A Holistic & Global Look at Body Art (Body Piercing & Tattooing)

1. A Holistic & GlobalLook at Body Art(Body Piercing &Tattooing) Myrna L. Armstrong RN, Ed.D, FAAN Professor & Regional Dean, Highland Lakes Campus

2. Research Goals (1990-Present) • Describe the phenomenon • Determine risks (physical & psychosocial) • Promote informed decision-making • Research team since 1999

3. Research • Participants • Women • Adolescents • Soldiers • College students

4. Historically • Bible • Slaves • Holocaust • Blood Typing in US for War • Transplants – sole of foot

5. Trends . . . • Mainstream activity • Popularity sweeping the world • Media describe as risqué, carefree behavior • More creativity, especially piercing • Movement toward branding, suspensions, implants

6. An artist-customer regulated business with: • No money-back guarantee • government testing • samples with the procedure • Limited regulations and controls • AND, blood-borne disease potential.

7. Why? Body Art • Self-Identity • “makes me feel good, special, unique” Other reasons Affiliation Marking special occasions Religious markings

8. Body Piercing . . . . • Rate 33-50% • Not a difficult procedure • Hollow, lancet-point needle, 12-16 gauge • Jewelry should be Gold, Niobium, Platinum, Stainless Steel, or Titanium • Skin and site infections are common 17-28% • Removal: client-centered, usually scar tissue

9. Major concerns with body piercing: • The artist • The equipment • The environment • The invasive procedure (jewelry, technique) and after care.

10. Risks?? • Lack of documented risks does not mean risks do not exist, rather just not reported.

11. Recommendation for Piercing • Studio vs mall • Piercing guns: • Research/literature • Should be outlawed, but strong lobbyist action • Unable to sterilize • Crush surrounding tissue • Need further research

12. “Complete” site healing • Phase I Immediate • Phase II 6-10 months. Skin inside hole epithelializes • Phase III A year or longer. Hole “toughens up” • Continual portal for organisms

13. Body Piercing • Infections occur because: • The individual’s health • Contaminated procedure (hepatitis B & C) • Poor after-care • Type of jewelry

14. ?????Removing jewelry???? • Infections: Obstacle or portal for drainage • Procedures: Teflon post, suture, fishing line • Remember, you haven’t removed the reason they have it

15. Organisms & treatment Organisms: Staphyloccus aureus Pseudomonas aeruginosa B-hemolytic streptocci Treatment Dicloxacillin, clindamycin Ciprofloxacin (only >18 years of age)

16. Systemic Infections • Occur because: • Previous health conditions • i.e. endocarditis • Untimely medical attention Limited attention by health care provider

17. Cartilaginous ear piercing • Includes pinna, helix, and tragus • Area prone to infections • Left untreated, • necrotizing lesions, • deformities • Body image concerns

18. Naval piercings: • Site appeals to many, “invisible” • Often self-inflicted • Up to 45% infected • Clothing, sweat, and • “fuzzies” problems • Pregnancy

19. Tongue piercings: • American Dental Association • Aspiration, tooth, or nerve damage • Tend to “play” with jewelry • Speech difficulties • Other oral sites- lip & labaret • Gly-oxide ©, non-alcohol mouthwash

20. Nipple piercing • Different piercing sites for females & males • Infected or scarred • lactation ducts? • Avoid tight, • restrictive clothing • Breastfeeding

21. Genital Piercing Limited data/many myths Various piercings for males & females. • Major reason: • Sexual Enhancement • Women: also reclaim body w/ rape & abuse

22. Variety of Male Genital Piercings Ampallang Apadravya Guiche Prince Albert Dydoe Hafada Foreskin

23. Creativity vs self-mutilation • Beyond usual sites • Lack of knowledge regarding location • For example: vulva, chest, knuckles, 3-D implants

24. Tattooing . . . • Multiple injections of pigment: • (non-FDA approved, “lack of purity/identity,” • i.e. car paint and printer’s ink) • 50 to 3,000 times per minute • 1/64 to 1/16th deep to epidermis junction • using 1 to 14 solid needles on a single bar • Both body and cosmetic tattooing popular

25. Tattooing . . . • Transcends gender, • socioeconomic • groups and • occupations. • Incidence: • 13-17 years old = 15-19% • 18-30 years old = 19-25%

26. Major concerns • The artist • The equipment • The environment • The invasive procedure (pigment, technique) and after care.

27. Adolescents with tattoos • Can be amateur or studio tattooing • Some start at an early age, tend to have impulsive decision-making, group pressure, undue stress/crisis, and lack of support. • Select unconcealed sites and big designs.

28. Adolescents with tattoos . . . . • Dissonance w/ self-identity vs deviancy • Believe they have a right to a tattoo • Determined, will obtain, regardless of costs, regulations, or risks

29. Influences • Image – yes • Identity – yes • Friends – yes • Family - no

30. Tattooing, after care/problems • Risks are limited, but present • Reactions to pigment • Photosensitivity • Hepatitis B and C • Psychosocial concerns

31. Tattoo Removal • “semi "permanent (“2 x 2” cost = $50, removal = $1250 ++) • Costly and time consuming • Need the right equipment, BUT • Pigment: (non-FDA approved, “lack of purity/identity”) • Black/blue tattoos – satisfactory response • Yellow, red, green - challenge

32. Tattoo Removal • Freedom2Ink-designed by MD, removal 100% • Two studies re “Motivation for Removal” • Recent study: more women because of more negative comments home, work & school. • Suggest strategic placement for control

33. Cosmetic Tattooing • Very popular – all ages 20-90++ • Check the Yellow Pages • Eyebrows, eyelids & lip liner • “Natural appearance • Limited literature and complications

34. Tattooing in Prisons • More research done outside of US • Difficult to conduct here in US. • Illegal activity, high risk population • Recent research: 58% of those tattoo were HCV antibody-positive. • Many use same needle and/or ink • Type of products used for needle and ink • Question of “prison tattooists”

35. How about this?

38. Branding . . . • Many non-traditional objects used, (coat hangers, paper clips, etc) • Thin strips of surgical stainless steel Several “strikes” are done, infections are common

39. Applicable health education: • Their belief: a right to have body art • Encourage belief of self ever-changing. • Emphasize direct involvement • with health decisions and • informed decision-making. • Removal-applicable approaches

40. YOUR Response • Non-judgmental approach from ALL • Procurement “without” our blessing • Avoid “no” and scare tactics • Learn as much as you can • Demonstrate we know our stuff!! • Proactive education