Tattoos & Body Piercing’s

1. Tattoos & Body Piercing’s

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

3. Tattoo History cont. • 1700 Japan - escalated the tattoo to an aesthetic art form. - At that time, only royalty were allowed to wear ornate clothing, so as a result of this the middle class adorned themselves with elaborate full body tattoos. • Ancient Japanese also marked criminals - 1st offense marked w/ line across forehead • 2nd was marked by adding an arch • 3rd marked by another line • Together the marks formed the Japanese character for “dog.” (2500 year old Pazyryk mummies)

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

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

6. Psychosocial Issues Elisa Ornelas, LMSW

7. Medical Issues • Related to Hemophilia • Related to other Health Concerns

8. Hemophilia Issues (Tattooing) • Bleeding can be an issue - Only a superficial puncture with needle, no risk for muscular bleeding • Hepatitis C & HIV - Is this really an issue? Magician: David Blane

9. Tattooing & Hepatitis C • Editorial of Research Study done by Dr. Robert Haley (epidemiologist – Univ. of TX Southwestern Medical Center at Dallas) cited in Dermatology Nursing, August 2001, by Rachel Franz, BSN, RN • Study found 1 in 9 risk of Hep C infection, in people who had tattoo done at comm. Parlor than those who didn’t have tattoo. • 626 patients studied, 113 had tattoo. 22% w/ tattoo had Hep C.(52 (33%)of these patients who had acquired tattoo in comm. Parlor had Hepatitis C) • Only 3.5% of these patients without tattoo had Hep C. (Few tattoo assoc infections could be traced to injection-drug use, transfusions or other known risks. • People w/ several tattoos or complex / lg tattoos had increased risk of Hep C. • People with white, yellow, orange or red pigments in their tattoos were more likely to have Hep C than those w/ only black pigment.(char. Of tattoo done in commercial parlor) • Most importantly, commercially acquired tattoos accounted for more than twice as many hep C infections as injection-drug use. This meant that it may have been the largest single contributor to the nationwide epidemic of this form of hepatitis.

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

11. Body Piercing and Hemophilia • Risk of Bleeding • Damage to Teeth & Gums • General Infection • HIV & Hepatitis C risk

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

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

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

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

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

17. What’s our Role? • Educate • RE: risk of viral & bacterial infections • Risk of bleeding with body piercings • If they’re going to have a piercing, then tell them to give factor first (because they’ll probably do it anyway It’s their body and they can do what they want with it, but they have to be responsible for it also.