tattooing process
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The process or technique of tattooing, creating a
tattoo A tattoo is a form of body modification made by inserting tattoo ink, dyes, and/or pigments, either indelible or temporary, into the dermis layer of the skin to form a design. Tattoo artists create these designs using several tattooing ...
, involves the insertion of
pigment A pigment is a colored material that is completely or nearly insoluble in water. In contrast, dyes are typically soluble, at least at some stage in their use. Generally dyes are often organic compounds whereas pigments are often inorganic compou ...
(via
tattoo ink Tattoo inks consist of pigments combined with a carrier, used in the process of tattooing to create a tattoo in the skin. These inks are also used for permanent makeup, a form of tattoo. Professional tattoo inks are available in many colors and ...
) into the skin's dermis. Traditionally, tattooing often involved rubbing pigment into cuts. Modern tattooing almost always requires the use of a
tattoo machine A tattoo machine is a hand-held device generally used to create a tattoo, a permanent marking of the skin with indelible ink. Modern tattoo machines use electromagnetic coils to move an armature bar up and down. Connected to the armature bar is a ...
and often procedures and accessories to reduce the risk to human health.


Physiological process of tattooing

Tattooing involves the placement of pigment into the skin's dermis, the layer of dermal tissue underlying the epidermis. After initial injection, pigment is dispersed throughout a
homogenized Homogeneity and heterogeneity are concepts often used in the sciences and statistics relating to the uniformity of a substance or organism. A material or image that is homogeneous is uniform in composition or character (i.e. color, shape, siz ...
damaged layer down through the epidermis and upper dermis, in both of which the presence of foreign material activates the
immune system The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splint ...
's
phagocyte Phagocytes are cells that protect the body by ingesting harmful foreign particles, bacteria, and dead or dying cells. Their name comes from the Greek ', "to eat" or "devour", and "-cyte", the suffix in biology denoting "cell", from the Greek ...
s to engulf the pigment particles. As healing proceeds, the damaged epidermis flakes away (eliminating surface pigment) while deeper in the skin
granulation tissue Granulation tissue is new connective tissue and microscopic blood vessels that form on the surfaces of a wound during the healing process. Granulation tissue typically grows from the base of a wound and is able to fill wounds of almost any siz ...
forms, which is later converted to connective tissue by collagen growth. This mends the upper dermis, where pigment remains trapped within fibroblasts, ultimately concentrating in a layer just below the dermis/epidermis boundary. Its presence there is stable, but in the long term (decades) the pigment tends to migrate deeper into the dermis, accounting for the degraded detail of old tattoos.Tattoo lasers / Histology
Suzanne Kilmer,
eMedicine eMedicine is an online clinical medical knowledge base founded in 1996 by doctors Scott Plantz and Jonathan Adler, and computer engineer Jeffrey Berezin. The eMedicine website consists of approximately 6,800 medical topic review articles, each of ...


Traditional tattooing

Some tribal cultures traditionally created tattoos by cutting designs into the skin and rubbing the resulting wound with ink, ashes or other agents; some cultures continue this practice, which may be an adjunct to
scarification Scarification involves scratching, etching, burning/branding, or superficially cutting designs, pictures, or words into the skin as a permanent body modification or body art. The body modification can take roughly 6–12 months to heal. In the ...
. Some cultures create tattooed marks by hand-tapping the ink into the skin using sharpened sticks or animal bones (made like needles) with clay formed disks or, in modern times, needles. Traditional Japanese tattoos (''
irezumi (also spelled or sometimes ) is the Japanese word for tattoo, and is used in English to refer to a distinctive style of Japanese tattooing, though it is also used as a blanket term to describe a number of tattoo styles originating in Japan, inc ...
'') are still "hand-poked," that is, the ink is inserted beneath the skin using non-electrical, hand-made and hand held tools with needles of sharpened bamboo or steel. This method is known as ''tebori''. Traditional Hawaiian hand-tapped tattoos are experiencing a renaissance, after the practice was nearly extinguished in the years following Western contact. The process involves lengthy protocols and prayers and is considered a sacred rite more than an application of artwork. The tattooist chooses the design, rather than the wearer, based on genealogical information. Each design is symbolic of the wearer's personal responsibility and role in the community. Tools are hand-carved from bone or tusk without the use of metal."Marked"
Article by Shannon Wianecki in ''
Maui No Ka 'Oi Magazine The island of Maui (; Hawaiian: ) is the second-largest of the islands of the state of Hawaii at 727.2 square miles (1,883 km2) and is the 17th largest island in the United States. Maui is the largest of Maui County's four islands, whic ...
'', Vol.15 No. 4 July 2011


Modern tattooing

The most common method of tattooing in modern times is the electric
tattoo machine A tattoo machine is a hand-held device generally used to create a tattoo, a permanent marking of the skin with indelible ink. Modern tattoo machines use electromagnetic coils to move an armature bar up and down. Connected to the armature bar is a ...
, which inserts ink into the skin via a single needle or a group of needles that are
solder Solder (; NA: ) is a fusible metal alloy used to create a permanent bond between metal workpieces. Solder is melted in order to wet the parts of the joint, where it adheres to and connects the pieces after cooling. Metals or alloys suitable ...
ed onto a bar, which is attached to an oscillating unit. The unit rapidly and repeatedly drives the needles in and out of the skin, usually 80 to 150 times a second. This modern procedure is ordinarily sanitary. The needles are single-use needles that come packaged individually. The tattoo artist must wash his or her hands and must also wash the area that will be tattooed. Gloves must be worn at all times and the wound must be wiped frequently with a wet disposable towel of some kind. The equipment must be sterilized in a certified autoclave before and after every use. Prices for this service vary widely globally and locally, depending on the complexity of the tattoo, the skill and expertise of the artist, the attitude of the customer, the costs of running a business, the economics of supply and demand, etc. The time it takes to get a tattoo is in proportion with its size and complexity. A small one of simple design might take 15 minutes, whereas an elaborate
sleeve tattoo A sleeve tattoo or tattoo sleeve is a large tattoo or collection of smaller tattoos that covers most or all of a person's arm. There is a difference between an arm covered in tattoos and a sleeve tattoo: a sleeve tattoo has a unified theme, wherea ...
or back piece requires multiple sessions that may consist of several hours at a time ranging over months or even years. In 1891 the first electric tattoo needle was patented in New York City by
Samuel O'Reilly Samuel F. O’Reilly (May 1854 - 29 April 1909) was an American tattoo artist from New York, who patented the first electric tattoo machine on December 8, 1891. Biography O’Reilly was born in Waterbury, New Haven County, Connecticut to Iri ...
, who modified Thomas Edison's electric engraving pen. O'Reilly's machine was based on the rotary technology of the electric
engraving Engraving is the practice of incising a design onto a hard, usually flat surface by cutting grooves into it with a burin. The result may be a decorated object in itself, as when silver, gold, steel, or glass are engraved, or may provide an in ...
device invented by
Thomas Edison Thomas Alva Edison (February 11, 1847October 18, 1931) was an American inventor and businessman. He developed many devices in fields such as electric power generation, mass communication, sound recording, and motion pictures. These inventi ...
. Modern tattoo machines use electromagnetic coils. Another early tattoo machine, with an electromagnetic coil, was patented by Sutherland MacDonald in 1894. The first twin-coil machine, the predecessor of the modern configuration, was invented by another Englishman, Alfred Charles South of London, in 1899. Another tattoo machine was developed 1970-1978 by the German tattoo artists
Horst Heinrich Streckenbach Horst Streckenbach “Tattoo Samy” (August 5, 1925 – June 27, 2001) was a well-known German tattoo artist and historian of the medium, who had been tattooing since 1946. Streckenbach is considered important in the development of tattooing in ...
(1929–2001) and
Manfred Kohrs Manfred Kohrs (born 24 January 1957) is a German tattooist and conceptual artist, who has been tattooing since 1974. He was a student of Horst Streckenbach ("Tattoo Samy") (5 August 1926 – 27 June 2001). Together they developed the barbell p ...
.


Permanent makeup

Permanent makeup or semi-permanent makeup tattoos are cosmetic tattoos that are meant to alter pigmentation in the facial features. Some types of permanent makeup are used for medical conditions, such as to cover up scars or
vitiligo Vitiligo is a disorder that causes the skin to lose its color. Specific causes are unknown but studies suggest a link to immune system changes. Signs and symptoms The only sign of vitiligo is the presence of pale patchy areas of depigmen ...
, while other types are simply for aesthetic reasons like tattooing eyeliner, lip color or eyebrows. The pigment is inserted into the surface of the skin in patterns to be able to cover the desired areas. Permanent makeup is typically done with some form of tattoo machine. There are machines now that are needle-less which should result in less painful procedures. These needle-free devices are considered safer and more sterile to use than traditional tattoo machines. They are designed to create a more comforting experience during the application process and eliminate the possibility of spreading disease like
HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...
,
hepatitis Hepatitis is inflammation of the liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes ( jaundice), poor appetite, vomiting, tiredness, abdominal ...
and other healthcare issues. The needle-less device is also capable of inserting the pigment deeper into the skin than machines that use needles. There are several different ways to get rid of these tattoos, the most common being laser removals. It is suggested that different color pigments should be removed with different lasers in order to reduce the risk of scarring and ink retention. The needle-free machines also have the capability of removing or lightening the pigment from the skin as well by adding in a removal solution into the skin. Permanent makeup or micropigmentation is much like any tattoo and can have side effects over time. Infections, fading, scarring, inflammation, and allergic reactions are just a few of the side effects that have been reported from patients who received permanent makeup procedures.


Nipple-areola Tattoos

Tattoos have also made an entrance into the medical field. Nipple-areola tattoos are a form of medical tattoos that can be done for those who lost their nipple during a mastectomy and had breast reconstruction surgery. The tattoo artist tries to recreate the same pigment and shape as the original nipple and areola, although it may not always result in an exact replica as the patient’s old nipple. The tattoo may not be the exact or desired shade of the nipple that the patient originally had because the artist may make the tattoo a bit darker in order for the tattoo to lighten up over time, ultimately resulting in the correct shade. The machine that is used during the procedure will also affect the color that the tattoo has and how the pigment will react with the skin. Not all nipple-areola tattoos are successful. There is a chance that the tattoo could get infected just as any tattoo can. In a study from 1988—1993 of 103 patients who received nipple-areola tattoos, 5 patients reported getting an infection, 1 patient reported getting a rash, one reported getting slough, and 19 patients had to have their tattoo touched up due to the pigment diminishing from the tattoo through the healing process. Nipple-areola tattoos tend to be one of the final steps to breast reconstruction surgery. In the study of those who received the tattoos, 86% said that they would get the procedure done again if they needed to.


Dyes and pigments

Early tattoo inks were obtained directly from nature and were extremely limited in pigment variety. In ancient Hawaii, for example, kukui nut ash was blended with coconut oil to produce an ebony ink. Today, an almost unlimited number of colors and shades of tattoo ink are mass-produced and sold to parlors worldwide. Tattoo artists commonly mix these inks to create their own unique pigments. A wide range of dyes and
pigment A pigment is a colored material that is completely or nearly insoluble in water. In contrast, dyes are typically soluble, at least at some stage in their use. Generally dyes are often organic compounds whereas pigments are often inorganic compou ...
s can be used in tattoos, from inorganic materials like
titanium dioxide Titanium dioxide, also known as titanium(IV) oxide or titania , is the inorganic compound with the chemical formula . When used as a pigment, it is called titanium white, Pigment White 6 (PW6), or CI 77891. It is a white solid that is insolub ...
and iron oxides to
carbon black Carbon black (subtypes are acetylene black, channel black, furnace black, lamp black and thermal black) is a material produced by the incomplete combustion of coal and coal tar, vegetable matter, or petroleum products, including fuel oil, fluid ...
, azo dyes, and
acridine Acridine is an organic compound and a nitrogen heterocycle with the formula C13H9N. Acridines are substituted derivatives of the parent ring. It is a planar molecule that is structurally related to anthracene with one of the central CH groups re ...
,
quinoline Quinoline is a heterocyclic aromatic organic compound with the chemical formula C9H7N. It is a colorless hygroscopic liquid with a strong odor. Aged samples, especially if exposed to light, become yellow and later brown. Quinoline is only sli ...
,
phthalocyanine Phthalocyanine () is a large, aromatic, macrocyclic, organic compound with the formula and is of theoretical or specialized interest in chemical dyes and photoelectricity. It is composed of four isoindole units linked by a ring of nitrogen ato ...
and
naphthol Naphthol may refer to: * 1-Naphthol 1-Naphthol, or α-naphthol, is a fluorescent organic compound with the formula . It is a white solid. It is an isomer of 2-naphthol differing by the location of the hydroxyl group on the naphthalene ring. ...
derivatives, dyes made from ash, and other mixtures. Iron oxide pigments are used in greater extent in cosmetic tattooing. Modern tattooing inks are carbon-based pigments that have uses outside of commercial tattoo applications. Concern has been expressed over the interaction between magnetic resonance imaging (MRI) procedures and tattoo pigments, some of which contain trace metals. The magnetic fields produced by MRI machines interact with these metals, including
nonferrous In metallurgy, non-ferrous metals are metals or alloys that do not contain iron (allotropes of iron, ferrite, and so on) in appreciable amounts. Generally more costly than ferrous metals, non-ferrous metals are used because of desirable proper ...
metal particles, and while rare, are capable of causing first-degree or second-degree burns or distortions in the image. The type and density of the ink as well as shape of the tattoo may increase the risk, particularly if the shape approximates an RF pick-up loop. The television show '' MythBusters'' tested the hypothesis, and found a slight interaction between commonly used tattoo inks and MRI. The interaction was stronger with inks containing high levels of iron oxide.


Studio hygiene


Procedures

The properly equipped tattoo studio will use
biohazard A biological hazard, or biohazard, is a biological substance that poses a threat to the health of living organisms, primarily humans. This could include a sample of a microorganism, virus or toxin that can adversely affect human health. A bioh ...
containers for objects that have come into contact with blood or bodily fluids,
sharps container Sharps may refer to: * Plural form of many of the terms as defined on Sharp (disambiguation) * Sharps waste, a form of biomedical waste composed of used ''sharps'' * Sharps, Virginia, unincorporated community in Richmond County * Sharps Bedrooms * ...
s for old needles, and an
autoclave An autoclave is a machine used to carry out industrial and scientific processes requiring elevated temperature and pressure in relation to ambient pressure and/or temperature. Autoclaves are used before surgical procedures to perform sterilizati ...
for sterilizing tools. Certain jurisdictions also require studios by law to have a sink in the work area supplied with both hot and cold water. Proper hygiene requires a body modification artist to wash his or her hands before starting to prepare a client for the stencil, between clients, and at any other time when
cross contamination Contamination is the presence of a constituent, impurity, or some other undesirable element that spoils, corrupts, infects, makes unfit, or makes inferior a material, physical body, natural environment, workplace, etc. Types of contamination Wi ...
can occur. The use of single use gloves is also mandatory and disposed after each stage of tattooing. The same gloves should not be used to clean the tattoo station, tattoo the client, and clean the tattoo. In some states and countries it is illegal to tattoo a minor even with parental consent, and (except in the case of
medical tattoo A medical tattoo is a tattoo used to treat a condition, communicate information, or mark a body location. Historical uses A crude practice of corneal tattooing was performed by Galen in 150 CE. He tried to cover leucomatous opacities of the ...
s) it is forbidden to tattoo impaired persons, people with contraindicated skin conditions, those who are pregnant or nursing, those incapable of consent due to mental incapacity, or those under the influence of alcohol or other drugs. Before the tattooing begins the client is asked to approve the final position of the applied stencil. After approval is given the artist will open new, sterile needle packages in front of the client, and always use new, sterile, or sterile disposable instruments and supplies, and fresh ink for each session (loaded into disposable ink caps which are discarded after each client). Also, all areas which may be touched with contaminated gloves will be wrapped in clear plastic to prevent cross-contamination. Equipment that cannot be autoclaved (such as counter tops, machines, and furniture) will be wiped with an approved disinfectant.


Incentives for continuing education

Membership in professional organizations or certificates of appreciation/achievement generally help artists to be aware of the latest trends. Most tattooists do not belong to any association.


Training and certification requirements

While specific requirements to become a tattooist vary between jurisdictions, many mandate only formal training in blood borne pathogens and cross contamination. The local department of health regulates tattoo studios in many jurisdictions. For example, according to the health departments in
Oregon Oregon () is a state in the Pacific Northwest region of the Western United States. The Columbia River delineates much of Oregon's northern boundary with Washington, while the Snake River delineates much of its eastern boundary with Idaho. T ...
and
Hawaii Hawaii ( ; haw, Hawaii or ) is a state in the Western United States, located in the Pacific Ocean about from the U.S. mainland. It is the only U.S. state outside North America, the only state that is an archipelago, and the only state ...
, tattoo artists in these states are required to take and pass a test ascertaining their knowledge of health and safety precautions as well as the current state regulations. Performing a tattoo in Oregon without a proper and current license or in an unlicensed facility is a
felony A felony is traditionally considered a crime of high seriousness, whereas a misdemeanor is regarded as less serious. The term "felony" originated from English common law (from the French medieval word "félonie") to describe an offense that resu ...
offense. Tattooing was legalized in
New York City New York, often called New York City or NYC, is the most populous city in the United States. With a 2020 population of 8,804,190 distributed over , New York City is also the most densely populated major city in the Un ...
in 1997, in Massachusetts in 2000 and Oklahoma between 2002 and 2006.


Aftercare

Tattoo artists and people with tattoos vary widely in their preferred methods of caring for new tattoos. Some artists recommend keeping a new tattoo wrapped for the first 24 hours while others suggest removing temporary bandaging after two hours or less to allow the skin to breathe. Many tattooists advise against allowing too much contact with hot tub, pool water or soaking in a tub for the first two weeks to prevent the tattoo ink from washing out. In contrast other artists suggest that a new tattoo be bathed in very hot water early. General consensus for care advises against removing the flakes or scab that may form on a new tattoo, and avoiding exposing a new tattoo to the sun for extended periods for at least three weeks; both of these can contribute to fading of the image. It is agreed that a new tattoo needs to be kept clean. Various products may be recommended for application to the skin, ranging from those intended for the treatment of cuts, burns and scrapes, to
panthenol Panthenol (also called pantothenol) is the alcohol analog of pantothenic acid (vitamin B5), and is thus a provitamin of B5. In organisms, it is quickly oxidized to pantothenic acid. It is a viscous transparent liquid at room temperature. Pantheno ...
,
cocoa butter Cocoa butter, also called theobroma oil, is a pale-yellow, edible fat extracted from the cocoa bean. It is used to make chocolate, as well as some ointments, toiletries, and pharmaceuticals. Cocoa butter has a cocoa flavor and aroma. Its mel ...
, A&D, hemp,
lanolin Lanolin (from Latin 'wool', and 'oil'), also called wool yolk, wool wax, or wool grease, is a wax secreted by the sebaceous gland A sebaceous gland is a microscopic exocrine gland in the skin that opens into a hair follicle to secrete an ...
, or salves. Oil based ointments are almost always recommended for use on very thin layers due to their inability to evaporate and therefore over-hydrate the already perforated skin. Recent scientific studies have demonstrated that wounds that are kept moist heal faster than wounds healing under dry conditions. In recent years specific commercial products have been developed for tattoo aftercare. Although opinions about these products vary, soap and warm water work well to keep a tattoo clean and free from infection. It is advised that fragrance-free soaps and soaps that contain alcohol not be used to clean the tattoo to avoid burning or drying out the tattoo too quickly. Try to avoid loofahs and unwashed clothes which both can contain bacteria that could get into the tattoo and cause an infection. The best way to dry your tattoo is to use a paper towel as regular towels may also contain bacteria, even if they are just washed. The amount of ink that remains in the skin throughout the healing process determines how the final tattoo will look. If a tattoo becomes infected or the flakes fall off too soon (e.g., if it absorbs too much water and sloughs off early or is picked or scraped off) then the ink will not be properly fixed in the skin and the final image will be negatively affected.


References

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