Safety concerns: Tattooing and piercing break the skin and may cause bleeding. They cause open wounds and infection is possible. Infections at the site may cause permanent deformity, scarring, severe illness and even death. Skin infected with resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA) can be life-threatening.

Needles and other equipment used contribute to the risk of cross-contamination and disease. If equipment is not new or properly sterilized, or if proper hygienic guidelines are not followed, blood-borne diseases, like hepatitis B and C (which may lead to life-long liver damage and subsequent liver cancer), HIV, tetanus and tuberculosis, may be transmitted.

One concern about tattooing is the dye used. Many dyes specific to tattooing are made from metals and can cause skin irritations and allergic reactions. Allergic reactions can only be remedied by removing the parts of the tattoo causing irritation. While irritation is not life threatening, the area will itch and the tattoo will not look as it should. The potential carcinogenic effect of dyes has not been well studied.

There are safety concerns related to piercing some parts of the body (e.g., ear cartilage, tongue, eyebrows, nipples, navel, genitals). There is an increased possibility of infection when cartilage is pierced because the blood supply is less. Piercing can easily cause keloids, greatly enlarged scars that project above the surface of the skin. Tongue studs and rings have been associated with tooth breakage, and some nipple piercings have been associated with partial removal of the breast due to infection or abscess.

What to look for in a safe studio: If you are interested in getting a tattoo or piercing, choose a safe, reputable studio. It is crucial that proper hygiene and safety standards are followed. Risks increase dramatically if individuals attempt the procedure on themselves or others.

The staff and studio area should be very clean. The studio should have separate areas for piercing and tattooing.

The studio should have and use an autoclave (equipment used to sterilize the necessary equipment). If there is not an autoclave, do not agree to a procedure.

Needles and other "sharps" should only be used once and should be opened (from individual packages) in front of you before the procedure.

Staff should wear new latex gloves during each procedure.

Piercings should not be done with a piercing gun as the "gun" cannot be properly sterilized in an autoclave and can spread infections.

Jewelry used for piercings should be non-allergenic only (stainless steel-300 series, gold, niobium, titanium or platinum) and should be available in a variety of sizes.

Inks used in tattooing should be placed in a single-use cup and then disposed. Ink should never be taken directly from the main source bottle or returned to that bottle!

Ask about after-care instructions. Read and understand the instructions before getting a tattoo or piercing.

Ask questions! How long has the person been piercing or tattooing? Are they knowledgeable? Ask to see photos of their work. Do you like it?

Ask if you can watch the preparation for and an actual piercing or tattooing of another person. Not all studios will let people watch, but this may give you a chance to check out sterilization and techniques.

If you feel uncomfortable in a studio or with the staff, leave.

Tattoo self-care: Tattoos take a couple of weeks to heal. They will scab over. The scabs will flake off. Your tattoo may be very itchy, but don't scratch or pick at it! Follow the directions your tattooist gives you or, if necessary, seek medical care. See When to See a Clinician.

Remove the bandage anywhere from an hour to the next morning after getting your tattoo.

During the healing process, gently wash your tattoo with a mild antibacterial soap. Pat dry - don't rub. Apply a thin layer of ointment until scabs flake off. Use an ointment like A&D, vitamin E, tea tree or a product recommended by your tattooist. After your tattoo has healed, apply a good quality moisturizing skin lotion to keep it healthy.

Don't soak in a tub or go swimming until your tattoo is fully healed.

Sunlight will damage your tattoo. Apply a sun block (with a high SPF) to your tattoo for the rest of your life.

Tattoo removal may be done by a dermatologist or plastic surgeon. The results are highly variable and the process can be expensive. If you are considering a tattoo, think of it as permanent.

Piercing self-care: A piercing can take a few weeks to several months to fully heal, depending on where it is on your body. Follow directions for care from your piercer, or, if necessary, seek medical care. See When to See a Clinician.

Do not touch the piercing. Do not pick at the piercing or jewelry. Your hands carry germs that can cause infection.

Use a warm sea salt-water soak or a mild liquid antibacterial soap used every day to aid healing and prevent infection.

Oral piercings need to be cared for differently than other piercings. Use an alcohol-free antibacterial mouthwash to cleanse the area in your mouth.

Do not use hydrogen peroxide or alcohol on piercings. These products can irritate the healing tissue.

Do not use antibiotic ointments, gels, or creams on piercings. They can attract dirt and prevent oxygen from reaching the area.

When to see a clinician: If you suspect infection, see a clinician because untreated infections can lead to further problems. Signs of infection include:

Tattoo: redness and burning beyond the normal healing period
Piercing: discharge of yellow or green pus; deep, dark redness that extends from the piercing; swelling; heat at the site; fever