A Holistic & Global
Look at Body Art
(Body Piercing &
Tattooing)
Myrna L. Armstrong
RN, Ed.D, FAAN
Professor & Regional Dean,
Highland Lakes Campus
Research Goals (1990-Present)
Describe the phenomenon
Determine risks (physical &
psychosocial)
Promote informed decisionmaking
Research team since 1999
Research
Participants
Women
Adolescents
Soldiers
College students
Historically
Bible
Slaves
Holocaust
Blood Typing in US for War
Transplants – sole of foot
Trends . . .
Mainstream activity
Popularity sweeping the world
Media describe as risqué, carefree behavior
More creativity, especially piercing
Movement toward branding, suspensions,
implants
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.
Why? Body Art
Self-Identity
 “makes me feel good,
special, unique”
Other reasons
Affiliation
Marking special occasions
Religious markings
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
Major concerns with body piercing:
The artist
The equipment
The environment
The invasive procedure (jewelry,
technique) and after care.
Risks??
Lack of documented risks does
not mean risks do not exist,
rather just not reported.
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
“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
Body Piercing
Infections occur because:
 The individual’s health
 Contaminated procedure
(hepatitis B & C)
 Poor after-care
 Type of jewelry
?????Removing jewelry????
Infections: Obstacle or portal for
drainage
Procedures: Teflon post, suture,
fishing line
Remember, you haven’t removed the
reason they have it
Organisms & treatment
Organisms:
Staphyloccus aureus
Pseudomonas aeruginosa
B-hemolytic streptocci
Treatment
Dicloxacillin, clindamycin
Ciprofloxacin (only >18 years of age)
Systemic Infections
Occur because:
Previous health conditions
i.e. endocarditis
Untimely medical attention
Limited attention by health
care provider
Cartilaginous ear piercing
Includes pinna, helix, and tragus
Area prone to infections
Left untreated,
necrotizing lesions,
deformities
Body image concerns
Naval piercings:
Site appeals to many, “invisible”
Often self-inflicted
Up to 45% infected
Clothing, sweat, and
“fuzzies” problems
Pregnancy
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
Nipple piercing
Different piercing sites for females &
males
Infected or scarred
lactation ducts?
Avoid tight,
restrictive clothing
Breastfeeding
Genital Piercing
Limited data/many myths
Various piercings for males & females.
Major reason:
•Sexual Enhancement
Women: also reclaim
body w/ rape &
abuse
Variety of Male Genital Piercings
Ampallang
Dydoe
Apadravya
Guiche
Foreskin
Prince Albert
Hafada
Creativity vs self-mutilation
Beyond usual sites
Lack of knowledge regarding location
For example: vulva, chest, knuckles, 3-D
implants
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
Tattooing . . .
Transcends gender,
socioeconomic
groups and
occupations.
Incidence:
13-17 years old = 15-19%
18-30 years old = 19-25%
Major concerns
The artist
The equipment
The environment
The invasive procedure (pigment,
technique) and after care.
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.
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
Influences
Image – yes
Identity – yes
Friends – yes
Family - no
Tattooing, after care/problems
Risks are limited, but present
Reactions to pigment
Photosensitivity
Hepatitis B and C
Psychosocial concerns
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
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
Cosmetic Tattooing
Very popular – all ages 20-90++
Check the Yellow Pages
Eyebrows, eyelids & lip liner
“Natural appearance
Limited literature and complications
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”
How about this?
Branding . . .
Many non-traditional objects used, (coat
hangers, paper clips, etc)
Thin strips of surgical stainless steel
Several “strikes” are done, infections are common
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
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