Think before you ink

Tattoos may be commonplace but that does not mean they are not without risks… here are some tips to share with patients

It seems like there are more people are getting inked and it is no longer a sign of rebellion, or as a result of a drunken night out (although, that still happens). According to a report by McCrindle Research, the number of women with a tattoo now outnumbers men.

One in five (19%) Australians has one or more tattoos. And with females it is almost in one in four (24%).

While a number of individuals report getting tattoos when they were younger, more than a third (36%) of people got their first tattoo aged 26 or older, and one in five (20%) Australians got their first tattoo aged mid 30s or older.

But it’s the Gen Ys who ink the most, with three in 10 (29%) of them (aged 22-36) with a tattoo, the largest portion of any age group.


Of the Australians who have tattoos, almost half (48%) only have one tattoo, 30% have two to three tattoos, and a further 15% have between four and nine, with another 7% having 10 or more tattoos.

Australians are marking milestones, commitments or life-chapters, not just with bracelet charms or certificates, but tattoos. In a generation, tattoos have moved from a sign of rebellion  and non-conformity to symbols of personal meaning and life-change,” Mark McCrindle, principal, McCrindle Research.


While for the majority (72%) of tattooed Australians their most recent tattoo was a picture or symbol, for one in five (19%) it was a phrase or a word. The biggest growth in tattoo design is in the phrase or word category, which has seen a massive increase over the last few years.


More than one in four (27%) Australians with tattoos say that they regret, to some extent, getting a tattoo. For this reason, 15% have commenced or looked into tattoo removal.

Of tattooed Australians, 17% would discourage or strongly discourage their adult children from getting a tattoo. However, almost a third would encourage them to get a tattoo, and just over half of parents would neither encourage for discourage their adult children to get a tattoo, if asked for advice.


In most states the legal age to get a tattoo is 18, although the Northern Territory is an exception to this, restrictions do apply. However, as a result, some people resort to backyard tattooing or buy home kits over the internet.

According to an article on Youth Central (an initiative of the Victorian Government), without proper training as professionals, backyard tattooists are generally unaware of safe health practices.

The risk of contracting blood-borne diseases such as hepatitis and HIV is a definite possibility when the same needles are used to tattoo two or more people, and when properly sterilised equipment is not available.


Backyard tattooing is a cause of concern for many professional, registered tattooing businesses – they get many customers coming in to get dodgy backyard tattoos covered up, says the article by Youth Central, 

“Backyard tattooists lack the knowledge of a reputable tattoo artist. They don’t understand the technique of ‘linework’ or shading or what artwork will make a good, lasting tattoo on skin. In the end a backyard tattoo could end up costing you more money than if you went to a professional tattoo artist in the first place.

“Professional tattoo artists also believe that backyard tattooing reflects badly on the tattoo industry as a whole.

“Backyard tattooing is not only a disgrace to the professionalism, hygeine and work quality produced from a good tattoo shop, it takes away work from good tattooists who have worked their backside off for many years,” says Sydney-based tattoo artist Laz Asaurus.

Kian Forreal, a tattoo artist with 18 years’ experience, is another professional who doesn’t take kindly to backyard tattooists.

“There is no good reason to get tattooed by anyone other than a skilled professional in today’s day and age. Doing otherwise is an embarrassment to your good sense and a health risk to your body and your family.”


In the US, the FDA reports that people can get serious infections from unhygienic practices and equipment that isn’t sterile, infections can also result from ink that was contaminated with bacteria or mould.

Using non-sterile water to dilute the pigments (ingredients that add colour) is a common culprit, although not the only one.

There’s no sure-fire way to tell if the ink is safe. An ink can be contaminated even if the container is sealed or the label says the product is sterile.

What is in tattoo ink?

Published research has reported that some inks contain pigments used in printer toner or in car paint. FDA has not approved any pigments for injection into the skin for cosmetic purposes.

What kinds of reactions may happen after getting a tattoo? Signs to look out for in patients

A person who has gotten a tattoo might notice a rash—redness or bumps—in the area of the tattoo, and may develop a fever.

More aggressive infections may cause high fever, shaking, chills, and sweats. Treating such infections might require a variety of antibiotics—possibly for months—or even hospitalisation and/or surgery.

A rash may also mean the patient having an allergic reaction. And because the inks are permanent, the reaction may persist.


Twenty-something Alison Hampton has a number of tattoos but has suffered slight allergic reactions to the ink.

“I love my tattoos and they are always being admired but it is certainly not without risks. I’ve always gone to reputable tattoo artists and have never gotten an infection, but I didn’t know you could have an ongoing allergy to the inks underneath the skin,” she tells AJP.

Alison says she thinks people need to be better educated about the risks.

“I’ve been given antihistamines to ease the irritation, which works, but I am living with these inks under your skin all the time. It’s not severe, but I do get itchiness, bumps, redness, tenderness and some swelling. Also, in the long run I don’t really know if it is bad for my immune system; some inks have chemicals in them that we don’t even know about.”

However, Alison stressed the difference between an immediate reaction to the tattoo and ongoing issues.

“I went to my GP who told me I had an issue because my body was fighting an ongoing allergic reaction in the area of my tattoo; he told me to get it removed!

“I also did not realise that you can react more to coloured inks than black ink. I would have avoided having tattoos with a lot of red ink in them, as for me, coloured inks are more likely to cause inflammation.

“Also, I cannot say it was the fault of the tattoo artist as I’ve had them done by different people and at different salons–it is just how I react. But for any future tattoos, I will make sure I am not having coloured inks just to be on the safe side.”


Youth Central offers six tips to follow before getting inked:

1. Do your Research

Asking around for people’s opinions on the artists they have been tattooed by also gives a good indication of reliable, talented tattoo artists.

The internet and tattoo magazines are useful resources when it comes to designing a tattoo and finding a suitable artist.

2. Don’t follow the trends

Over the decades the tattooing industry has gone through a number of fads, such as Chinese symbols, tribal designs, fairies and astrological symbols.

Your tattoo doesn’t have to have a deep, spiritual meaning, but don’t get a design just because it is the current trend. Remember, you will have to look at this tattoo every day for the rest of your life.

3. Consider the long-term

While tattoos are slowly becoming more accepted by society, they could possibly affect your future career prospects. Have a think about the possible consequences of getting tattooed before acting on an impulse.

Consider getting your first tattoo in place where it can easily be hidden, such as your back, upper thigh or your bicep.

4. Find a reputable tattoo shop

Under the Public Health and Wellbeing Act 2008, tattooing businesses must be registered with their local council. Generally a tattooist’s registration certificate can be found hanging on the wall, or can be presented when asked for. There are a number of health and hygeine standards (set out in the Public Health and Wellbeing Regulations 2009) that must be followed, such as:

  • keeping the shop clean and hygienic at all times;
  • using sterile equipment for each client; and
  • providing clients with health information before commencing the tattoo.

If a tattooist doesn’t display their registration, or won’t show it to you when asked, then don’t use them. 

5. Respect your tattoo artist

Tattoo artists are the professionals – they have gained invaluable knowledge over the years. Tattoo artist Mattoo Straney says, “Tattooing is an art form. A client’s skin is a gift from them to the artist and should be taken seriously.”

Don’t walk in and disregard what the tattoo artist has to say to you. They can refuse to tattoo someone if they feel like that person isn’t listening to their advice. Show them some respect and value their opinion. They know what will look best in the long run.

6. Take care of your new tattoo

The tattooed person is solely responsible for the tattoo once leaving the parlour. Make sure to carefully follow the after-care directions given by the tattoo artist to avoid infection, and for any concerns, don’t hesitate in contacting the tattoo artist or local doctor.

Further information:

Better Health Channel – Home Tattooing
The Better Health Channel offers advice on the risks of home tattooing.

Department of Health – Tattooing
Download fact sheets about how to look after your tattoos and how to get a safe and legal one.

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