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Abstract
Background: Tattooing is defined as 'the practice of producing an indelible mark on the human body by inserting pigment under the skin using needles or other sharp instruments' (Sperry, 1991). It has probably been practised for as long as man has walked the earth. Aims: The objective of the study was to compare the effects of a new post-tattoo cream with a control ointment on newly tattooed skin. Method: Subjects attended for visits on day 0 (approximately four hours after their tattoo was completed), then on day four, seven, 11, 14, 21, and 28. The study duration was 28 days, or less if the skin had returned to normal for both test sites. At each visit the same assessments, measures and questionnaires were completed and photographs were taken of the tattoo. The products investigated were Forever Ink Balm® (Forest Laboratories), which, in addition to manuka honey of UMF 10+, also contains panthenol, vitamin E, and a hyaluronic acid derivative; and a proprietary cream for 'nappy area care' which is water petrolatum-based and contains lanolin and lanolin alcohol. Results: No statistical differences were found between the purpose-designed post-tattoo cream and the nappy care cream.
... There is a lack of evidence to support any one aftercare method. In a randomized, controlled, double-blind study, researchers compared the use of two topical preparations: ''Forever Ink Balm'' and ''Nappy Area Care'' for tattoo aftercare ( White, 2012). Forever Ink Balm was a commercially advertised tattoo ointment that contained manuka honey, which the authors described as an antibacterial agent, and Vitamins B and E. The Nappy Area Care cream was ...
... Subjects applied the two products to separate areas of their tattoos and were evaluated by clinicians on Days 0, 4, 7, 11, 14, 21, and 28. The study showed no statistical differences between the interventional cream and the control cream ( White, 2012). Another study addressing the aftercare of tattoos included the use of hairless guinea pigs ( Fox et al., 2004). ...
Permanent skin tattoos are becoming increasingly more common in today’s society and culture. As tattoos become more prevalent in the mainstream, healthcare professionals need to understand how to properly care for tattoos, and this understanding will not occur without more available research into the subject of tattoo aftercare. The purpose of this study was to investigate tattoo aftercare methods by interviewing experts in this field, tattoo artists. The data analysis revealed the most recommended tattoo aftercare methods included the use of antibacterial soap and petroleum-based or unscented lotion two to three times a day. More than half of the participants recommended no dressings and leaving the tattoo open to air to heal, and almost a third of the participants recommended an unscented petroleum-based product for moisture during tattoo healing. Many participants stated the source of their knowledge to be trial and error or from directions passed to them from other artists. From this study, it was also discovered that there is a lack of instruction concerning proper aftercare hygiene with 12% of participants providing only verbal instructions to their clients, forcing clients to rely on remembering aftercare instructions.
... Las variables estudiadas fueron el eritema, la sequedad, el edema y el tejido desvitalizado. Los resultados no mostraron diferencias estadísticamente significativas entre la aplicación de ambas cremas 23 . ...
Objetivos: Identificar las complicaciones dermatológicas y los
cuidados locales de los tatuajes temporales y permanentes a través
de una revisión sistemática. Metodología: Se realizó una revisión
sistemática aplicando la Declaración PRISMA. La búsqueda se llevó
a cabo en 6 bases de datos (PubMed, Cochrane Library, CUIDEN,
CINHAL, DARE y LILACS) y dos bases no indexadas (Dermatología
Elsevier y Dermatology Online Journal). Se delimitó la búsqueda
por idioma (inglés/español) y por año (últimos 10 años). Una vez
depurada la base de datos se procedió a la evaluación de la calidad
por pares. Resultados: Se obtuvieron un total de 583 artículos, de
los cuales se eliminaron 86 por duplicado y 379 tras la revisión por
título y resumen. Se seleccionaron 118 artículos a texto completo,
y una vez evaluada la calidad a través de los criterios propuestos por
la Red EQUATOR, 30 artículos presentaron una calidad media alta. Finalmente, para su análisis cualitativo se incluyeron un total
22 casos clínicos (informe CARE), 5 estudios observacionales (informe
STROBE), 2 ensayos clínicos (informe CONSORT) y una revisión
sistemática (informe PRISMA). Conclusiones: Se ha evidenciado la
necesidad de actualizar conocimientos orientados al abordaje de los
tratamientos y la identificación de las complicaciones relacionadas
con los tatuajes basados en evidencias sólidas. El desarrollo de guías de práctica clínica que aborden la detección y la aplicación de tratamientos adecuados a este problema de salud puede ser el primer paso para integrar el manejo de los tatuajes en la cartera de servicios del sistema sanitario, permitiendo conocer la dimensión epidemiológica y los recursos necesarios en atención primaria.
... recomendaciones de expertos -21 -Para la elaboración de las recomendaciones se parte de la base que el grabado de un tatuaje permanente implica múltiples perforaciones en la piel para introducir la tinta en la dermis (15), provocando pequeñas lesiones y desencadenando el proceso de reparación tisular. Durante el transcurso de éste, pueden aparecer complicaciones, locales y/o sistémicas, relacionadas con la técnica, los materiales, las herramientas utilizadas o los cuidados post-tatuaje (14), que pueden enlentecer o impedir la correcta cicatrización del tatuaje. Las manifestaciones clínicas más comunes que refieren las personas tatuadas, según los estudios de Kluger (18) y Liszewski et al. (19) son: el prurito, el dolor y la infección, por este motivo, se establecen los diferentes apartados para enmarcar las recomendaciones propuestas en este documento. ...
... The first study was a randomized, controlled, double-blind clinical trial involving 25 subjects that compared the effects of two specific topical products applied twice daily after tattoo completion for 28 days. 20 ...
Background:
A moisturizer application during the healing process after a tattoo session is common practice to help wound healing and to reduce discomfort sensations. This practice was recently recommended by the standard European guidelines on tattoos, with the use of an adapted ointment to keep the site moist.
Aims:
To assess the efficacy and the tolerability of a specific dermo-cosmetic product (Cicabio Pommade, Laboratoire Bioderma, NAOS, France) in tattoo aftercare.
Patients/methods:
Thirty subjects included in this survey applied the product immediately after the tattoo session for 14 days. The objective symptoms (redness, oedema, skin repair quality) were assessed by the tattooist and the subjects. The subjective symptoms, discomfort sensations (pain, itching, burning sensations, tingling), soothing, moisturizing, and undesirable effects were assessed by the tattooed individuals.
Results:
After 14 days of application, redness was absent for 100% and 96% of subjects according to the tattoo artist and the subjects respectively, and the oedema had completely disappeared for both assessors. Most of the subjects rated the skin quality repair and the aesthetic outcomes as very good to excellent. Soothing and moisturizing effects were observed as early as the first day. The effects were maintained over 14 days. Discomfort sensations were judged absent to slight in 96% to 100% of cases after 7 days. They were assessed as absent to slight in all cases for pain, itching, and tingling, and in 96% for burning sensations after 14 days. The product was very well tolerated by 87% of the subjects.
Conclusions:
Our survey demonstrates that this dermo-cosmetic product is suitable for tattooed skin aftercare as it reduced skin discomfort as soon as the first day and led to a good skin quality repair, while being well tolerated.
... recomendaciones de expertos -21 -Para la elaboración de las recomendaciones se parte de la base que el grabado de un tatuaje permanente implica múltiples perforaciones en la piel para introducir la tinta en la dermis (15), provocando pequeñas lesiones y desencadenando el proceso de reparación tisular. Durante el transcurso de éste, pueden aparecer complicaciones, locales y/o sistémicas, relacionadas con la técnica, los materiales, las herramientas utilizadas o los cuidados post-tatuaje (14), que pueden enlentecer o impedir la correcta cicatrización del tatuaje. Las manifestaciones clínicas más comunes que refieren las personas tatuadas, según los estudios de Kluger (18) y Liszewski et al. (19) son: el prurito, el dolor y la infección, por este motivo, se establecen los diferentes apartados para enmarcar las recomendaciones propuestas en este documento. ...
... In a follow-up report, Professor Richard White from the University of Worcester [4] suggested that there are four causes of adverse dermatological effects besides allergic reactions -the techniques, the instruments (needles and machines), the aftercare and the ink products. ...
The regulation of the manufacture of tattoo ink products in the USA and the rest of the world is the focus of this article, which outlines the historical relationships between official and unofficial manufacturing and associated regulations, self-regulating movements within the industry and the impacts of over-regulation on the economics of ink manufacturing markets. The author, Mario Barth, highlights that changes in industry standards of production that are too rapid can cause the system to deteriorate, leading to an essentially negative shift to the underground markets. In addition, these regulations would not lead to a healthier end product because the currently considered health problems associated with tattoos (affecting 6% of tattoos performed in Germany) could be caused by multiple additional factors, such as the tattooing technique and aftercare. The pigment itself (which causes health issues in only 0.6% of tattoos) could in this equation not be optimized within an overregulated market. Further, aspects of price and revenue are analyzed in detail, showing that high quality suppliers are spending most of their efforts on passing regulations and that these regulations are not decreasing the amount of low-quality products in the general market. Finally, the notion of tattooing as 'an adult decision' is explained as another variable that has to be considered in creating regulations because the decision-making process for a tattoo (considering the price, quality and definitely the permanency) has and will have a self-regulating impact driven by the clients. © 2015 S. Karger AG, Basel.
Measurement of stratum corneum (SC) hydration often involves the use of commercial instruments. The aim of this study was to compare and validate two recent instruments: the Corneometer 825® (digital probe) and the Skicon-200 EX®.
In vitro calibration was carried out on filter pads using different solvents, measurements over different layers of plastic foils, and evaluation of desorption kinetics. In vivo measurements were carried out on skin sites covering a range of very dry to well-hydrated skin areas.
Conductance measurements are influenced by electrolytes while capacitance measurements are not. Dielectric constant of the solvents influences the values of both instruments (r respectively 0.92 and 0.99). The capacitance method carries information from deeper layers (up to 45 μm) compared with the conductance instrument (up to 15 μm). Desorption experiments show a strong relation between the amount of water and respectively the capacitance and the conductance values. The in vivo experiments revealed a strong relation between the two methods (r = 0.97). Sensitivity of the capacitance method is limited for the highest hydration values.
Both instruments allow a certain calibration and both give good estimates of the SC hydration.
Primary prevention is a priority for medical personnel. Despite societal popularity and a long association of the military with tattooing, little is known about the tattooed Army soldier, which hampers primary health planning. Basic recruits and advanced individual training students (N = 1,835) at one mid-western military installation completed a questionnaire about any tattooing experiences. Almost half (48%) of the soldiers were serious/very serious about getting a tattoo, with 31% stating that there were "no reasons" to keep them from getting a tattoo. More than one-third (36%) were tattooed, with 22% possessing three or more tattoos. Many soldiers (64%) entered the military with the tattoos. Limited use (15%) of alcohol and/or drugs before tattooing was reported. Findings included a high incidence of tattooing, a strong determination to obtain tattoos, the possession of tattoos for self-identity reasons, and the supportive role of friends. Reported procedural bleeding (76%) documents the potential for blood-borne disease transmission. These results confirm the need for targeted health education regarding the safety and potential risks of tattooing.
In this double-blind, within-patient vehicle-controlled study, patients with mild-to-moderate atopic dermatitis (AD) were treated for 3 weeks twice daily with pimecrolimus cream 1% on one forearm and with vehicle cream on the other forearm. Efficacy of treatment was assessed clinically using the Atopic Dermatitis Severity Index (ADSI), the Investigators Global Assessment (IGA) and the pruritus visual analogue scale. In parallel, blood microcirculation in the skin was measured as an objective parameter for skin inflammation. Skin hydration and transepidermal water loss (TEWL) were monitored as parameter relevant for the barrier function. Treatment with pimecrolimus cream 1% resulted in a quick and marked improvement of signs and symptoms of AD and a significant reduction of microcirculation from 33.90 to 15.55 AU (P < 0.0001). Skin hydration increased continually from 42.86 to 52.69 AU (P = 0.002) and TEWL decreased from 35.30 to 21.50 g/m(2)/h (P = 0.001), indicating restoration of skin barrier. At vehicle-treated sites changes of skin physiological parameters were less pronounced and observed only initially with later plateau or even reversal. At the end of the study, there were significant differences for all measured skin physiological parameters between pimecrolimus cream 1% and vehicle: microcirculation 12.15 AU (P = 0.004), skin hydration 7.12 AU (P = 0.002), TEWL 11.38 g/m(2)/h (P = 0.004). Non-invasive evaluation of microcirculation and barrier functionality thus represent a valuable tool for the objective assessment of treatment response to pimecrolimus cream 1%.
Experiments on skin moisture, i.e. the hydration state of the outer epidermis, were undertaken using three different types of equipment, i.e. the Skicon-100 and Corneometer CM 420 hydrometers and the Servo Med EPI evaporimeter. The studies included 10 healthy volunteers. Water was applied to test sites on the forearm and the palm of the hand, and effects monitored by the three methods. Parallel increases in conductance, capacitance and transepidermal water loss were registered for a duration of about 5 min. The Skicon-100 was more sensitive for measurement of increased hydration, while the Corneometer CM 420 might be more sensitive for measurement of decreased hydration. Inter- and intra-individual variations were minor with all instruments. According to reproducibility studies, the Corneometer CM 420 was more accurate than the Skicon-100. Technical experiments indicated that the Corneometer CM 420 depicts changes of hydration down to a depth of 0.1 mm, while the Skicon-100 measures very superficially. In conclusion, both hydrometers were deemed relevant and valid for assessment of skin moisture. The methods are complementary, and their combined use is recommended.
Bioengineering techniques for examination of the skin, measuring principles and sources of error relative to technique, study design, measuring conditions and variability related to test subjects and preconditioning are reviewed. Principles of validation and standard operating procedures (SOP) are discussed, including guidelines for measurement of transepidermal water loss (TEWL) and laser Doppler cutaneous blood flow. Today typical errors are not related to a measuring device but to the way it is used.
Moisturizers are used daily by many people to alleviate symptoms of clinically and subjectively dry skin. Recent studies suggest that certain ingredients in creams may accelerate the recovery of a disrupted barrier and decrease the skin susceptibility to irritant stimuli. In the present single-blind study, a moisturizing cream was tested for its influence both on barrier recovery in surfactant-damaged skin and on the susceptibility of normal skin to exposure to the irritant sodium lauryl sulphate (SLS). Parameters measured were transepidermal water loss (TEWL) and skin corneometer values, indicating degree of hydration. Treatment of surfactant-damaged skin with the test cream for 14 days promoted barrier recovery, as observed as a decrease in TEWL. Skin corneometer values also normalized more rapidly during the treatment. In normal skin, use of the test cream significantly reduced TEWL after 14 days of treatment, and irritant reactions to SLS were significantly decreased. Skin corneometer values increased after only 1 application and remained elevated after 14 days. In conclusion, the accelerated rate of recovery of surfactant-damaged skin and the lower degree of SLS-induced irritation in normal skin treated with the test cream may be of clinical relevance in attempts to reduce contact dermatitis due to irritant stimuli.
The effect of a moisturizer was tested on experimentally irritated human skin in two studies. In a prevention study, 12 volunteers had both hands immersed into a 0.375% sodium lauryl sulphate solution, 10 min twice daily for 2 days. Before each immersion one hand was treated with the moisturizer; the other hand served as control. In a therapeutic study, 12 volunteers had both hands immersed in the same way as mentioned above. After the last immersion one hand was treated for 5 days with the moisturizer; the other hand served as control. Skin barrier function was evaluated by transepidermal water loss (Evaporimeter), and blood flow was evaluated by laser Doppler flowmetry and skin hydration by electrical capacitance (Corneometer). A significant preventive effect was obtained on the treated hand, compared to the control hand, judged by all measured parameters. A significant therapeutic effect was observed on skin barrier function and on skin hydration on the treated hand, compared to the control hand, while no difference between the hands in blood flow was observed after the end of treatment. The moisturizer could prevent irritant skin reactions induced by a detergent, and it could also accelerate regeneration of the barrier function of irritated skin.
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.
There is increasing pressure on manufacturers of cosmetic products to provide data to support claims. Data are available from many sources including historical (published literature), laboratory data, cell culture experiments and human studies. Undoubtedly, human studies are the most reliable, and there are a wide range of tests available. Many meters have been developed for measuring different aspects of skin physiology but an understanding of these devices is essential, otherwise the data generated is of little value. There is some confusion as to what exactly some meters measure, an example of which is transepidermal water loss (TEWL) and water content (hydration) of the stratum corneum. Measurement of TEWL is used mainly to support claims that a product may, in the short or long term, improve or repair the barrier function of skin. It is not an indicator of hydration of the stratum corneum. One way to measure hydration is to look for the changes in electrical properties of the stratum corneum that the increased water content produces, i.e. measure capacitance or conductance. It is important that we do not loose sight of the fact that meters may measure something that is imperceptible to the consumer or has no meaning to them. Reliance only on devices that give numbers may lead to problems. An example of a study where three facial cosmetic products were subjected to perceptual tests and to a standard volunteer test for moisturization will be discussed. The relationship between any measured parameter, and what it means to the consumer, needs to be understood. A moisturization claim may be technically supported by a study using a device such as the Corneometer. However, a 20% increase in water content almost certainly does not represent a 20% better moisturization as far as the consumer is concerned. The way forward is to relate the two approaches to product testing during product development. Hopefully, this will allow the product development process to be more systematic.
La pression grandit parmi les fabricants de cosmétiques pour qu'ils fournissent la preuve que leurs informations se justifient vis-à-vis de plaintes. Informations disponibles provenant de diverses sources parmi lesquelles les publications historiques (litérature publiée), informations en provenance de laboratoires, expérimentations sur les cultures de cellules ainsi que des études sur les humains. Sans aucun doute les études sur les humains sont les plus sûres et donnent un plus grand choix de tests. Les compteurs ont ete développés afin de mesurer les différents aspects de la physiologie de la peau mais la compréhension de ces appareils est essentielle, sinon ces informations sont sans grande valeur. Une certaine confusion peut exister entre les mesures de certains compteurs, comme par exemple le TEWL (Perte transépidermale d'eau) et la contenance de l'eau (hydratation) du stratum corneum. La mesure du TEWL est principalement utilisée lors de plaintes portés contre la durée d'un produit réparateur de la ‘barriére de la peau’. Ce n'est pas un indicateur d'hydratation du stratum corneum. Une façon de mesurer l'hydratation est de rechercher les changements dans les propriétes électriques du SC produites par un supplément d'eau, c.-à-d. la mesure capacitante ou conductrice. Il est important que nous ne perdions pas de vue le fait que les compteurs peuvent mesurer quelque chose qui soit imperceptible aux consommateurs où qui n'a pas de sens pour eux. Dépendre uniquement d'appareils qui donnent des chiffres peut poser problème. L'exemple d'une étude où 3 produits ‘cosmétique visage’ ont ete testés par un processus de perception et par un test standard sera discuté. La relation entre un paramètre de mesure et la compréhension du consommateur doit etre notée. Une plainte concernant l'hydratation doit être supportée techniquement par une étude utilisant un appareil tel que le Corneometer. Cependant, une augmentation du contenu d'eau de 20% ne représente pas une augmentation de 20% d'hydratation pour le consommateur. Pour le futur, il faudra relier les deux façons de faire pour tester les produits durant la période du développement du produit. Ce qui devrait permettre un processus de développement plus systématique.