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There are some important things one should know before getting tattooed

By Thaddeus C. Hinunangan, MD

As a gangly seventeen-year-old, I once bravely walked inside a Quiapo tattoo parlor to get inked. The shop was located along the dusty Recto Ave., with a neon sign saying T TOO as the “a” and “t” bulbs looked burned. The walls were covered with sketches and there were full ashtrays everywhere. I was greeted by a long haired tattooed fellow with piercings, who led me to a seedier room upstairs.

I was so close to giving up but I did an hour’s pep talk with myself. The scene was straight out of an indie flick, just before the antagonist murders the unsuspecting victim. I handed out my design to the tattoo artist, it was a scarab beetle with its wings outstretched. I had copied it from an Egyptian book.

Next thing I know, I was seated on a Monoblock chair trying to keep myself from showing any emotion. The incandescent bulb was swinging from side to side as the tattoo artist created patterns using the tattoo machine. I didn’t even notice if he changed needles because I felt so dizzy back then.

Only seven years after, would I realize how foolish I was at the time. Tattoos were expressly forbidden from the Nursing school I studied in so I had to remove the tattoos- all three I had, with laser. The cost and pain of removing the tattoo was a hundred times more than having one. Now, every time friends tell me they want to get inked, I always give these four basic considerations:

1. What are the health risks in getting a tattoo?

Tattoos can be a way of expressing oneself, however unlike watercolor painting or maybe monochromatic drawing, they involve poking the skin with needles to embed the ink to the dermis layer of the skin. Needle stick injuries are a serious risk that can cause transmission of blood borne diseases such as Hepatitis or even human immunodeficiency virus (HIV).

When looking for a legitimate tattoo artist, ask for their certification and credentials first. Most legitimate tattoo shops are certified by the Department of Health and are members of an association for tattoo artists. They should sterilize their equipment either with dry heat or autoclave, and needles should be disposed after use. Look around the shop, usually the sanitary practices give clues if they are compliant with standards. If the place looks seedy and if you never saw them open a fresh, sterile needle, say NO.

2. Don’t scrimp on design/cost.

Most of the time, people get what they pay for. Legitimate tattoo artists take meticulous time with the design and the final look on the client. Most tattoos start at PhP 1,500 for tattoos with the size of two by three inches. Cost may also vary depending on the complexity of design, colors and pigments used, and even the artist’s reputation. Some artists charge per hour instead of the size.

Remember, tattoos are forever etched on your skin so make sure the design is correctly and beautifully rendered. You will regret an amateurish drawing just because you wanted to save up on artist’s fee.

3. Is it painful? Yes, of course!

Any procedure involving needles is no walk in the park. The pain in tattooing feels like someone hitting you continuously with a small hot rubber band. It also varies per site, generally the more adipose tissue (fat) you have on that area, the lesser the pain since the subcutaneous fat would function as cushion. The bonier the area (like nape of neck or near bony prominences, etc.), the harder it hurts. A good trick on how to test the sensitivity of the area is to Inked 2finely pinch it with your fingers.

Removing the tattoo is even more painful. The laser method will cause blisters that will eventually burst. Some that use strong exfoliants will cause chemical peeling and even burns.

4. Removing a tattoo will cost more than getting it.

When seafarers who previously have tattoos get accepted into an agency which forbids tattoos, they most invariably will have their tattoos removed for the sake of employment. The best way to remove a tattoo is by laser, which is usually done by Dermatology clinics with very expensive equipment. My tattoo which covered my right arm cost PhP 100,000 for the first session, PhP 50,000 for the second session and PhP 30,000 for the third session, before the pigments will be completely gone. My tattoos had cost PhP 1,500 when I got it in Quiapo. Do the math.

The use of laser is still the gold standard in tattoo removal. Laser works by breaking down the pigments into smaller pieces and allowing macrophages (monocytes, a type of white blood cells) in the blood to engulf the pigments during the inflammatory process.

Prior to the procedure, the eyes are protected with special tinted glasses similar to swim goggles. The laser feels like getting struck by hot rubber bands on the skin, and the cost is computed per impulse of the laser (or every time the laser is fired). Even with topical anesthesia applied prior to the session, the area will still feel sore after the session. Antibiotics are applied afterwards. For the next few days, blisters distended with serous fluid will form. Then eventually will heal and scab. It took three sessions for my tattoos to disappear.

Other methods include tattooing over the tattoo with a skin tone ink. I haven’t actually seen how the final product looks but other methods like using chemical peel to remove tattoos can be disastrous and very painful. Some even have small tattoo sexcised and the remaining skin sutured. These methods may even cause keloid scars which grow beyond the borders of the tattoo itself.

Tattoos are definitely one of the most unique ways to express oneself. In some cultures it is a mark of courage or even prestige. However, careful thought must be put into it before committing to being inked.

“Careful thought must be put into it before committing to being inked”

July 2017 Health and Lifestyle

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