPD (4/4 tested) reacted to toluene-2,5-diamine (2/2), aminophenols (1/2), Disperse Orange 3 (3/3) and several azoic textile dyes (1/3). Conclusions: Some skin paint preparations contain irritant and sensitizing aromatic amines. The peculiar conditions of applications and their repetition enhance the sensitization risk. Long-term consequences of sensitivity to PPD or derivatives are allergic contact dermatitis following hair dyeing or after contact with some azoic textile dyes. Occupational consequences may be of importance.
Tattooing has become a popular recreational practice among younger adults over the past decade. Although some of the pigments used in tattooing have been described, very little is known concerning the toxicology, phototoxicology or photochemistry of these pigments. Seven yellow tattoo inks were obtained from commercial sources and their pigments extracted, identified and quantitatively analyzed. The monoazo compound Pigment Yellow 74 (PY74; CI 11741) was found to be the major pigment in several of the tattoo inks. Solutions of commercial PY74 in tetrahydrofuran (THF) were deoxygenated using argon gas, and the photochemical reaction products were determined after exposure to simulated solar light generated by a filtered 6.5 kW xenon arc lamp. Spectrophotometric and high-pressure liquid chromatography (HPLC) analyses indicated that PY74 photodecomposed to multiple products that were isolated using a combination of silica chromatography and reversed-phase HPLC. Three of the major photodecomposition products were identified by nuclear magnetic resonance and mass spectrometry as N(2-methoxyphenyl)-3-oxobutanamide (o-acetoacetanisidide), 2-(hydroxyimine)-N-(2-methoxyphenyl)-3-oxobutanamide and N,N″-bis(2-methoxyphenyl)urea. These results demonstrate that PY74 is not photostable in THF and that photochemical lysis occurs at several sites in PY74 including the hydrazone and amide groups. The data also suggest that the use of PY74 in tattoo inks could potentially result in the formation of photolysis products, resulting in toxicity at the tattoo site after irradiation with sunlight or more intense light sources.
The First Edition of this contemporary classic can claim to have put ‘consumer culture’ on the map, certainly in relation to postmodernism. Updated throughout, this expanded new edition includes a fully revised preface that explores the developments in consumer culture since the First Edition. Among the most noteworthy areas discussed are the effect of global warming on consumption, the rise of the new rich, changes in the North/South divide and the new diversity of consumer culture. The result is a book that shakes the boundaries of debate, from one of the foremost writers on culture and postmodernism of the present day.
To investigate gender differences in substance use and associated high-risk behaviors and feeling states in 220 adolescent psychiatric outpatients.
One hundred seven females and 113 males with a mean age of 15.6 (SD +/- 1.4), seen in a tertiary care center adolescent psychiatry clinic, completed scales tapping substance use and associated feelings and behaviors. Approximately half had used nicotine and alcohol, one third had used marijuana, and 10% reported narcotic use.
Conduct disorder behavior, suicidality, and impulsivity scale scores decreased with age in females while marijuana use, conduct disorder behavior, and Hypophoria scale scores increased with age in males. Alcohol use in males, as contrasted with females, correlated more significantly with other substance use and high-risk behaviors. Suicidality tended to correlate more with polysubstance use in females and with sexual behaviors in females only. Substance use correlated with the Impulsivity and Need scale scores in males and scores on the Sociopathy scale in females.
Substance use in males correlates with high-risk behaviors and is associated with feelings of impulsivity and need. Substance use correlates with self-destructive behaviors and sociopathic feelings in females. There is evidence of more persistent high-risk behaviors, including substance use, in males than in females.
A cross-sectional, convenient sample of adolescents (N = 2101) from 8 states were queried regarding interest in tattooing. Permanent markings and blood-borne diseases were reasons respondents refrain from tattooing, yet 55% (n = 1159) expressed an interest in tattooing. Tattooed adolescents in the sample (10%, n = 213) responded with their experiences. Tattooing was frequently done around the 9th grade and as early as 8 years of age; over half (56%, n = 120) report academic grades of As and Bs. Potential health risks and definite psychosocial findings of purchase and possession risks were evident, building on data from a similar 1994 study by Armstrong and McConnell. Health providers and educators should initiate applicable health education and become community adolescent advocates regarding this risk-taking behavior. Findings indicate that adolescents who want a tattoo will obtain one, regardless of money, regulations, or risks. Adolescents view the tattoos as objects of self-identity and body art, whereas adults perceive the markings as deviant behavior. Informed decision-making could be promoted in health education by incorporating information about the possibility of blood-borne diseases, permanent markings, and themselves as growing and changing people.
To survey the prevalence of body art (body piercing and tattooing) in university undergraduate students and to determine the incidence of medical complications from these procedures.
Between February and May 2001, students were offered the opportunity to complete an anonymous, voluntary survey at the beginning of class or organizational meetings. The survey instrument requested information concerning body piercing and tattooing (current or removed) by body site, age, sex, height, weight, body mass index, undergraduate class, athletic status, and the occurrence of medical complications.
Four hundred fifty-four (94.4%) of 481 students completed the survey (14.7% of total campus enrollment). The prevalence of body piercing was 51%, and that of tattooing was 23%. The chi2 analysis showed female students were more likely to be pierced than males (P=.002); there was no significant difference in the prevalence of tattooing by sex. Male athletes were more likely to be tattooed than male nonathletes (P=.02). No relationships were shown between piercing/tattooing and age or measures of body somatotype. The incidence of medical complications of piercing was 17%, and these complications included bleeding, tissue trauma, and bacterial infections. Pierced navels were particularly prone to infection. There were no reported medical complications from tattooing. Eighteen percent of piercings (58/315) and 4% of tattoos (6/149) had been removed.
Body art is prevalent among undergraduate university students, and there is a significant incidence of medical complications among students with piercing. Male athletes were significantly more likely to be tattooed than male nonathletes.
Body adornment through tattoos and piercings is on the increase, making adverse side effects more common. Practitioners should be prepared to give advice, either before the event, or post-procedure in written and oral forms. The aim of this article is to inform practitioners of the sites and types of piercings, likely adverse side effects and estimated healing times.
We sought to determine the prevalence and sociodemographic characteristics of tattooed adolescents in a nationally representative sample and to evaluate the association between tattooing and several high-risk behaviors.
This is a secondary analysis of the National Longitudinal Survey of Adolescent Health Public Use Dataset, which provides a nationally representative sample of 6072 adolescents collected in 1995 and 1996. The association among permanent tattoos, sociodemographic factors, and high-risk behaviors was evaluated using bivariate and logistic regression analyses using SUDAAN.
Of the total sample of youths, 4.5% reported having permanent tattoos. Tattooing was significantly associated with older age, living in a single-parent household, and lower socioeconomic status but was not significantly associated with gender, ethnicity, or neighborhood type. Tattooing was strongly associated with peer substance use. Adjusting for sociodemographic factors and peer substance use, tattooing in adolescents was independently and significantly associated with reported sexual intercourse, substance use, violent behaviors, and school problems.
Permanent tattoos are strongly associated with high-risk behaviors among adolescents. In the clinical setting, the presence of a tattoo noted during clinical examination of an adolescent should prompt in-depth assessment for a variety of high-risk behaviors.
Postmodern perspectives of body piercing and tattooing interpret these as signifiers of the self and attempts to attain mastery and control over the body in an age of increasing alienation. In this exploratory study, 79 adolescent females, ages 15 to 18 (M = 16.08, SD = 1.36), completed the Coopersmith Self-Esteem Inventory (SEI; Coopersmith, 1981), the Beck Depression Inventory (BDI; Beck, 1978), the Body Investment Scale (BIS; Orbach & Mikulincer, 1998), and the State-Trait Anger Expression Inventory (STAXI-2; Spielberger, 1996). Analyses revealed that body piercings and tattoos were significantly correlated with trait anger (Angry Reaction subscale scores). A multiple regression analysis indicated that three of the dependent variables (Trait Anger-Reaction, BDI, and Feeling subscale of the BIS) were predictors of the total number of body piercings and tattoos.
Genital piercing has gradually become more 'popular' and may sometimes come as a surprise to the urologist who is examining or undertaking a procedure on the area in question. The first article in this section will be helpful as an 'aide memoire' to urologists. In the second article, the important question of premature ejaculation is addressed in a way that may be helpful to readers.
Body piercing is increasing in popularity around the world. In this review, I describe the history, origins, and peculiarities of various forms of body piercing, and procedures involved, variations in healing time, legal aspects and regulations, and complications and side-effects. I have also included a discussion of the motivation for and psychological background behind body piercing. In presenting research results, I aim to raise awareness of the many risks associated with body piercing. In presenting psychological data, I intend to create an understanding of the multifaceted and often intense motivations associated with body piercing, and, thus, to diminish any prejudices held by health professionals against people with piercings.
Tattooing has become a popular recreational practice among younger adults over the past decade. Although some of the pigments used in tattooing have been described, very little is known concerning the toxicology, phototoxicology or photochemistry of these pigments. Seven yellow tattoo inks were obtained from commercial sources and their pigments extracted, identified and quantitatively analyzed. The monoazo compound Pigment Yellow 74 (PY74; CI 11741) was found to be the major pigment in several of the tattoo inks. Solutions of commercial PY74 in tetrahydrofuran (THF) were deoxygenated using argon gas, and the photochemical reaction products were determined after exposure to simulated solar light generated by a filtered 6.5 kW xenon arc lamp. Spectrophotometric and high-pressure liquid chromatography (HPLC) analyses indicated that PY74 photodecomposed to multiple products that were isolated using a combination of silica chromatography and reversed-phase HPLC. Three of the major photodecomposition products were identified by nuclear magnetic resonance and mass spectrometry as N-(2-methoxyphenyl)-3-oxobutanamide (o-acetoacetanisidide), 2-(hydroxyimine)-N-(2-methoxyphenyl)-3-oxobutanamide and N,N''-bis(2-methoxyphenyl)urea. These results demonstrate that PY74 is not photostable in THF and that photochemical lysis occurs at several sites in PY74 including the hydrazone and amide groups. The data also suggest that the use of PY74 in tattoo inks could potentially result in the formation of photolysis products, resulting in toxicity at the tattoo site after irradiation with sunlight or more intense light sources.
A case report of endocarditis after tongue piercing is presented. Body piercing is a form of self-expression that is achieving greater acceptance and wider practice in modern society. Even in healthy individuals, significant health risks exist with this type of physical adornment. Despite this fact, no significant regulatory mechanisms are currently in place to guide practitioners of this craft or to protect the recipients of body piercing. Medical professionals should join the American Dental Association in their opposition of the practice of intraoral/perioral piercing and should call for the development of legislation protecting the recipients of such practices, particularly the population of young people in whom this type of body art is becoming increasingly prevalent.
To gain a better understanding of adolescents' knowledge, beliefs, and behaviors regarding hepatitis B.
Three types of data were collected as part of this investigation: (a) 45 in-depth individual interviews with staff from 20 adolescent health, sexually transmitted disease (STD), and family planning clinics; (b) 96 individual interviews with adolescents and young adults; and (c) questionnaires completed by 17,063 adolescents and young adults. All instruments focused on one or more of the following five topics: (a) knowledge about vaccines; (b) knowledge about hepatitis B; (c) barriers to vaccine acceptance, and ways to overcome these barriers; (d) benefits of the vaccine acceptance, and ways to enhance these benefits; and (e) eight hepatitis B risk factors. Interview data was analyzed using qualitative thematic note-based analyses. Survey data was analyzed using descriptive statistics and Chi-square tests.
Adolescents and young adults seen in these clinics know very little about vaccinations in general, or hepatitis B, in particular. Adolescents exhibit low levels of perceived susceptibility, severity, response efficacy, and self-efficacy toward hepatitis B and the hepatitis B vaccine. On average, these adolescents engage in 2.36 high-risk behaviors (the most frequent of which include sexual activity, body piercing, and tattooing). Those who were sexually active, had a tattoo, had a STD, or worked with blood were significantly more likely to begin the vaccination series.
There is a clear need for additional educational efforts regarding both vaccinations in general, and hepatitis B in particular. Though adolescents are engaging in a variety of high-risk behaviors, most perceive their risk to be low, and therefore many are not taking the necessary precautions to protect themselves.
This article describes adolescents' attitudes and practices toward body piercing and their awareness of associated health risks.
An anonymous, 32-item, random, convenience-sample survey was administered to 225 participants, ages 12-21 years, at an urban, hospital-based, adolescent clinic.
The mean participant age was 16.5 +/- 2.1 years; 78% were female; and 58% were African-American and 30% were Caucasian. Forty-eight percent had a body piercing. About half of participants (range, 45%-62%) endorsed each site as accepted by the public, except for nipple and genital sites, which fewer than 10% endorsed as accepted. African-Americans were more likely to have pierced noses, and to find that site acceptable, whereas Caucasians were more likely to have pierced navels and nipples, and to find those sites acceptable (odds ratio [OR] range, 3.05-19.37). Youth tended to see their own pierced site as more acceptable and less risky than others did (OR range, 8.99-23.61; effect sizes [r] range, .15-.60). The most common health problems from body piercing reported by participants from their personal experience were infection (10%), allergic reaction (1%), and bruising (1%). The most common health problems from body piercing reported by participants based on others' experiences were infection (74%), bleeding (30%), allergic reaction (26%), bruising (19%), and keloids (19%). Those who were pierced in a body-piercing shop reported more infections (18.4%) than those pierced in other places (1.9%) (OR, 11.49; 95% confidence interval [CI], 1.39-90.91). Youth who had pierced themselves perceived less risk from piercing from a nonprofessional (50%) compared with those pierced by a professional (77%) (p = .003).
Youth from this hospital-based urban adolescent clinic considered body piercings to be generally accepted by the public. Pierced youth in our survey often participated in body piercing practices that they perceived as minimally risky and that they defined as normative. Based on these findings, clinicians should discuss body piercing in the context of providing routine anticipatory guidance to adolescents and should educate adolescents about safer piercing strategies to help minimize associated health risks.
Temporary henna tattoos are a popular fashion accessory in recent years. The tattoo dye consists of henna extract from the plant Lawsonia, and p-phenylenediamine to create a darker shade to the tattoo. Increasingly, emergency departments are seeing children with atopic reactions to these tattoos. The p-phenylenediamine component can cause a spongiotic dermatitis with lympho-histiocytic infiltrates. I present two cases of reactions to temporary tattoos in children attending the emergency department. The acute management of these cases and the possible future consequences of sensitization to p-phenylenediamine are discussed.
The trend of body piercing at sites other than the earlobe has grown in popularity in the past decade. The tongue, lips, nose, eyebrows, nipples, navel, and genitals may be pierced. Complications of body piercing include local and systemic infections, poor cosmesis, and foreign body rejection. Swelling and tooth fracture are common problems after tongue piercing. Minor infections, allergic contact dermatitis, keloid formation, and traumatic tearing may occur after piercing of the earlobe. "High" ear piercing through the ear cartilage is associated with more serious infections and disfigurement. Fluoroquinolone antibiotics are advised for treatment of auricular perichondritis because of their antipseudomonal activity. Many complications from piercing are body-site-specific or related to the piercing technique used. Navel, nipple, and genital piercings often have prolonged healing times. Family physicians should be prepared to address complications of body piercing and provide accurate information to patients.
Tattooing has been around since the early beginnings of modern civilization. Modern tattoo artists use a myriad of colors to produce striking designs, resulting in permanent works of body art; however, we humans have been changing our minds since the beginning of time. Our fickle nature results in the desire to change what has been placed as a permanent reminder of a friend, spouse, or work of art. Removing tattoos began with abrasive and destructive measures to destroy the tattoo, and unfortunately, the skin it was contained in. The discovery of selective photothermolysis, the ability to selectively remove target structures without disrupting the surrounding skin, made it at least possible to remove tattoos without destroying the surrounding skin leaving a scar. Theory predicted that pulse durations in the nanosecond domain would be optimal for tattoo removal, and the Q-switched neodymium:yttrium-aluminum-garnet, alexandrite, and ruby lasers fulfilled this need. Too often, older lasers or intense pulsed light sources are used to treat tattoos, often with significant scarring. Since the advent of the Q-switched lasers more than a decade ago, improvement in tattoo-removal lasers has been incremental. Developments leading to new tattoo inks, feedback systems to detect the absorbance characteristics of tattoo inks, dermal clearing agents, and perhaps even shorter pulse-duration lasers should result in improved results for the future.
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.
Body piercings and tattoos are becoming more common in the adolescent population today. Despite their movement into mainstream society, literature to aid in counseling of teens about these issues is scant. The practitioner dealing with this population of patients must be armed with the information necessary that will help adolescents make informed decisions about tattoos and piercings.
Of 997 minority high school students, 8.6% had tattoos and 8% piercings (excluding earlobes); 21% with tattoos and 59% with piercings would not repeat the experience. Fifty-eight percent with tattoos and 43% with piercings reported parental knowledge before the procedure; 75% and 80%, respectively, were asked for proof of parental consent.
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