Biomedical Engineering Reference
In-Depth Information
4
Tattoo removal
William T. Kirby
tattoo history
In 1991, in the Alps mountain at the border of Austria and
Italy, the frozen body of a tattooed man was found (1). The
corpse was so well preserved that it was originally believed
that the individual had only recently died. Subsequent carbon
dating showed that this well-preserved human had died
approximately 5300 years earlier. The now famous, Ötzi the
Iceman, had 57 purposely placed skin markings (2-4), making
this discovery one of the best-documented cases of tattoos in
prehistoric man.
This was not an isolated incident however; prehistoric
mummies with tattoos have also been found in Siberia, Peru,
and Chile (5-7), and evidence of the ancient art of tattooing
has been traced as far back as the Stone Age (12,000 BCE) (8).
Primitive humans slashed their skin during bereavement cer-
emonies and rubbed ash (and conceivably the ashes of the
deceased) into the cuts as a sign of grief and to possibly create
a permanent reminder of their ancestors. Decorative tattooing
has also been linked to the Bronze Age (8000 BCE) by the cir-
cumstantial evidence of crude needles and pigment bowls
found in caves in France, Spain, and Portugal (9). People of
this age decorated animal skins worn for warmth with ocher
and plant pigments, and this may have eventually evolved into
the decorative tattooing of their own skin as mummies dating
from 4000 BCE have shown evidence of crude tattoos (10).
In 1796, Joseph Banks, a member of Captain James
Cook's expedition, used the Samoan word “tatau,” meaning to
“to mark,” to describe one of the earliest written records of
purposeful tattoos. It is notably similar to the Tahitian word
“tattau” and obviously the modern “tattoo” originates from
these South Pacifi c island words. In 1891, Samuel O'Reilly
modifi ed an engraving device that was patented by Thomas
Edison in 1876. With the edition of an electromagnetic oscil-
lating unit that drove a solid steel needle and ink into the der-
mis, at a rate of 50-3000 injections per minute, the modern
day tattoo “gun” was born.
In the 1980s, a surge in tattooing popularity occurred in the
USA. Surveys in the early 2000s showed that 3-8% of the gen-
eral population, 10-13% of adolescents, 19-35% of individu-
als in the 16- to 35-year-old age group, 11-28% of individuals
in the 36- to 50-year-old age group, and 5-6% of Americans
older than 50 years had tattoos (11-14). A 2006 study showed
that 24% of Americans between 18 and 50 years of age were
tattooed and that about 36% of Americans between 18 and
29 years of age had at least one tattoo (15), and a 2003 study
estimated that 36% of those aged 25-29 have one or more
tattoos (16). The average age of acquisition of a professional
tattoo is 18 years (17) and that of a self-inflicted amateur tattoo
is 14 years (18-20). However, one's quest for identity at the age of
14-18 years is often irrelevant or embarrassing by age 40 years,
and 50% or more of individuals regret their tattoos (13,21).
Although most psychologic studies of individuals with tat-
toos have been restricted to psychiatric inpatients (22-24),
prisoners in correctional institutions (21-23,25-27), military
personnel (20,28-30), adolescents (31-34), and college stu-
dents (35-38), and as such refl ecting only specific populations,
one common conclusion of these studies is that, of all the vari-
ous motives for obtaining a tattoo, the quest for personal iden-
tity is central. The skin serves as a useful canvas on which to
portray statements of individuality, sexuality, belonging,
machismo, frustration, boredom, and anger. The most com-
monly stated reasons for obtaining a fi rst tattoo are “to try
something new or experimental” or “peer pressure” (39,40).
Significantly, smokers are almost three times more likely than
nonsmokers to have tattoos, and slightly more women than
men on college campuses and entering military service have
tattoos (10,12,13).
In a 1991 study of professional women with tattoos, 94%
were pleased with the tattoo (41), although a potential bias
exists in that those who were pleased may have been more
likely to respond as 55% of respondents had friends with tat-
toos, a known influential factor. Despite this bias and stated
satisfaction, 38% mentioned significant problems with having
a tattoo and 28% were considering tattoo removal, and the
desire for tattoo removal has probably been around nearly as
long as tattoos themselves. In fact, Egyptian mummies from
4000 BCE show evidence of attempts at tattoo removal (42).
Motivation for tattoo removal may encompass not only
internal regret and desire for more mature identity and self-
expression but may be driven by external societal pressure (43).
Although tattoos are far more accepted now than in the
past, generally speaking, tattoos may not be well received by the
public (44), and tattooed individuals may be perceived as
antisocial, aggressive, or immature and unable to accept con-
trols and authority (13). Moreover, tattoos may be a significant
barrier to employment (45-47), social status, or religious
acceptance (48,49).
tattoo ink composition
The US Food and Drug Administration identifi es tattoo ink as
a “color additive,” and because ink manufacturers are not
required to provide purchasers a list of ingredients, tattoo art-
ists, patients, and physicians alike may not know the specifi c
composition of a given tattoo (50,51).
That said, the composition of specifi c ink color and type is
known and is shown in Box 4.1 (52).
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