Motivation for contemporary tattoo removal: a shift in identity

Laser tattoo removal strategies: Part II: A review of the methods, techniques, and complications involved in tattoo removal

The rising global popularity of cosmetic and corrective tattoos has concurrently led to an increased demand for their removal. While in the past, methods like surgical excision, chemical destruction, and dermabrasion were employed, lasers have emerged as a reliable and effective tool for tattoo removal. Increasing technological options and combination treatment strategies have raised the importance of understanding the various approaches to laser tattoo removal along with their respective clinical impact. This CME aims to describe the multifaceted aspects of laser tattoo removal, including the method selection, application principles, and safety considerations. Furthermore, it addresses the factors considered when selecting the most suitable laser to achieve optimal treatment outcomes.

Mental body representations of women with tattoos in emerging adulthood - a cluster analysis

Tattoo is a permanent body modification relevant to women's bodily experiences. Previous studies on the population of tattooers have focused mainly on searching for negative or positive aspects of tattooing, mainly in the field of self-esteem. The aim of this study was to explore the mental body representations of tattooed women during emerging adulthood. Three hundred and twenty-seven women with tattoos, aged 18 to 25 (M = 21.48; SD = 2.05), participated in the study. In the study, we adopted a quantitative research project; the data for analysis was obtained from questionnaires that were completed online between January and March 2021. Women with tattoos completed a survey containing demographic questions, questions regarding their tattoos, the Battery of Tests of Body Self Representations, and the Rosenberg Self-Esteem Scale. Based on that a cluster analysis, we have discovered three types of mental body representations that may characterize them: (1) unstable, (2) disordered, and (3) integrated. The study showed that having a tattoo is associated with experiencing carnality in a specific way.

Tattoos and Piercings in Female Adolescents and Young Adults

This article covers body art in female adolescents and young adults, including tattoos, piercings, and intimate piercings. We review the epidemiology, definitions, motivations, proactive counseling, regulations, complications, and removal practices. Providers are likely to encounter and manage young women with tattoos and piercings and should be familiar with how to support young women before and after obtaining body art. Providers should be familiar with the treatment of the most frequent complications of body art in young women, which include allergic reactions and localized soft tissue infections. Finally, we review the techniques and indications for body art removal.

Motivations for Seeking Laser Tattoo Removal and Perceived Outcomes as Reported by Justice Involved Adults

The goal of this study is to describe reasons for desiring removal of unwanted tattoos and self-reported outcomes among justice-involved adults (JIA) receiving free laser tattoo removal in Southern California. Between 2016 and 2021, JIA completed voluntary anonymous surveys at baseline (n = 53) and follow-up (n = 113) visits. Descriptive analyses were generated for quantitative items. Themes were identified from open-ended questions. Patients were predominantly male (74%) and most (81%) reported tattoo-related discrimination. Adjusted multivariate analyses showed that a higher number of domains in which patients reported tattoo-related discrimination was associated with having more tattoos to remove and citing reasons for removal related to employment and stigma by association (e.g., gang membership and police interactions). At follow-up, 48% of patients felt they were treated better in their community, and nearly a quarter of patients (25%) reported greater confidence and self-esteem. JIA seek tattoo removal due to stigma and discrimination. While JIA reported diverse benefits, tattoo removal should likely be considered as one element of comprehensive programing that addresses JIA's diverse emotional, social, and economic needs. Longitudinal research is needed to clarify the long-term effects of tattoo removal for JIA.

Non-laser treatment for tattoo removal

Tattoos are increasingly gathering attention in the young population, especially in second to fourth decade of life. With such trends, rate of its removal also has been on the rise. Treatment options for tattoo removal besides lasers are surgery, radiofrequency, infrared light, cryotherapy, dermabrasion and salabrasion. Unfortunately, none of these procedures are associated with satisfactory cosmetic results due to adverse effects such as scarring and dyspigmentation. Although laser treatment has become the gold standard for tattoo removal, it is also associated with some limitations. Some tattoo inks are resistant to laser, and multiple sessions and multiple wavelengths may be required for its complete removal. Considering these limitations, other treatment modalities for tattoo removal must be explored. This article highlights the non-laser treatment options for tattoo removal. We reviewed all published literature identified from electronic databases (MEDLINE and PubMed) till August 2021 to highlight the non-laser treatment options for tattoo removal.

Tattoo discrimination in Mexico motivates interest in tattoo removal among structurally vulnerable adults

Tattoos are less prevalent in Mexico and tattooed persons are frequently stigmatized. We examine the prevalence and correlates of interest in receiving tattoo removal services among 278 tattooed Mexican adults living in Tijuana, Mexico who responded to interviewer-administered surveys, including open-ended questions. Overall, 69% of participants were interested in receiving free tattoo removal services, 31% reported facing employment barriers due to their tattoos, and 43% of respondents regretted or disliked some of their tattoos. Having a voter identification card, reporting moderate/severe depression symptoms and believing that tattoo removal would remove employment barriers were independently associated with interest in tattoo removal. Our findings suggest that there is substantial interest in tattoo removal services. Publicly financed tattoo removal services may help disadvantaged persons gain access to Mexico's labor market and it may positively impact other life domains such as mental well-being and interactions with law enforcement.

A Descriptive Analysis of the Epidemiology and Motivations for Laser Tattoo Removal in an Underserved Population

Tattoos of formerly gang-involved and incarcerated individuals can negatively impact their ability to reintegrate into society. Laser tattoo removal is essential to helping individuals obtain employment, re-cultivate positive relationships, and disengage from gangs. The objective of this study is to describe the demographics and motivations for laser tattoo removal at a large nonprofit clinic. This was a single center retrospective study conducted on patients presenting to Ya'stuvo Tattoo Removal between January 2016-December 2018 and had at least three laser tattoo removal sessions. Data was recorded on patient demographics, geographic location of residence (e.g. zipcode), comorbidities, probation/parole status, referral source, transportation mode, and motivations for receiving and removing tattoos. A representative sample of 862 patients was used to conduct our analysis. Average age at first visit was 30. 16% (n = 134) were on probation, 8% (n = 66) were on parole, and 63% (n = 544) did not report their probation/parole status. Reasons for receiving a tattoo included gangs (46%, n = 368), a current or ex-relationship (28%, n = 223), and decoration (20%, n = 159). The most common reasons for tattoo removal were employment (66%, n = 546), readiness to change life (47%, n = 392), maturity (47%, n = 392), family (43%, n = 356), and negative attention from tattoos (37%, n = 303). The current study highlights the importance of laser tattoo removal in reintegration and gang disengagement. Expanding cost efficient laser tattoo removal is paramount to meet the safety and socioeconomic needs of this population.

Tattooed and Non-Tattooed Women: Motivation, Social Practices and Risk Behavior

Abstract This study aimed at identifying motivations, risk behavior and social practices, comparing tattooed and non-tattooed women. 316 women (50% tattooed) were surveyed online, answering questions on sociodemographic data, social practices, motivations, and risk behavior. Data collection strategies included snow-balling, social networks, personal contact, and visits to tattoo parlors. The main results indicate that the majority of women express satisfaction with their physical appearance after getting tattooed, and wouldn’t get the tattoo removed. Being tattooed correlated with risk behaviors such as casual sex with unknown people, alcohol and drug use, and psychopathology. The sample presented more similarities than differences between tattooed and non-tattooed groups, suggesting that growing popularization and social acceptance of tattooing has led to a decrease of the differences between the groups. Such results may inform future research and the production of informative materials aimed at demystifying negative stereotypes associated to tattoos.

Do young women with tattoos have lower self-esteem and body image than their peers without tattoos? A non-verbal repertory grid technique approach

Available evidence regarding the reasons for people to acquire body markers such as tattoos is contradictory. The present study was designed to investigate the relationship between self-esteem and body image in young women with tattoos. To this end, the repertory grid technique (RGT) was adapted and used to assess differences between women with and without tattoos in terms of self-esteem and body image. Sixty young women with tattoos and sixty young women without (all aged 18-35 years), performed the Color RGT in order to evaluate the relationship between self-esteem and body image. Compared to women without tattoos, women with tattoos showed significantly lower self-esteem and displayed stronger relationships between three constructs: ideal body, ideal self and tattooed woman status. No significant differences in body image were detected between the two groups. Women with tattoos were characterized by an association between body image and self-esteem, while women without tattoos did not display such a correlation. Thus, it appears that links between self-esteem, ideal body, ideal self and constructs of "woman with tattoos" may play a role in tattooing behavior in young women.

Tattoos yesterday and today in the Polish population in the decade 2004–2014

Background

The fashion for tattooing the body is becoming increasingly widespread. It seems that both the structure and role of factors motivating individuals to obtain tattoos have changed in recent years. The objective of this study was to evaluate the hypothesis that factors encouraging tattooing and the meaning of tattoos have evolved, leading to some significant recent changes.

Participants and procedure

The participants were individuals of Polish ethnicity aged 16-67 years, having at least one tattoo. The first survey, conducted in 2004, encompassed 100 subjects, while the second one, in 2014, involved 200 subjects. Both groups of respondents answered questions about the functions of tattoos and the factors motivating them to obtain a tattoo, as well as expressing their opinions about individuals with body art.

Results

In the studied decade we found a rise in the number of tattooed women, with tattoos being primarily perceived as an art form and a way to express one’s personality, aid self-enhancement, and improve one’s sexual attractiveness. Currently, tattooing more seldom serves as a provocation, self-identification, a mark of subculture affiliation, or a way to enhance self-esteem.

Conclusions

The functions of tattooing have been rapidly changing. The use among women causes that the perception of tattooing is changing and becoming less aggressive. The mass media insistently promote the fashion for tattoos, which is why this form of body art is becoming more and more popular.

Tattoos as a window to the psyche: How talking about skin art can inform psychiatric practice

Tattooing the skin as a means of personal expression is a ritualized practice that has been around for centuries across many different cultures. Accordingly, the symbolic meaning of tattoos has evolved over time and is highly individualized, from both the internal perspective of the wearer and the external perspective of an observer. Within modern Western societies through the 1970s, tattoos represented a cultural taboo, typically associated with those outside of the mainstream such as soldiers, incarcerated criminals, gang members, and others belonging to marginalized and counter-cultural groups. This paper aims to review the more recent epidemiology of tattoos in Western culture in order to establish that tattooing has become a mainstream phenomenon. We then review psychological and psychiatric aspects of tattoos, with a goal of revising outmoded stigmas about tattooing and helping clinicians working with tattooed patients to facilitate an exploration of the personal meaning of skin art and self-identity. We suggest that as a kind of augmentation of the physical exam, looking at and talking to patients about their tattoos can provide a valuable window into the psyche, informing clinical practice.

Tattoo removal with ingenol mebutate

An increasing number of people are getting tattoos; however, many regret the decision and seek their removal. Lasers are currently the most commonly used method for tattoo removal; however, treatment can be lengthy, costly, and sometimes ineffective, especially for certain colors. Ingenol mebutate is a licensed topical treatment for actinic keratoses. Here, we demonstrate that two applications of 0.1% ingenol mebutate can efficiently and consistently remove 2-week-old tattoos from SKH/hr hairless mice. Treatment was associated with relocation of tattoo microspheres from the dermis into the posttreatment eschar. The skin lesion resolved about 20 days after treatment initiation, with some cicatrix formation evident. The implications for using ingenol mebutate for tattoo removal in humans are discussed.

Muscle relaxation for individuals having tattoos removed through laser treatment: possible effects regarding anxiety and pain

Effectively managing pain is vital for the well-being and satisfaction of patients undergoing dermatologic treatments involving lasers. This study investigates the potential outcome of using muscle relaxation techniques to reduce pain among people having their tattoos removed with laser treatment. This study consists of 56 participants (mean age 18.1 ± 2.1 years) that had tattoos removed using the principle of selective photothermolysis. These participants underwent muscle relaxation before receiving the laser treatment. Their peripheral skin temperatures (PST) were measured both at the beginning and the end of the muscle relaxation period. Then, the Beck Anxiety Inventory was applied to evaluate anxiety levels. Once the laser treatment was completed, pain levels were measured using a visual analogue scale. A total of 125 person-sessions of laser treatment and psychometric assessments were performed in this study. The muscle relaxation method significantly increased the PST of the participants while reducing the levels of anxiety and pain throughout the course of the laser treatment procedure. The PST, anxiety scores, and pain scores all showed significant correlations with one another. According to the results obtained, this study proposes that muscle relaxation techniques be considered possibly auxiliary treatment options for individuals having tattoos removed through laser treatment. Additional studies with a comparison group and a larger sample size are required in the future to confirm the effectiveness of such intervention.

Tattoo Practices in North-East India: A Hospital-based Cross-sectional Study

Background:

Tattooing has become increasingly popular, particularly among young people. However, little is known about the tattoo practices in North-East India.

Objectives:

The primary objective of this study was to know the reasons and motivations of tattoo application and tattoo removal in individuals asking for tattoo removal. The secondary objective was to identify the demography, methods and safety of tattoo practices in these tattooed individuals.

Materials and Methods:

A hospital-based cross-sectional study was carried out in 212 consecutive individuals seeking tattoo removal. Chi-square and Fisher's exact tests were performed for intergroup comparisons.

Results:

There were 178 (84%) males and 34 (16%) females. The mean ± standard deviation (SD) age of individuals seeking tattoo removal was 21.8 ± 4 years. The mean ± SD age of doing tattoo was 15.8 ± 3 years. Most individuals possessed an amateur tattoo (94.3%), 4.2% a professional one and 1.4% had a combination. Sewing needle was the most common instrument used for making tattoos in 51.4%. The individuals made their tattoos in an unsterile manner in 49.1%. The most common reason for doing tattoo was for fashion in 87.7%. The participants wanted tattoo removal to qualify for jobs, especially in armed forces in 49.5% and due to regret in 21.7%. Black was the most preferred colour in 37.3% followed by green in 28.3%. The fabric ink was the choice of ink in maximum number of individuals, i.e. 93.9%.

Limitations:

It was a hospital-based study done only on individuals seeking tattoo removal. It needs caution to generalise the findings in population. In addition, there may be recall bias in the participants.

Conclusion:

The tattoo was done mostly below 18 years of age in a crude unsterile way. The individuals had poor risk perceptions about various infections and complications of tattooing. There is an urgent need to caution and educate the youngsters and school-going children about safe tattooing and consequences of tattooing.

The risks of do-it-yourself and over-the-counter devices for tattoo removal

The tattoo removal market has boomed over the years following the increased prevalence of tattooed individuals around the world. Surgery and laser are currently the gold standards for tattoo removal. However, both of them have drawbacks. Surgery is better suited for small tattoos in areas of adequate skin laxity but leave a scar, while laser removal is a long and painful procedure, with no guarantee of a complete efficacy. Both are expensive procedures, and not all individuals are ready to fund them privately. Consequently, some individuals are in the search of faster, easier, and cheaper procedures that can be performed either by themselves or by laypeople. The unregulated market of internet provides a favorable ground for many websites to offer various tattoo removal methods. Besides, some tattooists and other non-medical laypeople have started to get interested by such a growing market, especially as some laser devices manufactured in Asia are now available at competitive prices, and due to weaknesses in the EU legislation regarding the use of lasers for cosmetic procedures by non-medical laypeople. We review here different do-it-yourself and over-the-counter tattoo removal methods. We discuss the potential risks for tattooed individuals and stress the importance of a better regulation of such a market.

Long-term evaluation of ink clearance in tattoos with different color intensity using the 1064-nm Q-switched Nd:YAG laser

OBJECTIVE

The aim of the study was to evaluate the efficacy of tattoo removal treatments using the 1064-nm Q-switched (QS) Nd:YAG laser.

BACKGROUND DATA

Today, QS lasers appear to be the most common, effective, and safest methods to treat unwanted markings.

MATERIAL AND METHODS

A total of 64 patients with 75 unwanted tattoos were enrolled in the study. Tattoo clearance was evaluated according to the color intensity - concentration of pigment: group I (34) - black; group II (41) - gray. Consideration included methods of tattooing and tattoo techniques.

RESULTS

In group I, after the first treatment session the median of clearance was 30% (10-50%), while in group II, the median was 50% (40-70%). After the second treatment session, median in group I increased to 40% (30-50%). Median of group II increased to 70% (50-80%). The highest number of treatment in group I was 7. After that, the median grew to 75%, while the highest amount of treatment in group II was 5 and a median of 90% was achieved.

CONCLUSIONS

Effects were dependent upon the amount of ink deposited in the tissue. Old amateur tattoos and tattoos containing small quantities of ink (technique: shading and lines) demonstrated the quickest and the most efficacious results. Tattoos with large quantities of ink, obtained by filling, required the greatest number of treatment sessions. The final outcome in tattoo clearing can only be assessed following treatment completion, which may in some cases take 2-3 years. Presumably, in some cases, complete clearance is impossible.

Laser tattoo removal: a clinical update

Techniques for tattoo removal have evolved significantly over the years. The commonly used Quality-switched (QS) ruby, alexandrite, and Nd:YAG lasers are the traditional workhorses for tattoo removal. Newer strategies using combination laser treatments, multi-pass treatments, and picosecond lasers offer promising results. The tattoo color and skin type of the patient are important considerations when choosing the appropriate laser. Standard protocols can be developed for the effective and safe treatment of tattoos.

[Tattooed people, who are you? Demographic and behavioral characteristics of tattooed individuals]

Over the past 20 years, tattoos have become extremely popular in Western countries. In Germany for instance, 8.5% of the population (aged between 14 and 90 years) have tattoos. Trends in France are similar according to a recent poll (10%). However, tattoos are becoming increasingly common among the young, involving up to 25%, according to the individual country. Reasons for getting a tattoo are plentiful and personal. There is no specific profile of tattooed individuals nowadays but a rather wide spectrum of different types. Herein, we review the epidemiology of tattooed individuals in the light of the most recent publications on the subject.

Tattoos on 18-year-old male adolescents--characteristics and associated factors

BACKGROUND

Prevalence of tattoos is around 10-26% in men and 10-22% in women, and can involve negative effects such as: regret, removal attempts, physical and biological changes of the skin and association with some viral diseases.

OBJECTIVE

to determine the prevalence, characteristics and factors associated with tattoos in recruiters joining the military.

METHODS

the recruiters were examined by dermatologists that documented the presence or absence of tattoos, as well as their sizes, colors, designs and patterns, and whether they needed a parent's consent to get a tattoo.

RESULTS

1,968 recruiters were examined and the prevalence of tattoos was 10.82% (213), 141 (66.20%) had a single tattoo, 44 (20.66%) two tattoos, 15 (7.04%) three tattoos, 9 (4.23%) four tattoos, and 4 (1.88%) had more than four. Of the total sample, 168 (80.77%) reported getting the first tattoo before the age of 18. 158 (74.53%) were monochromatic. In relation to size, 108 (50.70%) had tattoos of up to 10 cm, 75 (35.21%) had tattoos measuring between 11-20cm, while 30 had ones over 21cm (14.09%).

CONCLUSIONS

The population studied had a high prevalence of tattoos for their age, the percentage of complex (large and polychromatic) tattoos was also high.

Awareness of health risks related to body art practices among youth in Naples, Italy: a descriptive convenience sample study

Background

Body art practices have emerged as common activities among youth, yet few studies have investigated awareness in different age groups of possible health complications associated with piercing and tattooing.

Methods

We investigated perceptions of and knowledge about health risks. To highlight differences among age groups, we gathered data from students at high schools and universities in the province of Naples.

Results

Of 9,322 adolescents, 31.3% were pierced and 11.3% were tattooed. Of 3,610 undergraduates, 33% were pierced and 24.5% were tattooed (p < 0.05). A higher number of females were pierced in both samples, but there were no gender differences among tattooed students. Among high school students, 79.4% knew about infectious risks and 46% about non-infectious risks; the respective numbers among university students were 87.2% and 59.1%. Only 3.5% of students in high school and 15% of university undergraduates acknowledged the risk of viral disease transmission; 2% and 3% knew about allergic risks. Among adolescents and young adults, 6.9% and 15.3%, respectively, provided signed informed consent; the former were less knowledgeable about health risks (24.7% vs. 57.1%) (p < 0.05). Seventy-three percent of the high school students and 33.5% of the university students had body art done at unauthorized facilities. Approximately 7% of both samples reported complications from their purchased body art.

Conclusions

Results indicate a need for adequate information on health risks associated with body art among students in Naples, mainly among high school students. Therefore, adolescents should be targeted for public health education programs.

Tattoo removal in the typical adolescent

BACKGROUND

Although popular tattoos are often regretted later on for different reasons. Nevertheless, tattoo removal is a complicated and costly procedure seldom providing satisfactory results. The aim of this study was to investigate the awareness of the implications of tattoo removal among a substantial sample of Italian secondary school adolescents.

FINDINGS

Students were recruited by a stratified convenience sample and surveyed by a self administered questionnaire. Logistic regression analysis was performed, reporting adjusted Odds Ratios (OR), with 95% Confidence Interval (CI).4,277 pupils returned a usable questionnaire. Piercings were more frequently undertaken than tattoos. Only 40% of the respondents were aware of the issues related to tattoo removal. Males and pupils with younger fathers were less likely to be aware, whereas students satisfied with their physical appearance and those with a positive attitude towards body art were more likely to be aware.

CONCLUSIONS

Male adolescents with younger fathers can be regarded as the ideal target of corporate health education programs driven by school counsellors and primary care physicians.

Marked for life? A prospective study of tattoos on appearance anxiety and dissatisfaction, perceptions of uniqueness, and self-esteem

Previous studies on psychosocial aspects of tattooing have not examined prospective changes in self- and body-related attitudes as a result of obtaining a tattoo. In the present study, 82 British residents obtaining their first tattoo completed measures of state appearance anxiety and dissatisfaction prior to, and immediately after, obtaining a tattoo. They also completed measures of trait body appreciation, distinctive appearance investment, self-ascribed uniqueness, social physique anxiety, and self-esteem before obtaining a tattoo and three weeks later. Results showed that both women and men had significantly lower appearance anxiety and dissatisfaction immediately after obtaining their tattoo, and significantly higher body appreciation, distinctive appearance investment, self-ascribed uniqueness, and self-esteem after three weeks. Women reported greater social physique anxiety after three weeks, whereas men reported lower anxiety. These results are discussed in relation to the positive impacts of obtaining body art and the mainstreaming of tattooing in Western societies.