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To compare the results of a 1996 study of tattoo possession and motivation for tattoo removal with those of a 2006 study, in light of today's current strong mainstream tattoo procurement and societal support within the young adult population. Descriptive, exploratory study. Four dermatology clinics in Arizona, Colorado, Massachusetts, and Texas. The 2006 study included 196 tattooed patients (66 men and 130 women). Incidence of purchase and possession risk, as measured by a 127-item survey and factor analysis. In contrast to the 1996 study, more women (69%) than men (31%) presented for tattoo removal in 2006. Women in the 2006 study were white, single, college educated, and between the ages of 24 and 39 years; they reported being risk takers, having stable family relationships, and moderate to strong religious beliefs (prayer and closeness to God). Commonly, tattoos were obtained at approximately 20 years of age, providing internal expectations of uniqueness and self-identity. Tattoo possession risks were significant, cited when the quest for uniqueness turned into stigmata (P < .001), negative comments (P < .003), and clothes problems (P < .004). In both the 1996 and the 2006 studies, a shift in identity occurred, and removal centered around dissociating from the past. However, in the 2006 study, more women than men were notably affected by possession risks. Societal support for women with tattoos may not be as strong as for men. Rather than having visible tattoos, women may still want to choose self-controlled body site placement, even in our contemporary society.
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Motivation for Contemporary Tattoo Removal
A Shift in Identity
Myrna L. Armstrong, EdD, RN, FAAN; Alden E. Roberts, PhD; Jerome R. Koch, PhD;
Jana C. Saunders, PhD, RN; Donna C. Owen, PhD, RN; R. Rox Anderson, MD
Objective:To compare the results of a 1996 study of
tattoo possession and motivation for tattoo removal with
those of a 2006 study, in light of today’s current strong
mainstream tattoo procurement and societal support
within the young adult population.
Design:Descriptive, exploratory study.
Setting:Four dermatology clinics in Arizona, Colo-
rado, Massachusetts, and Texas.
Participants:The 2006 study included 196 tattooed pa-
tients (66 men and 130 women).
Main Outcome Measures:Incidence of purchase and
possession risk, as measured by a 127-item survey and
factor analysis.
Results:In contrast to the 1996 study, more women
(69%) than men (31%) presented for tattoo removal in
2006. Women in the 2006 study were white, single, col-
lege educated, and between the ages of 24 and 39 years;
they reported being risk takers, having stable family re-
lationships, and moderate to strong religious beliefs
(prayer and closeness to God). Commonly, tattoos were
obtained at approximately 20 years of age, providing in-
ternal expectations of uniqueness and self-identity. Tat-
too possession risks were significant, cited when the quest
for uniqueness turned into stigmata (P.001), nega-
tive comments (P.003), and clothes problems
Conclusions:In both the 1996 and the 2006 studies, a
shift in identity occurred, and removal centered around
dissociating from the past. However, in the 2006 study,
more women than men were notably affected by posses-
sion risks. Societal support for women with tattoos may
not be as strong as for men. Rather than having visible
tattoos, women may still want to choose self-controlled
body site placement, even in our contemporary society.
Arch Dermatol. 2008;144(7):879-884
peal.1-6 The incidence of tat-
toos among young adults
aged 18 to 30 years is ap-
proximately 25%,1,4,7-13 and
it is estimated to approach 40% in the next
few years.2In Texas, registered tattoo stu-
dios (1300 in 2006) have increased 55%
annually since 1996.14
While a tattoo is often thought to be a
masculine trait,9,15 it has been reported that
women make up 45% to 65% of the tat-
tooed population.16,17 Uniqueness and gen-
der seem to be motivating factors in tat-
too procurement. In one study involving
career-oriented women with tattoos,17
many of whom were counselors, nurses,
physicians, lawyers, and business manag-
ers, deliberate decision making and self-
controlled body site placement were
described as assistive for their tattoo sat-
isfaction. The tattoos symbolized indi-
viduality and identity,17 projecting both
femininity and personal strength.18,19 Ty-
ing in with gender, findings from mul-
tiple body art studies cite “it helped me feel
unique”4,9-12,15,17,20 as a major purpose for
getting a tattoo. Risk taking is normal when
pursuing their need for uniqueness and is
viewed as a positive way to “build their per-
sonal distinctiveness.”2,10,21,22
While the vast majority of individuals
who are tattooed are pleased with their skin
markings (up to 83%),4,7-13 the popular-
ity and prevalence of tattoos often mean
that dermatologists are increasingly hear-
ing stories of regrets and requests for tat-
too removal.23 Estimated prevalency rates
of dissatisfied tattoo wearers hover around
20%,2,8 with a smaller number who actu-
ally seek removal (6%).3In 2006, the
American Society of Dermatologic Sur-
See also page 948
Author Affiliations: School of
Nursing, Texas Tech University
Health Sciences Center
(Drs Armstrong, Saunders, and
Owen), and Department of
Sociology, Anthropology, and
Social Work, Texas Tech
University (Drs Roberts and
Koch), Lubbock, Texas; and
Harvard Medical School and
Wellman Center for
Photomedicine, Massachusetts
General Hospital, Boston
(Dr Anderson).
©2008 American Medical Association. All rights reserved.
at Texas Tech University Health Sciences Center, on July 21, 2008 www.archdermatol.comDownloaded from
gery reported a reduction in laser procedures for tattoo
removal in 2005 (6%) compared with 2001 (8%) and 2003
(9%).2The reason for this reduction could be the tran-
sition of tattoo removal services from medical offices to
“spa or clinic” environments (or even tattoo studios), cre-
ating an underreporting of removal activities. Tattoos,
which have classically been considered as “socially mar-
ginal products,” can create purchase and possession risks
that could be strong motivators for removal.15,20,24 Pur-
chase risks center around procedural problems with the
artist, product, expense, pain, and/or inexperience con-
cerning decision making about the tattoo.24 Possession
risks include the dissonance between the purpose (or
meaning) of the tattoo and the societal response to it.24
Motivation for tattoo removal was initially studied in
1996 with 105 patients. The study included men (61%)
and women (38%) between the ages of 17 and 62 years.25
Many (75%) of them were single adolescents between 12
and 19 years of age at the time of their tattooing. The pur-
poses cited for the tattoos included impulsive decision
making, “to be part of a group,” “just wanted one,” and
“for the heck of it.” While the tattoos were acquired for
internal expectations of self-identity at an early age, tat-
too removal also seemed to be internally motivated to dis-
sociate from the past and to improve self-identity. Simi-
lar findings were cited in a study involving 68 patients
in Wales.26 Waiting time for removal in both studies was
at least 14 years.25,26
To compare the motivation for tattoo possession and removal
in 1996 with today’s contemporary acceptance and removal of
tattoos, we conducted a descriptive, exploratory study at sev-
eral locations. Exempt study status for this research was granted
from the institutional review board of the Texas Tech Univer-
sity Health Sciences Center, Lubbock. Since 1999, the author
team has collected and published data on tattooing and body
piercing research (
The study purpose and benefits were presented on the front page
of the survey, and participants were told that completion of the
survey indicated their voluntary participation. No names or clin-
ics were asked to ensure candidness. Risks, other than those nor-
mally found in day-to-day activities, were not anticipated. Data
were collected using a 127-item survey, which was written at a
7.7 grade level and based on current information in the medical
literature as well as on applicable, reliable questions from previ-
ous body art studies. Two scales used in previous body art re-
search were included in the survey4,9: the reliabilities-for-the-
purpose scale was 0.86 and the risk scale was 0.84.
The 2006 survey included the following sections: (1) ob-
tainment of the tattoo, 37 questions (Cronbach =0.73); (2)
removal of the tattoo, 11 general questions, 13 questions re-
garding reason for removal (Cronbach =0.81), and 26 ques-
tions regarding contributing factors (Cronbach =0.92); and
(3) general subject demographics, with 40 questions regard-
ing risk taking, education, and religious perspectives. The ques-
tions were either multiple choice or Likert-type statements with
scores ranging from 1 (strongly disagreed or unlikely) to 5
(strongly agreed or very likely). Ethnicity was included to note
tattoo acquisition patterns; the ethnic categories were not de-
fined and participants self-reported.
Letters of agreement for data collection were obtained from
4 clinics providing tattoo removal services in Arizona, Colo-
rado, Massachusetts, and Texas. Clinic representatives esti-
mated the survey tools that they thought might be completed,
and a total of 750 surveys were sent. Data collection ran from
May 2005 through January 2006. According to institutional re-
view board stipulations to avoid coercion, a notice was posted
in waiting areas of the respective clinic lobbies inviting clients
who were there to request laser tattoo removal to complete a
survey. No tabulation was kept on how many individuals either
saw or reviewed the survey. If the clients completed the sur-
vey (20-30 minutes), they placed the survey within a provided
envelope, which they then sealed and gave to the office staff;
196 (26%) usable surveys were returned. The surveys were kept
in a secured drawer until it was time to send them to the stat-
istician. A commercially available statistical software package
(SPSS Version 14; SPSS Inc, Chicago, Illinois) was used for data
analysis. Cross-tabulation and 2analysis were performed.
The typical respondents in our 2006 study, which exam-
ined tattoo possession and motivation for removal, were
female (69%), white, single, college educated, and be-
tween the ages of 24 and 39 years (Table 1); their reli-
gious beliefs (prayer and closeness to God) were moder-
ate to strong. Hispanics, the second highest represented
ethnic group, also had more tattooed women than men.
More than half of the tattoos (Table 1) were obtained be-
tween the ages of 16 and 23 years (mean [SD] age, 20
[6.6] years). While both men and women obtained sig-
nificantly more tattoos in high school and college, fewer
women sought them in the elementary grades and mili-
tary. Other nonsignificant gender differences included
(1) having stable and/or positive family relationships, (2)
more than half (60%) reporting pleasure with their tat-
too, and (3) having a lifetime tattoo (men, 170 tattoos;
women, 355 tattoos). More tattoos were placed in vis-
ible (arms or ankles, 49%) locations than in semivisible
(chest or back, 39%) or intimate (groin or breasts, 20%)
sites. Major purposes for getting a tattoo included “helped
me feel unique” (n=82 [44%]), “helped me feel inde-
pendent” (n= 60 [33%]), and “made life experiences stand
out for me” (n=52 [28%]). Factor loadings of the pur-
pose scale indicated a strong associated underlying theme
that the tattoo supported internal expectations of unique-
ness and self-identity (eigen value, 5.2 [47% of vari-
ance]; range, 0.59-0.79).
Respondents were between the ages of 14 and 73 years
(mean [SD] age, 30 [ 8.6] years) and had waited an av-
©2008 American Medical Association. All rights reserved.
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erage of 10 years before seeking removal. Again, there
were no significant gender differences regarding rea-
sons for being at the removal clinics. The participants came
(1) requesting tattoo removal for the first time (25%),
(2) returning, as part of a removal series (55%), or (3)
returning, this time for more tattoos to be removed (20%);
some had already tried other removal methods, such as
recoloring (n=43 [23%]) and retattooing (n =38 [20%]).
More than half (66%) of the respondents were not in-
terested in getting more tattoos, but one-third (34%) said
they would seek them again.
Two methods were used to examine motivation for
tattoo removal: (1) purchase and possessions risks25 were
reviewed and possession risks were evident; and (2) the
conceptual integrity of the scales for tattoo removal rea-
sons and contributing factors were evaluated to better un-
derstand the motivation for removal. The main reasons
and contributing factors for tattoo removal are summa-
rized in Table 2. The major themes (factor loadings) of
the tattoo removal reason and contributing factor scales
were highly associated with internal influences about their
unique product: “they were tired of it,” “they just grew
up,” “it was embarrassing them,” “they now had to hide
their tattoo,” and “they wanted to remove it.” A “new job/
career” was another reason for tattoo removal.
While the women had been pleased with their tattoos when
they first got them, possession risks (Table 3) over the
past 1 to 5 years had affected their present feelings about
their tattoos. These women had experienced significantly
more negative comments (P.003) and stigma problems
(P.001) in public, workplace, or school settings than had
the men with tattoos. Problems with clothes were also sig-
nificant (P.004) and led them to use cosmetics, creams,
and adhesive bandages to cover their tattoos.
Among those respondents who had answered that their
tattoo had “helped me feel unique” (n=82 [44%]), gen-
Table 1. Demographics of 196 Tattooed Subjects Requesting Tattoo Removal
No. (%)
2Test, PValue
(n= 58 [31%])a
(n= 130 [69%])a
Single 48 (84) 96 (81) .61
White 42 (73) 83 (63)
Hispanic 11 (19) 25 (19)
Religion .40
Very/moderately religious 34 (61) 71 (57)
Pray, daily/more 25 (42) 43 (34)
Pray, never 15 (27) 23 (18)
Feel close to God 34 (63) 81 (65)
Time of tattoo obtainment (150 respondents) 2
3=17.0, .001
Elementary 6 (13) 6 (6)
High school 21 (44) 52 (51)
College 12 (25) 42 (41)
Military 9 (19) 2 (2)
Age at time of tattoo, y .29
12-15 9 (16) 20 (16)
16-18 23 (41) 58 (41)
19-23 16 (29) 30 (23)
24 8 (14) 21 (16)
Age, current, y .04
17 3 (5) 2 (2)
18-23 4 (7) 18 (14)
24-29 19 (33) 54 (41)
30-39 21 (37) 43 (33)
40 10 (18) 13 (10)
Education .76
High school 2 (3) 3 (3)
High school graduate 16 (28) 27 (21)
College 27 (47) 65 (50)
Graduate school 13 (22) 35 (27)
Parental relationships .09
Father, neither positive nor negative 20 (35) 39 (32)
Father, positive 26 (45) 49 (40)
Mother, neither positive nor negative 20 (35) 26 (21)
Mother, positive 31 (53) 65 (51)
aNumbers will not always add up to 100 because of missing data.
©2008 American Medical Association. All rights reserved.
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der differences were again evident (Table 3); more women
than men were significantly worried about “going too far
or becoming addicted” to tattoos; they also had signifi-
cantly more piercings (average number, 1.9) and re-
mained satisfied with the piercings. Also, this subset of
women who had used their tattoos to help them feel
unique reported significantly more “risk-taker” and “de-
viancy” feelings at the time of tattooing.
The 2006 study provided a snapshot of those individu-
als who were dissatisfied with tattoos and who sought
tattoo removal. It presented another opportunity to ex-
amine underlying motivations that had not been exam-
ined in sufficient depth in previous studies.25,26 Yet, the
study sample and the conclusions we can draw from the
study results are constrained by (1) the use of self-
reporting anonymous surveys, which can produce bias,
inaccurate recall, or inflation; and (2) the small cross-
sectional sample of respondents who described their opin-
ions regarding why they wanted their tattoos removed.
This survey methodology did allow us to identify the key
factors behind motivation for tattoo removal and en-
abled us to develop better scales to describe and moni-
tor changes in body art trends more completely.
When the results of the 1996 study outcomes25 were com-
pared with those of the 2006 study, a different societal pic-
ture of tattooing was noted. Respondents in the 2006 study
had more tattoos (2.8 vs almost 2.0), were older when they
got the tattoo (16-23 years of age in high school and college
vs 12-19 years of age in high school), and were younger when
they presented for removal (average age, 30 years vs 33 years).
Waiting time for removal was shorter (10 years vs 14 years).
Tattoos in general, and especially those on women, were worn
on more visible body locations (88%) than they were 10 years
ago (82%).3-5 Unfortunately, no relational questions were
asked about body placement and specific tattoo removal sites.
Also, even though the subjects were seeking tattoo removal,
more than one-third of them were still interested in getting
more tattoos, suggesting that further research should be con-
ducted on whether the removal of the tattoo is more about
an actual design problem than about the feelings and effects
associated with the tattoo.
Tattoos can be obtained to demonstrate group affili-
ation,3,8,13 which then puts them into a subculture of their
own. Yet, while tattoos can be used to establish group
identity, they can also be used for individual differentia-
tion.8,9,12 More than 40% of the persons who had chosen
the tattoo to help them feel unique or to seek unique-
ness were disillusioned because their unique product had
lost its luster and excitement.10 In such cases, faster de-
cisions of removal could be made, especially with readily
available removal services, equipment, and personnel. In-
dividual actions regarding removal were still about dis-
sociating from the past,25 as well as about shifting iden-
tity focus, to “move on,” perhaps even to seek other
products (or for some, another tattoo) that would again
contribute to the need for uniqueness. Tiggemann and
Golder22 suggest that further research should be con-
ducted in the tattooed population to examine whether
seeking uniqueness is more important in the motivation-
for-procurement phase or in the possession phase.
A new job or career was also a motivation for tattoo
removal. Negative attitudes toward tattoos in the work-
place could revert to “negative overt behavior,” with per-
ceived interference for a tattooed individual’s achieve-
ment.27-30 Findings of perceived lowered credibility,28
competence, and sociability30 still continue to surface and
to diminish the image of tattoo wearers in the work-
place. While some employers (eg, Boeing, Wal-Mart,
Wells-Fargo, Yahoo, and Ford Motors) support the per-
ceived distinctiveness (uniqueness) of nonoffensive tat-
toos in the workplace, others do not (eg, Tenet Health-
care, Starbucks, and White & Case).31
Historically, getting a tattoo has been a male-dom-
inant activity, but now women have more than half of
the tattoos. For women, their tattoo procurement may
be a way to break out of the gender norms and take some
social risk by visually displaying their assertive identity.
Yet, there still may be many members of society who con-
sider tattoos on women to be a “transgression of gender
In the 2006 study, a shift in gender presentation for
tattoo removal was observed; in the 1996 study, more men
than women requested tattoo removal, but in the 2006
study, more women (including Hispanics)9did. While
men also reported some of these same tattoo problems
leading to removal, there seemed to be more societal fall-
out for women with tattoos, as the tattoos began to cause
embarrassment, negative comments, and clothes prob-
lems and no longer satisfied the need for uniqueness.
Table 2. Ranked Items of Reasons and Contributing Factors for Tattoo Removal
Reasona% Contributing Factorb%
Just decided to remove it 58 Got tired of itc68
Suffered embarrassment 57 Just grew up c66
Lowered body image 38 Having to hide the tattoo c67
New job/career 38 Negative comments from“significant other” 32
Problems with clothes 37 Lack of time for decision 29
Experienced stigma 25 Negative parental comments 26
An occasion (eg, birthday, marriage, award, newly found independence) 21 Negative comments at work, in public, and at schoolc24
aTattoo removal reason scale: Cronbach = 0.80. Factor analysis: eigen value, 4.2 (32% of variance); range, 0.44-0.74.
bContributing factors for removal scale: Cronbach = 0.92. Factor analysis: eigen value, 10.1 (38% of variance); range, 0.60-0.94.
©2008 American Medical Association. All rights reserved.
at Texas Tech University Health Sciences Center, on July 21, 2008 www.archdermatol.comDownloaded from
These negative internal and external outcomes contrib-
uted to the possession risks and to the subsequent iden-
tity shift for tattoo removal.16,17,25
Negative responses were also documented among
career-oriented women with tattoos.25 Strong tattoo
support from their significant others and friends was
Table 3. Factors That Significantly Affected Tattooed Women to Request Tattoo Removal
Factors (No. of Respondents)
No. (%)
2Test, PValueMales Females
More tattoos in high school and college (n= 150) 2
3=17.1, .001
Elementary 6 (13) 6 (6)
High school 21 (44) 52 (51)
College 12 (25) 42 (41)
Military 9 (19) 2 (2)
Time needed for removal decision (n= 187) 2
4=11.10, .03
A few min 13 (22) 25 (19)
Waited awhile, then a few min 18 (31) 38 (30)
1-2 wk 9 (16) 13 (10)
A few mo 11 (19) 19 (15)
1y 7 (12) 34 (37)
If unique, worried more about “going too far or becoming addicted” to tattoos (n= 81) 2
1=4.02, .04
Yes 1 (5) 15 (25)
No 20 (95) 45 (75)
If unique, had more piercings (n= 81) 2
2=8.86, .01
No 17 (81) 26 (43)
1-2 piercings 3 (14) 24 (40)
3 1 (5) 10 (17)
If unique, still liked piercings (n= 69) 2
2=11.7, .003
No piercings 10 (67) 16 (30)
Yes, liked them 2 (13) 34 (63)
No, did not like them 3 (20) 4 (7)
Removed, clothes problems (n= 184) 2
4=30.0, .001
Strongly disagreed 32 (57) 46 (36)
Disagreed 16 (29) 14 (11)
Uncertain 4 (7) 5 (4)
Agreed 1 (5) 25 (20)
Strongly agreed 1 (2) 38 (30)
Removed, stigma problems (n= 184) 2
4=10.9, .03
Strongly disagreed 29 (52) 63 (49)
Disagreed 14 (25) 19 (15)
Uncertain 1 (2) 12 (9)
Agreed 4 (7) 15 (12)
Strongly agreed 1 (2) 19 (15)
Removed, hiding the tattoo (n= 183) 2
4=23.9, .001
Strongly disagreed 17 (30) 16 (13)
Disagreed 13 (23) 12 (9)
Uncertain 6 (11) 6 (5)
Agreed 10 (18) 35 (28)
Strongly agreed 10 (18) 58 (45)
Removed, “tired of it” (n= 182) 2
4=12.9, .01
Strongly disagreed 16 (29) 18 (14)
Disagreed 6 (11) 7 (6)
Uncertain 4 (7) 7 (6)
Agreed 19 (34) 37 (29)
Strongly agreed 11 (20) 57 (45)
Removed, “grew up” (n= 183) 2
4=17.1, .002
Strongly disagreed 17 (30) 21 (17)
Disagreed 9 (16) 8 (6)
Uncertain 4 (7) 3 (2)
Agreed 14 (25) 33 (26)
Strongly agreed 12 (2) 62 (49)
Removed, negative comments in public, workplace, and school (n= 183) 2
4=15.1, .004
Strongly disagreed 30 (54) 57 (45)
Disagreed 18 (32) 21 (17)
Uncertain 3 (5) 10 (8)
Agreed 5 (9) 20 (16)
Strongly agreed None 19 (15)
©2008 American Medical Association. All rights reserved.
at Texas Tech University Health Sciences Center, on July 21, 2008 www.archdermatol.comDownloaded from
counterbalanced by negative remarks about the tattoos
from their fathers, physicians, and the public. It is evi-
dent, then, that negative societal connotations still
exist for women with tattoos. Therefore, for women to
avoid the possession risks of their tattoos, as in the
past, they may still need to deliberately think about
controlling the body placement of their tattoos to
reduce cognitive dissonance and to increase their psy-
chological comfort.
In summary, tattooing is ancient, but popularity, so-
cial acceptance, tattoo inks, and laser technology are rap-
idly changing. How these changes will affect tattooing
and tattoo removal is unknown. In the 2006 study, there
was a prevalence of women seeking tattoo removal; their
motivations for obtaining tattoos were often a desire for
uniqueness, whereas self-reported embarrassment, nega-
tive comments, and clothes problems were motivations
for tattoo removal, diminishing their feelings of unique-
ness associated with the tattoo.
Accepted for Publication: September 20, 2007.
Correspondence: Myrna L. Armstrong, EdD, RN, FAAN,
School of Nursing, Texas Tech University Health Sci-
ences Center, TTU-Highland Lakes, 806 Steven Hawk-
ins Pkwy, Marble Falls, TX 78654 (myrna.armstrong
Author Contributions: Dr Armstrong takes responsibil-
ity for the accuracy of the data analysis. Dr Roberts had
full access to all the data in the study and takes respon-
sibility for the integrity of the data. Study concept and de-
sign: Armstrong, Roberts, Koch, Saunders, Owen, and
Anderson. Acquisition of data: Armstrong, Roberts, and
Koch. Analysis and interpretation of data: Roberts. Draft-
ing of the manuscript: Armstrong, Roberts, Saunders,
Owen, and Anderson. Critical revision of the manuscript
for important intellectual content: Armstrong, Roberts,
Koch, Saunders, and Owen. Statistical analysis: Roberts.
Obtained funding: Armstrong. Administrative, technical, and
material support: Armstrong and Owen. Study supervi-
sion: Armstrong, Roberts, Koch, and Saunders.
Financial Disclosure: Dr Armstrong is an education con-
sultant for Freedom2Ink. Dr Anderson is a cofounder and
a consultant for Freedom-2, LLC; he also conducts re-
search with laser equipment under sponsored research
agreements with his employing institution.
Funding/Support: This work was supported in part by the
Research and Practice Committee of the School of Nurs-
ing, Texas Tech University Health Sciences Center.
Role of Sponsor: The funding sponsor had no role in the
design or conduct of the study; in the collection, analy-
sis, or interpretation of the data; or in the preparation,
review, or approval of the manuscript.
Additional Contributions: Pam Gandy, School of Nurs-
ing, Texas Tech University Health Sciences Center, and
the office staff and physicians in Arizona, Colorado, Mas-
sachusetts, and Texas assisted with data collection.
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... Since the Neolithic era, tattoos have served an important role in society. Largely considered a mark of self-expression emphasizing individuality, tattoos can also be a representation of religious or cultural affiliation [1,2]. Within the United States, the popularity of tattoos has continued to grow. ...
... Reports show that 36% of Americans aged 18-25 and 40% aged 26-40 have at least one tattoo [3]. Furthermore, the appeal of tattoos is ever changing, with more women and younger adults seeking multiple tattoos on visible parts of the body [1,4]. ...
... For individuals who decide to leave a gang, tattoos remain a stigma and serve as a significant barrier to safety and stability [1]. Tattoos demonstrating past gang affiliation can Content courtesy of Springer Nature, terms of use apply. ...
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Tattoos of formerly gang-involved and incarcerated individuals can negatively impact their ability to reintegrate into society. Laser tattoo removal is essential to helping individuals obtain employment, re-cultivate positive relationships, and disengage from gangs. The objective of this study is to describe the demographics and motivations for laser tattoo removal at a large nonprofit clinic. This was a single center retrospective study conducted on patients presenting to Ya’stuvo Tattoo Removal between January 2016-December 2018 and had at least three laser tattoo removal sessions. Data was recorded on patient demographics, geographic location of residence (e.g. zipcode), comorbidities, probation/parole status, referral source, transportation mode, and motivations for receiving and removing tattoos. A representative sample of 862 patients was used to conduct our analysis. Average age at first visit was 30. 16% (n = 134) were on probation, 8% (n = 66) were on parole, and 63% (n = 544) did not report their probation/parole status. Reasons for receiving a tattoo included gangs (46%, n = 368), a current or ex-relationship (28%, n = 223), and decoration (20%, n = 159). The most common reasons for tattoo removal were employment (66%, n = 546), readiness to change life (47%, n = 392), maturity (47%, n = 392), family (43%, n = 356), and negative attention from tattoos (37%, n = 303). The current study highlights the importance of laser tattoo removal in reintegration and gang disengagement. Expanding cost efficient laser tattoo removal is paramount to meet the safety and socioeconomic needs of this population.
... Individuals with tattoos placed near their face or hands may be judged to be of poor character (6,34,35), discriminated against by employers (6,36), or harassed by police (16). Tattoo-related stigma may create feelings of regret, lead some to hide their tattoos in order to avoid discrimination or generate an interest in tattoo removal (15,16,(37)(38)(39)(40)(41). While laser tattoo removal is effective (42), it is also a financially burdensome and time consuming procedure (43). ...
... Tattoos may include images that make the individual uncomfortable or embarrassed, hinder their participation in social or economic pro-social activities, or the images may contribute to personal harm due to interpersonal violence (e.g., gang-related motifs) (71). These findings are concordant with extant studies that report that tattoos can provoke adverse mental health impacts when personal identities evolve (e.g., older age) or social affiliations change (e.g., withdrawing from gangs) (14, 39,72). Entities implementing tattoo removal programs should consider the mental health consequences of having unwanted tattoos when defining the eligibility criteria in order to provide the maximum benefit to persons seeking this service. ...
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Tattoos are less prevalent in Mexico and tattooed persons are frequently stigmatized. We examine the prevalence and correlates of interest in receiving tattoo removal services among 278 tattooed Mexican adults living in Tijuana, Mexico who responded to interviewer-administered surveys, including open-ended questions. Overall, 69% of participants were interested in receiving free tattoo removal services, 31% reported facing employment barriers due to their tattoos, and 43% of respondents regretted or disliked some of their tattoos. Having a voter identification card, reporting moderate/severe depression symptoms and believing that tattoo removal would remove employment barriers were independently associated with interest in tattoo removal. Our findings suggest that there is substantial interest in tattoo removal services. Publicly financed tattoo removal services may help disadvantaged persons gain access to Mexico's labor market and it may positively impact other life domains such as mental well-being and interactions with law enforcement.
... In the past, tattoos served as rites of passage, religious symbols, decorations for bravery or punishments, and marks of outcasts and slaves. 1 Similarly, today, the motivations for acquiring a tattoo vary, including change of appearance, assertiveness, self-esteem, and expression of uniqueness. 2 The prevalence of tattoos in the USA is estimated to be 30% of the general population, and 40% of Americans aged 26-40. 3 Owing to the increased acceptance, tattoos' popularity has been growing. ...
... At the beginning of the 1990s, half of all tattoos were done by women across different social classes. 1 In 2018 Dalia, a German consultancy found that 60% of individuals seeking to erase their tattoo were women, an average of 30 years. Half of them had a high educational level; 47% had university or tertiary education levels. ...
... Je nach Umfrage bedauern etwa 20-50 % der Tattooträger, dass sie sich haben tätowieren lassen, in einer Umfrage waren es 28 %, die die Entscheidung innerhalb des ersten Monats bereuten (49). Immerhin 6-8 % unterziehen sich dann auch einer Tattooentfernung (49,50). Die Geschichte der Tattooentfernung geht zurück bis zu den alten Ägyptern, so finden sich erste Versuche bei ägyptischen Mumien aus dem Jahr 4000 vor Christus. ...
... (Line, 79). The idea that tattoos can be used as a way to portray a meaning or message through tattoos has been suggested that most tattooing is motivated by this (Armstrong et al., 2008). Tattoos are considered a creative form of personal expression (Shelton and Peters, 2006) and individuals use their body as a platform for exhibition (Velliquette et al., 1998). ...
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A coletânea intitulada Corpos, poderes e processos de subjetivação: discursos e práticas na cultura contemporânea reúne artigos construídos a partir de diferentes abordagens metodológicas, envolvendo técnicas de pesquisa e recortes empíricos diversos e que tomam como temática central o corpo, em suas várias dimensões, enquanto objeto central de análise das ciências sociais.
This article covers body art in female adolescents and young adults including tattoos, piercings, and intimate piercings. We review epidemiology, definitions, motivations, proactive counseling, regulations, complications, and removal practices. Providers are likely to encounter and manage young women with tattoos and piercings and should be familiar with how to support young women prior to and after obtaining body art. Providers should be familiar with the treatment of the most frequent complications of body art in young women which include allergic reactions and localized soft tissue infections. Finally, we review the techniques and indications for body art removal.
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The goal of this study is to describe reasons for desiring removal of unwanted tattoos and self-reported outcomes among justice-involved adults (JIA) receiving free laser tattoo removal in Southern California. Between 2016 and 2021, JIA completed voluntary anonymous surveys at baseline (n = 53) and follow-up (n = 113) visits. Descriptive analyses were generated for quantitative items. Themes were identified from open-ended questions. Patients were predominantly male (74%) and most (81%) reported tattoo-related discrimination. Adjusted multivariate analyses showed that a higher number of domains in which patients reported tattoo-related discrimination was associated with having more tattoos to remove and citing reasons for removal related to employment and stigma by association (e.g., gang membership and police interactions). At follow-up, 48% of patients felt they were treated better in their community, and nearly a quarter of patients (25%) reported greater confidence and self-esteem. JIA seek tattoo removal due to stigma and discrimination. While JIA reported diverse benefits, tattoo removal should likely be considered as one element of comprehensive programing that addresses JIA's diverse emotional, social, and economic needs. Longitudinal research is needed to clarify the long-term effects of tattoo removal for JIA.
Tattoos are increasingly gathering attention in the young population, especially in second to fourth decade of life. With such trends, rate of its removal also has been on the rise. Treatment options for tattoo removal besides lasers are surgery, radiofrequency, infrared light, cryotherapy, dermabrasion and salabrasion. Unfortunately, none of these procedures are associated with satisfactory cosmetic results due to adverse effects such as scarring and dyspigmention. Although laser treatment has become the gold standard for tattoo removal, it is also associated with some limitations. Some tattoos inks are resistant to laser and multiple sessions and multiple wavelengths may be required for its complete removal. Considering these limitations, other treatment modalities for tattoo removal must be explored. This article highlights the non‐laser treatment options for tattoo removal. We reviewed all published literature identified from electronic databases (MEDLINE and PubMed) till August 2021 to highlight the non‐laser treatment options for tattoo removal.
This chapter covers a variety of noninvasive cosmetic techniques for rejuvenating skin, removing tattoos, and improving body contour. It covers device selection; pre-, intra-, and postoperative considerations; the advantages, disadvantages, and indications of each device; previous and current devices on the market; and the mechanisms by which each of these devices work. The chapter begins by discussing laser resurfacing for multiple cosmetic disorders and laser tattoo removal, how to select the appropriate laser to treat the targeted condition, and complications to consider. It then covers body-sculpting devices such as cryolipolysis and lasers and corresponding devices, followed by magnetic resonance, radiofrequency, and ultrasound therapy for body contouring.
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▪ Abstract Inscriptions on the body, especially tattoo, scarification, and body paint, have been part of ethnographic literature since before the birth of anthropology as a discipline. Anthropology's origins as the study of the exotic Other can be seen in the early descriptions of the body art of non-Western peoples. Anthropologists have generally focused on how the inscribed body serves as a marker of identity in terms of gender, age, and political status. More recently, scholars interested in this subject have looked also at issues of modernity, authenticity, and representation. The recent focus on the inscribed body responds to postmodern theory, the importance of body art in contemporary Western culture, reflections on the meaning of representations of the exotic, and an interest in the visible surface of the body as the interface between the individual and society. This article reviews recent literature in anthropology and related disciplines pertaining to the cultural construction of the inscribed body.
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Almost 50 percent of all tattoos are being done on women, many of whom are counselors, nurses, doctors, lawyers and business managers. Career-oriented women (N = 137) who had tattoos for at least six months were surveyed in a national study. Consequences associated with the unconventional, permanent product--purchase risk (pain, expense, inexperience), possession risk (self, family and general society response) and health risks--were examined. Women obtained tattoos as an expression of individuality. Almost no elements of purchase or health risks were reported, but possession risk occurred. Strong support for the tattoo was expressed by the significant person in the women's life and friends, while mild support was perceived from mothers, siblings and children. Respondents cited a lack of, or negative response from their fathers, physicians, registered nurses and the general public. Misunderstanding of what a tattoo means to the individual and stereotyping of women with tattoos continues. Understanding career-oriented women's experience of seeking tattoos may provide a new gender/cultural perspective which has implications for health care professionals. In addition, nursing may have a role to play in educating tattoo artists about health care risks.
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Motivational issues surrounding tattoo removal are important to understand because tattooing is flourishing, thus creating many requests for tattoo removal. A descriptive study and a 67-item survey were used to examine characteristics of tattooed patients seeking laser therapy for tattoo removal. The setting was the Laser Dermatology Center, Massachusetts General Hospital in Boston, a large metropolitan ambulatory clinic. Patients queried were 64 tattooed males and 41 tattooed females between the ages of 17 and 62 years with a wide variety of vocational and professional occupations. We assessed risk factors surrounding tattooing decisions and experiences that might later influence their motivation to have the tattoos removed by laser therapy. Motivation, treatment, and cost, in terms of money, pain, and risk of disfigurement all entered into the decision making to have the tattoos removed. Strong elements of purchase and possession risks were documented as well as an improved sense of self and maturity. The patient's maturation was in contrast to the notion of a waiting room filled with ill-behaved stereotypical tattooed individuals. Most participants impulsively obtained their tattoos for internal expectations of self-identity at an early age and were still internally motivated to dissociate from the past and improve self-identity. Poor decision making and subsequent personal regret seem to be frequent motivations for tattoo removal, thus viable methods and accessibility to tattoo removal programs are important. In addition, educational programs for adolescents about tattooing to reduce risks and promote dissuasion should be implemented.
BACKGROUND: Tattoo removal is a common request in dermatologic surgery practices. Conventional tattoo removal modalities consist of mechanical, chemical, and thermal methods, but these interventions may result in undesirable dermal damage, disfiguring scars, and pigmentary changes. objective: To evaluate the efficacy of topical imiquimod and tretinoin for the removal of tattoos in a guinea pig model. METHODS: Five albino guinea pigs (A–E) were tattooed with black, red, green, and yellow. Beginning 6 hours after tattooing, A received no treatment, B was treated with petrolatum, C had imiquimod cream alternating with tretinoin gel, D had imiquimod cream alone, and E received tretinoin gel alone. The animals were treated for 7 days. Biopsies of the tattoos were taken at 6 hours, 7 days, and 28 days. RESULTS: Control guinea pig B had normal-appearing tattoos with consistent histopathology on day 28. Guinea pig D, treated with imiquimod cream clinically, had no visible tattoo, consistent with greatly diminished or no dye evident on histopathology. Guinea pig E, treated with tretinoin gel, and guinea pig C, treated with combination tretinoin gel and imiquimod cream, had faded tattoos and moderate clearance of pigment on histopathology. CONCLUSION: In the guinea pig, the use of imiquimod was successful as a nonsurgical method of acute-phase tattoo removal, but was associated with fibrosis and the loss of dermal appendages.
Conference Paper
Background and Objectives: 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. Methods: 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. Results: 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. Conclusions: In a population of military recruits, tattoos were associated with predictable adverse health-risk behaviors. This represents an important opportunity for targeted preventive counseling.
Attitudes of health care providers and medical and nursing students (n=513) towards tattooed adults and adolescents were examined. No respondent group had mean scores reflecting a positive attitude towards tattooed persons. Overall, physicians (MDs) and registered nurses (RNs) rated tattooed people less positively than did students. Womens’ attitudes were consistently less favourable than those of men, especially towards tattooed professional women. Attitudes towards tattooed adolescents were generally less positive than attitudes towards the adult groups. Research has found that negative attitudes impact patient care. This study suggests that tattooed persons, especially adolescents, may be at risk of being negatively perceived when they seek health care. Increased efforts are needed to assure that those with tattoos receive non-judgemental and sensitive care.
The primary purpose of this study was to examine undergraduate students' attitudes toward women with tattoos. A basic scenario was written to act as the base description and the control stimulus. The independent variables size of tattoo and visibility of tattoo were manipulated. Attitudes were measured using the Semantic Differential (Osgood, Suci, & Tannenbaum, 1958), which was presented after the scenario. The Neosexism Scale (Tougas, Brown, Beaton, & Joly, 1995) and the Feminism and the Women's Movement Scale (FWM; Fassinger, 1994) followed. In our sample, 23% of women but only 12% of men were tattooed, which supports recent claims that women may be more than 50% of the individuals currently obtaining tattoos. Men and women both had more negative attitudes toward a woman with a visible tattoo than toward the other women in the descriptions. The size of the tattoo was a predictor of evaluation only for men and women who did not have tattoos themselves. Finally, participants with more conservative gender attitudes evaluated all women more negatively, beyond the effects already accounted for by gender differences. Future research directions are offered.
A total of 242 employers were surveyed over the telephone to assess their attitudes toward prospective employees with visible tattooing. Employers were divided into eight categories according to type of industry. Responses to the survey were tabulated and confidence intervals produced. It would appear that significant bias exists against the employment of persons with visible tattoos in the hospitality, beauty, retail and office sectors where less than 30% of those surveyed would employ a person with a tattoo. All industries except building and the public service admitted that they would be influenced by a visible tattoo in over 40% of cases.
Motivations for removal of tattoos may be similar among different populations. Our data support the Boston, Mass, report1 that tattoos applied impulsively in youth are regretted in later years. In a survey of 68 patients, 44 men and 24 women, requesting tattoo removal at the Bridgend Laser Clinic, Bridgend Mid Glamorgan, Wales,2 we found that 71% of patients had tattoos applied before 18 years of age. Forty-five percent of patients had applications because tattoos were perceived as fashionable, 22% because of peer pressure, 7% through "sheer stupidity," and 6% because they were in love. Only 13% were under the influence of alcohol or drugs at the time. Ten percent of patients regretted the tattoo immediately and 28% voiced remorse within the first month. The primary motive for removal of a tattoo was an overwhelming desire to improve self-esteem (48%), followed by removal of a socially stigmatizing and discrediting
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.