Piercing
the skin
| Body art, especially tattoos and piercings, does more than make a fashion statement—it brings with it increased risk of skin infections and allergic reactions, along with more serious health problems, experts say. But many “decorated” people don’t realize that they are at risk.Piercings and tattoos are invasive procedures that pose the possibility of bloodborne diseases. According to health experts, the greatest threat from body art is hepatitis, especially hepatitis B, which can be transmitted in as little as 0.00004 ml of blood. It’s a hardy virus and can survive for a number of days or even weeks on surfaces such as instruments and doorknobs. Piercing and tattooing needles can also spread HIV, experts say, although the risk is smaller because HIV dies at room temperature. Spore-forming bacteria such as the tetanus bacillus also can be transmitted.Transmission risk“Hepatitis B and C have been reported. Granted, not much given the amount of tattooing that’s done, but the potential is there,” said Myrna Armstrong, EdD, RN, FAAN, professor at the School of Nursing at Texas Tech University Health Sciences Center in Lubbock.”We like to say HIV can be transmitted, but in my literature review, there were only two very suspect cases of HIV from tattoos, and these were done in prison with who knows what kind of needles and ink.”The National Center for HIV, STD, and TB Prevention, an arm of the national Centers for Disease Control and Prevention, offers “Personal Service Worker Guidelines,” which stress the importance of all body artists being educated about the transmission of bloodborne infections. Artists who use needles or other instruments that penetrate the skin should follow the same precautions as healthcare workers, according to the center.The risk of transmission exists when there is both “trauma to one of the individuals that would provide a portal of entry for the virus” and “access of blood or serous fluid from one infected person to the open tissue of the other,” according to the guidelines.”Any time you deal with non-intact skin, you run the risk to allow infectious agents to enter the body,” said Fran Slater, MBA, RN, president of the Association for Professionals in Infection Control and Epidemiology and manager in the infection control department at The Methodist Hospital in Houston. “You can’t rely solely on gloves for protection. It is a prudent practice to cover an open area regardless of what you’re doing, whether it’s yard work or changing a baby’s diaper.”Piercing problemsJanice Chussil, MSN, president of the Dermatology Nurses’ Association, has cared for many people who have had piercings. “I see more inflammation and problems with navel rings than any other piercing, perhaps because it gets rubbed against clothing, ” Chussil said. “We also encourage people not to get the cartilage of their ears pierced, because blood supply is poor in that area and risk of infection is high.”Site seeing for more informationFood and Drug Administration: information about tattooing practices, the selection of a tattoo artist, tattoo removal, and health risksNational Centers for Disease Control and Prevention: information on hepatitisUniversity of Washington in Seattle: article on body artGauntlet International: detailed after-care instructions and other information about body piercing and tattooing. (Gauntlet is a California-based chain of piercing salons.)Most people don’t think of manicures and salon tanning as high-risk activities, but Chussil said poor hygiene and the right virus-breeding conditions can lead to a wide array of ailments. Poor cleaning procedures are the culprit in almost every case.”We see a lot of yeast and bacterial infections in people who frequently get manicures and pedicures,” Chussil said. “And we’ve seen people get herpes from tanning beds. It was not cleaned well, the virus remained, and the heat exacerbated it.”Ask about cleanlinessSlater said anyone considering a piercing or tattoo should question the studio about cleaning procedures. Instruments should be cleaned with soap and water to remove any body fluid and then be disinfected and stored properly, she said.”HIV is easily killed by soap and water. Hepatitis B is hardy and can remain viable for a number of days or weeks. Hepatitis C, we’re unsure,” Slater said. “There are a lot of questions about hepatitis C—how much inoculant does it take to cause the disease or what are the ways it can be transmitted.”Proper procedures usually aren’t followed for a variety of reasons. Staff may be cutting corners or trying to cut costs—or may simply be uninformed, said Chussil, adding, “People don’t realize what can be hanging on to an instrument.”Little regulationOregon, Wisconsin, and Texas are the only states that have regulations for tattooing and piercing artists’ businesses. In Texas, a tattoo shop must be registered with the state and adhere to regulations, which Armstrong says are “pretty good.”The Texas Department of Health requires that tattoo artists take precautions to prevent the spread of infection such as washing hands with germicidal soap, wearing clean clothing and single-use gloves, and using tools that are either disposable or routinely sterilized. Texas authorities also require tattoo artists to have sterilization records showing routine sterilization practices, maintain records for each person receiving a tattoo, and report any infection or adverse reaction.If piercings are done in a tattoo studio, the regulations apply, but a shop that only does piercings is not covered. Enforcement of regulations can be spotty, Armstrong said. “Sometimes studios are checked only if there’s a complaint.”She hopes healthcare providers will talk about possible problems with these procedures so consumers know the risks.Armstrong, who has researched tattoos and piercings for 10 years, recently surveyed nurses and physicians about their attitudes toward people with tattoos. “They don’t like such people,” she said, “especially adolescents with tattoos. That’s a big concern because it’s hard to get teens into health care in the first place, and if there’s a judgment, they’re never coming back.” | |
