Dr. Wong’s Tips for Getting a Tattoo

• Do not have a tattoo placed when you areinebriated.
• Do not get a tattoo because you and your friends are bored and cannot think ofanything else todo.
• Do not have a tattoo placed as a sign of eternal love. If you choose to ignore my advice, at least do not do get an extremely large tattoo. You may truly regret this later as haveseveral of mypatients.
• Do not do it in the immediate aftermath of a personal crisis or major life change, such asa breakup with long time partner, death, or jobloss.
• If you feel you need to make a change in your life and the tattoo represents the change,first consider a vacation destination where you have never been or get a different hairstyle or hair color.
• Women who have not yet been pregnant should give careful consideration to having a tattoo placed on the breasts or abdomen. These body areas may develop significantstretch marks following child birth, which can distort the appearance of thetattoo.

One of my patients was appropriately, emotionally devastated when her husband suddenly announced he was divorcing her after 30 years of marriage. She decided to treat herself to something fun and different.  She had a pretty floral vine tattooed on her leg, beginning at the ankle and extending to the hip. Unfortunately, after several weeks, she developed severe itching, blistering, crusting, and soreness in all the areas where she had red pigment. She had developeda severe allergic reaction to the tattoo. She sought treatment from several dermatologists who specialized in laser removal of tattoos and all of them declined to treat her because of concern she could potentially develop anaphylaxis, which could be potentially life-threatening if laser was performed on the tattoo and dispersed the pigment throughout her body. All prescription topical and oral medications used to treat allergic reactions were completely ineffective forher.

If I had seen her before she had gotten the tattoo, I would have advised her to have a small flower tattooed on the ankle. A good tattoo artist could have later altered this to the climbing vine easily. Also an allergic reaction confined to a small area would have been more amenable to treatment.

It is not possible to predict ahead of time how your skin may react. Besides an allergic reaction, risks include infection and scarring. The tattoo parlor should be clean and the needles sterilized. The tattoo artist should follow sanitary precautions to avoid spreading bacterial and viral infection. Certain body regions are more prone to scarring in everyone. Make an appointment to discuss this further with Dr. Wong. Be extremely cautious if you or someone in your family has a tendency for excessive scarring.

You changed your mind and want it removed:

• Up to 20% of people change their minds and want to have their tattoo removed.Don't assume you can reverse your decision with laser technology. Although the technology is continuing to improve, there are still risks to the procedure and there isno guarantee of perfectresults.
• Tattoo removal is expensive. It will cost many times more than the tattoo itself. Depending on the tattoo, anywhere from 6 to 25 laser treatments may be needed. Removal can run many thousands of dollars. Insurance companies will notcover cosmetic or decorative tattooremoval.
• Not every tattoo can be removed. Professional tattoos are more difficult to remove than amateur tattoos. The ink is placed deeper within the skin and many different vibrant colors are used. In general, multicolored tattoos where the pigment has been placed deeply are the most difficult to remove. There is no one laser system that can remove all the colors in a given tattoo. In general, a different laser will be required for each color range. You may need 3 to 6 different lasers to treat 1 tattoo at each lasersession.
• Not every tattoo can be removed without leaving scarring, a change in the skin texture and/or color of the skin. Permanent hypopigmentation or hyperpigmentation arepossible side effects. Even with the best result there is still often a slight "ghost like" color remaining in the shape of the formertattoo.

If you are certain you want to have a tattoo, Dr. Wong recommends the following:

• Have your tattoo done professionally. Do not try to economize and have your friend doit at home with his ink and needle set? You will have a tattoo that looks like a threeyear-old child drewit.
• Make sure words are spelled correctly and you have placed accents over the correct letters. Double-check the spelling in the dictionary even if you are positive you are Having misspelled words tattooed on your body looks terrible and will be an annoying reminder of your mistake whenever you look at it. One of my teenage patients had a friend tattoo what was intended to be a shocking fourletter expletive in bold capitals across his chest. Unfortunately, the C missing and he was quite distressed when I informed him of the correctspelling.
• The chosen site for the tattoo should be free of moles, rashes, and skingrowths.

• The chosen site should be easy to see and easily accessible for washing andaftercare.Do not tattoo personal information on your body such as your name, telephonenumber, address, or social security number. I had a patient who tattooed this information on his chest out of fear he may one day have a medical emergency that would render him unconscious and he would not be correctly identified at thehospital.
• Start with a small tattoo in an inconspicuous body area and see if you and the tattooare compatible.
• The best colors for a first time tattoo are blue or green. There is always time to get the colorful fire-breathing dragon wrapping around yourtorso.
• Limit your color palate to no more than 2 colors for the first tattoo. Be aware that tattoo artists mix many colors to make an unusual hue or to obtain an especially vibrant color. You may think you are getting 1 color but the peach color you chose is a combination of different pigments. Be advised that each of these pigments require a different wavelength of laser light for removal and maybe 6 different lasers! Ask the tattoo artist if it is a pure color pigment he or she will be using. Avoid custom mixed colors for your firsttattoo.
• Consider having the tattoo done using inks developed by a company called Freedom2. The inks are incorporated into polymer coated microbeads. These inks are more amenable to laser removal and require fewertreatments.

OTHER CONSIDERATIONS

If you have metallic components such as iron in your tattoo, it may interfere with MRI (magnetic resonance imaging) studies. There have been reports of patients experiencing burns, and an unpleasant tingling sensation when undergoing an MRI scan. Tattoo inks can contain aromatic amines (azo pigments), which may release carcinogens. It is forbidden to put these chemicals in cosmetics but it is not forbidden to have them in tattoo inks.

• Make an appointment with Dr. Wong. She can evaluate your skin and give you an opinion as to how your skin may react to the tattoo pigments and your potential risk for scarring. Bring your tattoo design and colors that you are contemplating using with you for your appointment. Certain colors have more potential problems associated with them. Dr. Wong can advise you how to prepare your skin for tattoo placement and on aftercare to minimize complications and optimize healing. Getting a tattoo is painful! Ask Dr. Wong for a prescription for a topical anestheticcream.
• Wong is no longer performing laser tattoo removal, but she is happy to discuss how to choose a dermatologist specializing in laser tattoo removal. She can also discuss alternative methods of tattoo removal that do not involve laser treatment. Please call our office to make an appointment if you have any of these concerns so she can assist you in your decision and help you responsibly prepare for placement of your tattoo.