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Updated: July 14, 2013 00:37 IST

Tattoo may be the in-thing but your problems won’t be skin-deep

Dr. Tiny Nair
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If our skin had a political affiliation, it would say: ‘We want justice, we are not a canvas’

I consider myself a liberal father. I believe that my children have imbibed good moral and ethical values right from childhood. So, normally, my kids never ask for anything that I need to refuse. But this was an exception.

Most of us consider human skin just a tunic but it is actually much more than a simple wrapper. It shields and protects, controls the temperature and water content of the body, manufactures some important vitamins and conveys sensation, whether the coffee cup is too hot or the handshake too cold.

Most of the complex structures of the skin, like the pain receptors, the nerve endings, and the sweat gland complexes, are located deep inside a layer called the ‘dermis’.

The dermis is protected by a covering, ‘epidermis’, a fast growing layer, the top of which flakes off continuously, acting as a bumper to the dermis. It bears the brunt of dailylife traumas like rubbing, scratching and bruising. Normally, nothing gets past the epidermis, excepting a bullet wound in the war-field, a knife attack from a backstreet assassin or the more common injection prick from the nurse.

Imagine the quite sleepy dermis waking up one fine morning to an unknown intruder. A dark blob of a complex chemical, delivered deep by a sharp needle, at a speed of 50 times a second, a plan more sinister than the dermis had ever imagined.

The overwhelmed dermis does what it is meant to do. It sounds the fire alarm. Local blood vessels are dilated; cells that fight infections are recruited and quickly transported to the site. Suddenly, the quiet town of dermis turns into a battlefield. Neutrophils, phagocytes and macropahges, all the top ranking anti-terrorism cells move in, with an idea to gobble up and digest the intruder with strong, intracellular enzymes. Human immune cells are programmed to do that. But human plans are much more sinister.

The tattoo ink is designed to be an indestructible chemical, resistant to intracellular degradation. The activated immune cells gobble up the ink and die.

The dead cells contain the ink inside their bodies. The fibroblasts form a strong envelope, to contain the damage, making sure the dye would not fade with time. But the non-degradable ink remains inside those cells, permanently. The colour of the dye in a bizarre pattern adorns the delicate skin of our kids, “but ohh dad, its so cool”.

Tattoo done in an aseptic ‘licensed,’ ‘hygienic’ parlour by an ‘authorised’ specialist is considered safe in the U.S. and the U.K. But even the U.S. Red Cross prohibits a person who has received a tattoo from donating blood for 12 months, while it is six months in the U.K., just to make sure that you have not acquired a blood borne infection. There are chances of infections like hepatitis and HIV if disposable needles are not used. In 1995, after more than 13,000 cases of tattoo associated hepatitis made headlines, licensing of parlours became stricter in the U.S. In 2006, the Center for Disease Control (CDC), Atlanta, Georgia reported 44 cases of antibiotic resistant staphylococcus infection (MRSA) from unlicensed tattooists.

As long as an approved dye is used, allergic reactions will be rare. But many coloured tattoo dyes use mercury and azo whose safety is questioned. Some traditional tattoo inks contain metallic salt including toxic lead. It is estimated that up to 20 micrograms of lead may be present in a stamp-sized tattoo. It is estimated that 40 per cent of the colours used for tattoo in the U.S. and Europe are not approved for cosmetic use.

Metallic salts in tattoo can interfere with MRI scanning where strong magnetic fields used for scanning excite the metallic molecules. Burns, bleb and skin peeling of the tattoo area after MRI scanning have been reported. In India, with a lax health licensing system, where we are trying to fight needle recycling and fake medicines, tattoo licensing is a non issue.

Finally, in the era where change is a norm we expect fashion to change — dress, shoes, jewellery, hairstyle, everything. Cut hair would grow, new dress would replace old ones, recycled jewellery will give you the latest look, but the pigment delivered deep inside your dermis will not, unless you are ready for another painful, expensive and long session to undo the tattoo by laser treatment.

A fingernail sized tattoo might need 5 to 10 sessions of laser therapy to remove it, costing Rs. 500 to 1000 per session, taking up to 12 weeks, with variable results.

So outdated or not, it will be there for life. Be ready and prepared to explain that skull and snake stuff to your spouse, your kids, and perhaps a couple of decades later, to your grandchildren.

If skin had a political affiliation, it would have put up a poster “We want justice, we are not a canvas.”

This article changed my daughter’s mind, at least for now. Why not try it on your kid?

(The writer is Head, Department of Cardiology, PRS Hospital, Thiruvananthapuram. Email:


The ink will always be awesome!July 14, 2013

More In: Open Page | Opinion

I think the mehendi is a perfectly fine and healthy alternative to the permanent tattoo
. So yes, I would also unquestionably deny this to any of my kids.

from:  Sanket Korgaonkar
Posted on: Apr 2, 2013 at 08:57 IST

A very thought provoking, must-read article. Thank you Dr. Tiny Nair.

from:  Nathan TPS
Posted on: Apr 1, 2013 at 07:47 IST
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