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Pediatricians Issue First-Ever Guidelines For Tattoos And Body Piercings On Kids

Poorly planned tattoos and piercings can cause all sorts of health problems, AAP cautions.

Children and teens should carefully consider the risks and consequences of getting tattoos and body piercings, according to a new report from the American Academy of Pediatrics. The report is the first to offer clinical guidelines for body modification in minors, and cautions that poorly-planned tattoos and piercings can be dangerous.

There’s some concern—and potential risk—if you go to a place where there’s not a clean needle,” says coauthor of the study Dr. Cora Breuner, chair of the AAP Committee on Adolescence, citing risks of HIV, Hepatitis B, Hepatitis C. Breuner adds that prominent tattoos could also get in the way of future job prospects. “The placement of tattoos is a huge, controversial issue because many people want other people to see their tattoos, but sometimes it gets in the way of employment.”

tattoo artist placing stencil

Physicians once considered tattoos and body piercings warning signs for high-risk youth, with one retrospective analysis finding that tattoos are associated with drug use, violence, and suicide. But the data suggest that is no longer the case. As of 2010, nearly 40 percent of 18- to 29-year-olds report having at least one tattoo, and more than 20 percent have a non-earring body piercing. “I think tattooing right now is much more accepted than it was 15 or 20 years ago,” Breuner says. “We used to see people that had tattoos [and consider them] somewhat high-risk.”

But that doesn’t mean body modifications are safe. Breuner and colleagues note that tattooing (especially outside of a licensed parlor) can lead to infection when artists do not disinfect properly between clients, or use tainted ink and contaminated needles. Although the actual rates of infection are unknown, the report suggests that improper tattooing practices have lead to hepatitis C, hepatitis B, and HIV, and that use of non-sterile water has caused mycobacterial infections. Isolated case reports have further cited subpar tattooing practices as the causes of gangrene and amputations. There are also unconfirmed links between tattoos and cancer.

Parents tend to think of piercings as safer than tattoos, but the report suggests this is not the case. Even ear piercings come with a battery of potential complications, from allergic reactions to traumatic tears, and nose and mouth tattoos have been known to cause breathing problems or pose choking hazards. Nipple rings can render women unable to breastfeed. Genital piercings can cause nasty infections and, for boys, a host of urologic problems including incontinence.

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female tattooist

At the same time, the vast majority of body modifications are safe and can be empowering when done by a licensed professional and with parental supervision. The AAP recommends that parents discuss how tattoos and piercings can affect a child’s job prospects, choose a salon carefully, and ensure that children and teens are up-to-date on their shots.

“In most cases, teens just enjoy the look of the tattoo or piercing, but we do advise them to talk any decision over with their parents or another adult first,” said coauthor Dr. David Levine in a statement. “They may not realize how expensive it is to remove a tattoo, or how a piercing on your tongue might result in a chipped tooth.” Breuner adds that, even as tattoos and body piercings become mainstream, parents must remain vigilant to protect their children. “These services have come a long way, safety-wise,” she says. “But it’s best to proceed with caution.”