One of the most-frequently-read series of articles on this blog talks about nickel allergies.  Reader Stacey has just added an excellent and informative post to a previous message and I think everyone who is interested would find it well worth reading.  You can find the message and all its comments here.
photo credit: icedtia.

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I got my calendars mixed up, and thought that the Diabetes Expo and the Ink & Iron tattoo show were both in Long Beach last weekend. (Ink & Iron’s next month.) I thought it’d be an interesting combination of venues, and people could go from one to the other without too much trouble (Diabetes Expo at the Convention Center, Ink & Iron on the Queen Mary).

People who have chronic diseases can’t be as carefree and casual about getting tattoos as perhaps they’d like to be.  While it might not be a case of “For every action, there is an equal and opposite reaction” for everyone, certainly the process of invading your skin with foreign substances can stress some people’s bodies more than others.  Diabetics don’t heal as fast.  People with autoimmune disorders might be pushed into a flare-up.  People with allergies, especially nickel allergies, might have inflamed skin for years.  People with latex allergies should definitely make sure the artist is using some other kind of gloves.

I have three tattoos, and I’m a Type 2 diabetic.  I also have nickel allergy.  I got my first tattoo before I got my diabetes diagnosis, but I went to the tattoo parlor fully informed the second and third time.  Interestingly enough, I was never asked about health conditions by any of the artists who inked me.  In retrospect, I think I should have been.  I don’t think it would have changed anything, but (again in retrospect) I think it’s only right that the artist should know that much about the person he/she is working on. If I get another tattoo (still under consideration) I’ll tell the artist up front if he or she doesn’t ask.

And, of course, people with chronic medical conditions should absolutely do some research before getting body art or piercings.  The more we know ahead of time, the better we can be prepared for possible problems afterwards.  If I’d known there was a connection between tattoo ink and nickel allergy, I might have changed the colors of my designs (although as it turned out, I had no problem with the blue or green colors, only with the red which does not contain nickel).  Knowing that diabetics heal more slowly would not have stopped me from getting any of my tattoos, but knowing that I had diabetes did inspire me to make sure my blood sugar levels were well under control before I got inked.

Have you had to take your health into consideration before getting inked?  Have you been asked about health problems by your artist?  How did you handle the issue?

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People get asked if their tats are going to sag or stretch, or get told they shouldn’t get inked precisely because the skin is inevitably going to sag or stretch.  I would venture to guess that most of us don’t give a hoot about that, at least when it comes to deciding to get tattooed.  But in general…  well, we should be concerned.

Like most people my size, I’ve gained and lost weight many times over the years.  I was thinking of it as more or less inevitable.  But during the last six months I became aware of something.  Both my husband and son lost a noticeable amount of weight.  They didn’t change what they ate.  What they did change was how much they walked around.  (Or, rather, their jobs changed that for them.)

Could it really be just as simple as that?  A lot of the supermarket magazines have certainly said so for a long time.  There’s never a cover that doesn’t say “walk off the weight” on it somewhere.  I know when I was working at the big box store and on my feet all day, I lost 50 pounds without doing anything different at all.  So it wasn’t as though I didn’t know what was good for me.

This year, I have done two things.  I got a copy of The Step Diet, and I got a FitBit.  The Step Diet comes with its own basic pedometer, and I used that while I was waiting for my FitBit to arrive (more about the FitBit in a moment).  The book lays out a simple plan for getting more exercise in a day, and gives you goals to consider.  It also has a very simple plan for cutting down the amount that you eat, painlessly.  It’s not, in the usual sense of the word, a “diet” at all.  Head on over to your local public library and see if they’ve got a copy (it likely won’t have the pedometer attached) and see what you think.

The FitBit is a brand new gadget, that uses some of the same technology as a Wii controller.  It can tell you how many steps and how far you’ve gone in a day.  It can also tell you how long you’ve sat on your ass doing nothing.  I needed that.    It can tell you how long and how restfully you’ve slept, if you want.  It can tell you how active you’ve been.  It’s also noticeably pricier than a plain old pedometer.  However, for me, that’s more motivation.  I sure wouldn’t want to let $100 go to waste, and I bet that’s true for a lot of people.

So, while my tats are not on skin that’s likely to stretch or sag much before I kick off, I’m doing my best to turn the body they’re on into something smaller and fitter.  And honestly, it’s been painless so far.

Have you done anything to lose weight or get in shape that you’d like to share with the rest of us?  I for one can always use more suggestions on how to get a move on and display my ink on a better body.

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I just went through one of my annual inspections.   Standing there buck nekkid in front of the doctor is no easy thing for me, but the alternative would be a lot worse.   I’d just like to take time today to ask all my readers to be vigilant.   Our beautiful multicolored skins might make it a little more difficult to spot the changes that could indicate the onset of skin cancer.

Once a month, stand in front of a mirror and look yourself over.   Enlist someone to take a good look at your back, since most of us can’t see the whole expanse of it clearly (my husband was the one who discovered the melanoma on mine).   Check the palms of your hands and the soles of your feet.   Use a mirror to inspect your private parts (yes, you can get moles and melanomas there, too–years ago I had to have a mole removed that made sitting down rather uncomfortable for several days).

Do you have red or scaly or crusty places that don’t seem to ever go away?   Get them checked.   Most times it’s just a matter of irritation or dry skin, but it could be an indication of skin cancer.   For melanomas, use the mnemonic ABCD.

• A: Appearance, or Asymmetry.   One side looks different from the other.
• B: Border.   The shape of the spot is irregular and sometimes the borders are not distinct.
• C: Color.   The color is uneven or blotchy.
• D:   Diameter.   If it’s bigger than a pencil eraser it needs to be checked out.

Now, a mole could have one or more of those signs and still not be cancerous (that was the case with the mole on my rear end) but why take chances?

I’d like to keep all my readers as long as possible and I want to be here to keep typing likewise.   Take time today to be extra careful with your beautifully decorated skin, OK? Here is a short guide from the American Melanoma Foundation to show you how they recommend looking at your skin.

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Tattoo ink is not an inert substance.  The pigments in it can cause allergic reactions, and unfortunately there really is no perfect way to tell whether you’re going to react to any particular color.  You could have the artist do a few dots of each color in an inconspicuous place, wait a few days and go back to get the tattoo, but just because you don’t react to a small amount of the ink doesn’t mean you won’t end up with problems when a lot of it goes into your skin.  And then there’s always the possibility that the small amount didn’t cause problems itself, but it sensitized you against any further applications.

I had a nice tattoo applied to my ankle at a tattoo show on the Queen Mary.  It was an impulse decision, something I ordinarily advise strongly against.  But it definitely made a mediocre already-existing design look better, so I went for it.  I’m not sorry I did.  But that’s how I learned I’ve got problems with red ink.  Fortunately, as you can see in the photo, there’s not a lot of red ink in the design.  But those small red areas remained swollen, itchy, and intermittently crusty for close to two years after I got the tattoo.  Nothing seemed to help, although Benadryl makes some nice anti-itch lotion that made it quit bothering me for a while.   I put Nivea cream (the thick stuff in the small blue tin) on it regularly, and finally my body and the red ink agreed to co-exist peacefully.  But that reaction has made me somewhat hesitant to go get any more tattoos.

Your own health may also be an issue.  If your immune system isn’t up to par or if you heal slowly (as many diabetics do) it will definitely affect your ink.  Be sure you let your artist know about those conditions before he or she starts work.  It might be that he or she will not want to do the work if the healing will be compromised.  This is something that you and the artist will have to deal with.  No matter how eager you are to go ahead with the tattoo, the artist has to think of the possible consequences for both of you if things go wrong.

Some people worry about infections or HIV.  Going only to a reputable shop will reduce the likelihood of that to the bare minimum.  Tattoo needles are used only once, on only one person.  The rest of the equipment is sterilized at high heat in an autoclave.  The artist wears gloves and everything that touches your skin is disposed of after the work is done.  It’s as close to sterile conditions as human ingenuity can make it.  This is not to say you still can’t get infected after you leave the shop (we live in a germ filled world, after all) but the likelihood of the needles being the source of the contamination is vanishingly small.

I’ve written more extensively on tattoo health issues in the past, and I invite you to check out that series of messages starting here.    I’ve also written about the surprisingly common problems with nickel allergies here, here, and here.

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Although like most things nickel is a bit more expensive than it used to be, it’s still inexpensive enough that it’s a very common element in jewelry.   And it is quite common (and easy) to be sensitized to it, especially when it’s in jewelry that goes into the skin.   I got sensitized to nickel by wearing inexpensive earrings after my first ear piercings.   I’ve since had earrings from Tiffany’s in New York that had enough nickel in them to make my ears itch.     Just because it’s high end doesn’t mean it’s nickel free.

What does this mean for tattooed people?   Well, as I mentioned before, nickel can be a component of tattoo ink, especially the blue and green shades.   If you’re already sensitive to nickel, you could end up with serious problems if that’s the kind of ink you get.   And if you’re not already sensitive to nickel, the exposure to those inks could rile up your system to the point where any further exposure to nickel-containing ink or jewelry would be a problem.

It is not easy to tell which inks contain nickel.   It might or might not be listed on the label and even the best tattoo artists might not have any indication that the ink has nickel in it till it’s too late.   That is not their fault; the manufacturers should be upfront about potential allergens in their products.

So, what to do?

Cosmetics manufacturers always advise people to do a patch test before applying any new product to vast expanses of skin.   Granted, this is not quite as easy to do with permanent tattoo ink, but the procedure can be modified to suit the purpose.   If you know already that you are sensitive to nickel, it is vital that your artist know about that in advance.   Save yourself a lot of misery and pay your artist to do a small trial patch of each color of ink somewhere inconspicuous.   Wait a week to see what happens.   If you have no reaction, then it’s likely you will be OK with that ink and you can go ahead with your design.   Better to delay the gratification of getting new ink, than to have a weeping, ugly mess on your skin for ages afterwards.

If you aren’t already sensitive to nickel, your first tattoo will probably be safe, but you don’t know if it will sensitize you.   About the only way you’ll know for sure is if your earrings and watch start itching you like crazy afterwards.   If you want to be absolutely sure the ink is safe, talk to your artist about doing a patch test first.

For allergies to nickel jewelry, if the item is something you for whatever reason don’t want to throw or give away, you can coat the part that touches your skin with clear nail polish if the item is small.   For larger items, a small can of spray lacquer or fixative from an art supply store can be used to seal the surface and keep it away from your skin.   You will have to reapply the protective coating from time to time.

Here is an informative article from the American Osteopathic College of Dermatology about nickel allergies, if you’re interested in further reading.

photo credit: Mad African!

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The last tattoo was slow to heal, but I believe that was more due to a reaction to the red ink. Diabetics don’t heal as quickly as other people, and the slow healing can be even slower if the person’s blood sugar isn’t under good control. It’s not a complete barrier to getting inked, but it’s something to take into consideration. Slower healing means more chance of infection, scarring, and generalized messing-things-up.

This week I started on insulin at bedtime because my blood sugar was NOT under good control. Something went haywire somewhere over the last six months and I was getting higher and higher readings and having little success getting back to business-as-usual with my former combination of diet, exercise, and oral medication. Many Type 2′s think of going on insulin as somehow having failed. I don’t see it that way. It’s a lot easier to adjust the dosage of insulin than it is to try to monkey around with oral meds. I mean, how many times can you break a pill before you’ve got nothing but dust?

As I watched my readings get higher and higher I knew that it would be a very bad idea for me to get any more tattoos. High readings mean slow healing, and since I’m leaning very strongly toward having a more-visible tattoo next time (if there is a next time) I definitely do not want to have something that will swell, itch, weep, crust, and look like space-alien skin for months. So I have even more incentive to get the insulin dose right and keep things in equilibrium.

Doing a Google search on “tattoo diabetic” brings up a lot of interesting articles including several on the concept of having your Medic Alert information tattooed on your skin so you won’t have to wear a tag. Of course, if your medical condition makes tattoos a bad idea in the first place…. um, all in all, I’d rather just keep wearing my removable tag.

Do you have health issues that make you wary of getting more ink?

photo credit: mcbill

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Which is a good thing, because they really are the worst that can happen: Tetanus, MRSA, hepatitis and HIV. All of them come from unclean conditions and a lack of proper precautions. While no one can guarantee 100% that you won’t end up with serious health problems from getting tattooed, starting out with a reputable artist and making sure you take care of the tattoo properly afterwards can put you pretty close to that hundred percent.

If you’re getting a homebrew, gang, or prison tattoo… you’re on your own.

Tetanus

It never dawned on me that one should be sure to have an up-to-date tetanus shot before getting a tattoo. As it happened, I had gotten one only a few years before (they are supposed to be good for ten years) so I was not at risk. But if you don’t know when your last shot was, or don’t know if you’ve ever actually had one–time to check with your doctor. People who are my age (born in the 1950s) might or might not have gotten immunized as children. People younger than that most likely got the full series of immunizations–but they have to be kept up to date and booster shots given every ten years or so for the immunity to remain strong. Getting a shot might be inconvenient, but getting tetanus is far, far worse. You don’t have to step on a rusty nail to get it. Here is the official FDA page that talks about tetanus and how to prevent it.

MRSA

MRSA is the abbreviation for “methicillin/oxacillin-resistant Staphylococcus aureus.” While Staphylococcus bacteria have probably been around for longer than humans have, it’s only in recent years that the antibiotic-resistant form has become common enough to be a serious health concern. It got its start in hospitals, and the most common place to get infected by it remains health-care facilities, but that doesn’t mean someone who isn’t in a hospital or nursing home can think they’re home free. “Staph” bacteria are everywhere–you’re probably carrying billions of them around right now even though you are perfectly healthy, and you may even have the MRSA variant without knowing it. It isn’t till they get into your body through a wound of some kind that they can cause problems. And guess what a tattoo is?

All kinds of staph infections produce small red bumps that can quickly turn to deep abscesses. It goes without saying that if you see anything like that, run, do not walk, to get medical attention. You don’t want to take chances with your life, because make no mistake about it, MRSA can kill you. Ask your doctor to test the wound for the presence of MRSA before prescribing treatment. Ordinary antibiotics that are used to treat staph won’t help and can make the problem far worse. Here is a good, clearly written article from the Mayo Clinic that should give you an idea of what MRSA is all about.

Hepatitis

Hepatitis comes in several variants, but the one most commonly transmitted through unclean needles is Hepatitis B. Again, if your artist uses proper sterilization procedures and the shop is kept clean, your chances of getting Hep B are pretty close to zero. However, again, since you have an open wound, contact with other people might be a problem, the more so because something like 30% of Hep B carriers have no symptoms of the disease themselves. While there is a vaccine available, many people have never been vaccinated and are thus at risk of infection. Treatment is available, but far better never to contract the disease in the first place. If you haven’t gotten the Hep B vaccine, ask your doctor about it. You will have to wait before getting your tattoo, to allow the vaccine to become effective. Here is a fact sheet from the CDC about Hepatitis B.

HIV/AIDS

The good news is that according to everything I’ve read, there has never been a reported case of HIV being spread by a tattoo parlor in the USA. Again, if you’re letting someone other than a tattoo artist in a tattoo shop where proper sterilization is practiced have his or her way with your skin, what happens to you after that is up for grabs. They may tell you it’s perfectly fine to just wipe things down with alcohol or boil them for a few minutes. Don’t fall for that. It’s obviously also not perfectly fine to just put ink on your skin and have at it with a sharp instrument. It doesn’t matter how many of those National Geographic shows you’ve seen about some teenager out in the jungle getting who-knows-what cut or punched into his or her body with no apparent concern for germs or disease, and living to tell the tale just like the people who are punching the ink or cutting the skin. You don’t have to prove yourself that way. Getting a homebrew tattoo may be inexpensive; the real cost may be your life. Here is what the CDC has to say about the risks of HIV from tattooing.

Conclusions

Avoiding health problems when you get tattooed is mostly a matter of simple common sense. Spend a little time checking things out. Don’t take risks with your newly inked skin. Keep yourself and your surroundings clean during the healing process. Make sure your immunizations are up to date. A little time spent on things like that can keep you safe from a lifetime of misery. Doesn’t it make sense to just take care?

Starting next message, I’ll talk about happier subjects.

photo credit: geishaboy500

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One look at any tattoo artist’s portfolio that includes photos of brand new tattoos will show you that the entire area around a
tattoo is bright red.   This is inflammation, and shouldn’t be disregarded.   First and foremost, do not let your artist put plastic wrap on your tattoo.   It will only seal in contaminants and keep the newly punctured skin from protecting itself in the only way it knows how, by forming a scab.   Make sure the artist covers the new ink with a gauze bandage.   Although most artists say you can take the bandage off when you get home, my own personal recommendation is that you leave it on overnight.   That will keep your new ink from being rubbed by whatever you sleep in, or your sheets.
It’s very likely that the skin around and under your tattoo will be swollen after the work is done.   This is a normal reaction to trauma, and it should go away after at most a day or so.   If the swelling increases, or won’t go away, it’s time to see a doctor. You may be having a serious reaction to the ink, the artist’s latex gloves, the ointment or cream that you’ve been using on the skin, or something else.   It may be that you’re finding out the hard way about an allergy you knew nothing about up till then.   (I found out about the fact that my body doesn’t like red ink like that.)

Since the tattoo process punctures the skin, it’s almost inevitable that you will bleed while the work is being done.   Any reputable artist knows how to deal with that and will wipe your skin with something that will clear away the blood.   The liquid used varies from artist to artist.   Some use plain distilled water, some use an antiseptic of some kind.   It would be a good idea to ask the artist what he or she uses so you will know if you react to it.   Your skin will probably continue to bleed a little bit after the tattoo is finished.   If it’s still bleeding more than 24 hours later, call the artist and see what he or she recommends.

The oozing usually continues for several days.   While you don’t want to rebandage the inked area after you’ve taken off the bandage, it’s a good idea to wear old clothing that you won’t worry about if the ink comes off a bit or if the clothing gets oozed on.   When I was getting ready to have my dragon tattoo put on my back, I went to the local thrift shop and bought several shirts for a couple bucks each.   They all buttoned up rather than pulled over my head, and had busy enough patterns that if the shirt got oozed on, it wouldn’t be glaringly apparent.   I wore those shirts while the healing process was going on.   They were nice enough to wear to work, but for a couple bucks apiece I could consider them disposable if need be.

And the new tattoo is going to itch while it’s healing.   Don’t scratch.       Seriously, you do not want to do anything that might pull off or crack the newly formed scab.   Some people say to just slap the area lightly.   That does work.   You could also use a topical antiseptic/anaesthetic like Bactine Pain Relieving Antiseptic Spray.

Those are the most common and least dangerous health issues that newly tattooed people encounter.   In the next post I’ll take up less common but more serious things to be concerned about.
photo credit: kitsune tsuki
photo credit: rbatina

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Don’t just look at the flash on the walls or the artist’s portfolio and walk out after picking a design. There are more important things to look at, believe it or not.

• Is the shop clean? Do the floors look like they’re washed, and is the furniture in good shape? What does the artist’s work area look like? Can you see debris lying around? What does the waiting area look like?
• Is smoking allowed in the shop? In some states smoking is prohibited in all places of business, but if your state isn’t among them, and there are smokers in the shop, you might be better off going somewhere else. Tobacco smoke puts all kinds of noxious chemicals and particulates into the air and it’s impossible to keep them from spreading throughout the whole interior. You don’t want that stuff being imbedded in your skin along with the ink.
• Are the inks dispensed into single-use containers that are discarded after each tattoo? Are the needles used on one person only, and discarded in a proper “sharps” container after use?
• Does the shop have proper sterilization equipment, especially an autoclave? No reputable tattoo artist will object if you ask about sanitary procedures.
• Is the tattoo equipment covered with plastic during the procedure and is that discarded afterwards? Blood is shed during tattooing, and you don’t want the artist using equipment that has been used unprotected on someone else.
• If possible, stick around long enough to see how the artist cleans up his or her work area after the tattoo is finished. All surfaces should be wiped down with disinfectant and all materials should be put away and ink cups discarded. An extra half hour watching the artist might save you a lifetime of grief afterwards.

If you’re sure you’re in good shape and the shop is clean, you’ve taken the most important steps toward getting a safe tattoo. But sometimes, things happen that you can’t prepare for. I’ll talk about those in the next posts.

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