People all over the world have been decorating their bodies with art both temporarily with paint and henna and permanently with tattoos for millennia.

The practice is just as common today with around 40% of the population worldwide having one or more tattoos. Some tattoos, whether permanent or temporary, are purely decorative, other times they hold more personal, cultural or spiritual significance.

Love them or loathe them, tattoos as body art are a common thread throughout human history. The following guide explores the history and cultural significance of tattoos as well as providing more general information on this form of body art including skin health.

History Of Tattoos

In 1991 the remains of a Neolithic human were discovered in a glacier near the Austrian-Italian border; the body was 5300 years old and had horizontal and vertical lines tattooed on his skin. This is the oldest known example of human body art.

In 2018, researchers studying 5000-year-old Egyptian mummies discovered the earliest examples of figurative tattoos. Marks that were previously thought to be of little consequence scientists realized were figures of animals, ‘s’ shapes, and crossed batons (like those used in ritual dance at that time).

There is evidence too from other places around the globe suggesting that tattooing was practiced by many other ancient peoples. In the areas now known as China, South East Asia, and Oceania this method of skin marking was practiced at least as early as 2000 BC often with obsidian, shells, bones, feathers, or sharpened sticks.

In ancient Greece, tattoos tended to be reserved for slaves and prisoners and this perhaps is where the stigma surrounding tattoos originated. But certainly, the idea that it is only in modern times that tattoos have begun to be an accepted form of expression and art is erroneous.

Throughout history tattoos have been around, have adorned bodies of all kinds and classes of people. In the 1800s tattooing was an expensive practice and as such was seen as a symbol of wealth. It is thought that many of Europe’s most affluent people including some heads of state sported tattoos at this time.

The process of tattooing became more affordable with the invention of the tattoo machine. Although modifications of a machine made by Thomas Edison had been used successfully for tattooing in the late 1800s the real change came with Percy Waters designs in the 1920’s some of which are still used today.

With the affordability of tattoos also came a period when tattoos began to be considered a practice for the lower classes. This stigma remained for another 40 or 50 years until tattoos once again began to be considered as something for everyone and even regarded as a respected art form in its own right.

Cultural Significance Of Tattoos

Body art can symbolize transitions into adulthood, be a sign of status, purity, or a mark of shame or ownership.

Tattoos have also been used for identification purposes; the tradition of sailor tattoos being so that their bodies could be easily identified in the case of their ship going down and their bodies spending prolonged time in the water.

In the Nazi concentration camps, prisoners were forcibly tattooed with identification numbers to identify and dehumanize them. More recently in gang culture tattoos show allegiance and rank within gangs, sometimes showing whether and how many people they have murdered.

In cultures around the world and since the very beginnings of humankind it seems that perhaps tattoos have served the same purposes as they do now. Some are to show allegiance, remember ancestors, others are religious or spiritual symbols, others are a form of story-telling – showing where people have been, what they like, and what they do. Others still are a symbol of love or betrothal.

Some examples of cultural tattoo practices include New Zealand’s Maori culture. Maori facial ‘Moko’ show among other things rank and status, but their meaning also includes many other aspects of a person’s cultural identity such as an ancestral history and are added to as important milestones or goals are achieved. In Thailand, the traditional animistic tattooing practices were for luck and protection. A common element of these as with many cultural tattooing practices is the reverence of the person who gives the tattoos.

Types of Tattoos

 

Cosmetic Tattoos

Cosmetic tattoos, also known as permanent makeup, are common in Europe and the USA in particular. These types of tattoos are usually in the form of lip colors, eyebrows, eyeliners, and nipple coloration, usually following breast reconstructive surgery.

 

Water Soluble Temporary Tattoos

Usually made with water-based ink, these tattoos are temporary lasting from a day or so to a couple of weeks and wear away with normal washing. They can be removed sooner with a skin-friendly oil such as olive or almond oil or baby oil.

 

Permanent Tattoos

Modern permanent tattoos are made with tattoo machines making holes with a needle in the dermal skin layer (around a millimeter deep) and leaving behind a drop of ink. The needle moves very fast anywhere between 50 and 3000 times per minute.

 

Traditional Tattoos Or Stick And Poke

Tattooing with sharp bamboo or other sticks is a traditional method of tattooing still used in some places and by some tribes. The sharp end is used to make small holes in the skin into which dye or sometimes soot is rubbed in making a permanent tattoo. To avoid the spread of disease and risks of infection it is advisable to avoid this method.

 

Penned Temporary Tattoos

For people who want the experience of having body art, temporary body art pens are a popular choice. They allow for freehand artworks and therefore can be more personalized than water-soluble ready-designed temporary tattoos.

These pens can be washable or semi-permanent. It is important to choose non-toxic pens that specifically say they are safe to use for body art. Some pens contain dangerous neurotoxic chemicals which may cause organ damage.

 

Painted Temporary Tattoo

Face and body paints can be washed off and so are a temporary way to enjoy body art or to test out the idea of a tattoo before making it permanent. Painted tattoos are often used in films and TV.

It is important to ensure that any paint used on the body is non-toxic and safe to use. You should also always do patch testing for each color and paint used to avoid allergic reactions.

 

Henna Tattoos

The traditional painting of henna tattoos or Mehndi is practiced throughout India, Pakistan, Bangladesh as well as some other Asian and African countries.

Usually applied to women, particularly on their hands and feet it forms part of traditional Hindu wedding ceremonies and other festivals.

Henna is a natural, temporary dye and rarely causes allergic reactions. It is red, orange in color. Modern use of henna tattoos is common for people who want beautiful, traditional-looking temporary designs.

 

‘Black Henna’ Tattoos

So-called ‘Black henna’ is not henna at all. Traditional henna is always red/orange in color. Sometimes the black dye used in this type of temporary tattoo is made of the highly toxic and banned dye: paraphenylenediamine (PPD). PPD has been associated with many cases worldwide of moderate to severe allergic reactions causing chemical burns, lifelong scarring, and even death. This type of paint-on black temporary tattoos should be avoided.

Tattoo Aftercare

• Always follow the instructions and advice given by the tattoo artist following a tattoo.
• Remove bandage/covering within 24 hours of getting your tattoo
• Wash your hands before and after touching your tattoo
• Treat your new tattoo as you would an open wound to avoid infection
• Wash gently with water, using your (clean) hands not a cloth.
• Dab gently with a clean tissue to remove excess water then leave to air dry for 15 minutes
• Apply a thin layer of the ointment suggested or given to you by the tattoo artist
• Do not re-bandage it
• Repeat the above steps 3x daily for 3 days
• Don’t soak in the bath, swim, or otherwise immerse your tattoo until it is fully healed
• Once your tattoo begins to scab over do not pick or scratch even if it itches this will damage your tattoo
• Keep your tattoo out of the sun
• Wear loose clothing so that it does not get chafed

Tattoos and Skin Health

Tattoos of both the permanent and temporary variety can cause or are associated with a variety of skin problems. These can include:

 

Infections

• Prevention

The risk of infection from a tattoo is greatly reduced by using a registered (if the area you live in registers or licenses tattoo artists) or reputable tattoo artist. The risk is further reduced by checking and asking about the artist’s sterilization methods and equipment. Follow the recommended aftercare for a tattoo. Aftercare for a tattoo includes washing carefully, patting dry, and covering with an ointment such as petroleum jelly several times a day for 4 days.

• Symptoms

Redness, itching, swelling, pain that does not go away or increases instead of decreasing with expected healing time, pus or oozing, lumps and/or sores within the tattoo, and fever are all signs of a tattoo becoming infected

• Treatment

Tattoo infections can lead to severe health problems as well as damage the appearance of the tattoo. Suspected infections should be reported to a doctor or dermatologist as soon as symptoms become apparent (rather than to the tattooist). A topical antibiotic may be prescribed or for more severe infections an oral antibiotic may be advised. The length of treatment will depend on the severity of the infection and could be from a few days to a few months.

 

Transmission of diseases including MRSA, HIV, Hepatitis, Syphilis, HPV (human papillomavirus), and Tuberculosis

This was more common in the past when knowledge of communicable diseases and their spread was minimal and when hygiene standards were poor. In past times tattooists would mix dyes with their saliva to create the ink, reuse equipment without washing it, and wipe away the blood with unclean rags. This understandably led to the spread of disease. There was a time in the 18th century when syphilis and tattoos were synonymous because the spread of the disease in this way was so common.

Thankfully this is no longer the case. Transmission of diseases as a result of tattooing is rare but it is possible. It is more likely to occur in the modern age among those who have tattoos done by non-professional tattoo artists, in non-sterile environments, with non-sterile equipment including some traditional methods of tattooing. There have been some modern occurrences of diseases being spread by the ink used for tattooing, namely MRSA. This is although unlikely still possible due to the lack of regulations surrounding tattoo inks worldwide. This however is changing in Europe and the FDA in the USA is likely to follow suit.

To prevent risk from trans communicable diseases, always ensure that a tattooist is reputable, licensed, or regulated (if that is possible in your area) and ask about their hygiene standards and practices.

Allergic Reactions

A cutaneous (skin) reaction can occur with a temporary tattoo or permanent one. Surprisingly, an allergic reaction can occur months or even years after having a tattoo as well as soon afterward. Sometimes people have an allergic reaction years after a tattoo as a result of particular medical treatments such as antiretroviral medication for HIV or following joint replacement surgery. Temporary tattoos, particularly ‘Black Henna’, often contain a substance called paraphenylenediamine, commonly known as PPD. PPD is a toxic chemical, the use of which can be illegal. Despite this, it is often used in temporary painted-on tattoos. It can cause mild symptoms but can also cause severe allergic reactions as well as causing a sensitivity which can make contact with the chemical in the future fatal.

• Common signs and symptoms of an allergic reaction include localized redness, swelling, sores, fluid-filled blisters, oozing, lumps and scaling. Sometimes a severe allergic reaction will occur and spread throughout the body causing breathing difficulties, dizziness, large swellings, increased or irregular heartbeat, and/or a rash not limited to the tattoo site.
• If the allergic reaction is severe, seek medical attention straight away.
• For moderate or mild allergic reactions seek medical attention if the symptoms last more than a week but in the meantime ask your tattooist if there is anything they can recommend.
• To treat a mild or moderate allergy to a tattoo try an over-the-counter antihistamine or a topical steroid-based cream such as hydrocortisone. A sterile, cool, damp cloth may also help to relieve symptoms.

 

Sun sensitivity

Some tattoos, particularly those with yellow and red inks which contain cadmium sulfide can cause a photo-toxic reaction, that is, a sun allergy. The symptoms of this will be redness and swelling at the site of the tattoo upon exposure to sunlight.

New tattoos are also extra sensitive to sunlight so it is important to keep healing tattoos out of the sun to prevent skin damage and burning.

Sun exposure will also damage the tattoo itself, fading colors and blurring clean lines. Tattoo artists recommend that new tattoos are kept out of the sun completely until completely healed. Even when tattoos are completely healed it is recommended that they are protected from the sun with clothing or a high-strength sunscreen to prevent fading.

 

Trigger or exacerbate skin conditions such as eczema, psoriasis, vitiligo, and keloid scarring

People with pre-existing, active skin conditions may find that some tattoo artists may not agree to tattoo them. It is a good idea to discuss having a tattoo with the chosen artist beforehand as well as with a dermatologist.

Having a tattoo may trigger one of the skin conditions above in people who are unaware that they have a genetic or other predisposition to them. If a skin condition develops following a tattoo is it important to see a doctor or dermatologist seek appropriate advice and/or treatment.

 

Skin Cancer

Although studies have shown there is no increased risk of skin cancer from tattoos. There is a risk that the chemicals present in the inks used in tattooing may be carcinogenic. There has been no regulation of tattoo ink and therefore bodies such as the FDA in the US have usually only investigated the ingredients in inks and the dangers they may pose once problems have already been identified. In Europe, there are currently moves to ban the use of particular chemicals in tattoo ink including those which are known or thought to be carcinogenic. The US will likely follow suit.

However, although tattoos themselves are not thought to cause cancer there is an increased risk due to tattoos masking the initial signs of skin cancer.

References:
Fedorenko, J., Sherlock, S., & Stuhr, P. (1999). A Body of Work: A Case Study of Tattoo Culture.Visual Arts Research,25(1), 105-114. Retrieved August 16, 2021.
Gayle E. Long, and Leland S. Rickman. “Infectious Complications of Tattoos.”
Clinical Infectious Diseases, vol. 18, no. 4, 1994, pp. 610–619.JSTOR Accessed 9 Apr. 2021