Clinical Review

Health Risks Associated with Tattoos and Body Piercing



From the West Virginia University School of Medicine, Morgantown, WV.


  • Objective: To review the health risks associated with tattoos and body piercing.
  • Methods: Review of the literature.
  • Results: Tattooing and piercing have become increasingly popular practices in the United States. There are important physical and behavioral risks associated with these forms of body modification. The most common complications from tattooing include skin infections and allergic reactions. Minor complications such as infection and bleeding occur frequently with piercings, but major complications have also been reported. Tattoos and piercings appear to be a marker for risk-taking behavior.
  • Conclusion: Clinicians should understand the potential complications of these procedures and be able to counsel patients on how to reduce their health risks.

Tattoos and piercings are ancient practices of body modification that have gained widespread acceptance in modern society, particularly among young adults. Tattoos involve the insertion of colored pigment into the dermal layer of the skin with the goal of creating a permanent marking. They are commonly applied using an electrically powered handheld tattoo machine that moves a needle up and down to inject ink through the epidermis and deposit a drop of ink into the dermis [1]. The cells of the dermis are more stable compared with those of the epidermis, so the ink will mostly stay in place for a person’s lifetime [2].

Body piercing is defined as the insertion of a needle or specially designed piercing gun to create a fistula-like opening into either cartilage or skin for the introduction of decorative ornaments [3]. These ornaments can include jewelry, plastic or wood plugs, beads, or pearls. Body piercing has been part of ritualistic or cultural practices for centuries but is rapidly becoming a worldwide mainstream fashion trend, especially among young women aged 17 to 25 years [4]. Ear piercing has become so well accepted that most studies of body piercing do not include earlobe piercing [5].

There are important physical and behavioral risks associated with body modification. In this paper, we review the epidemiology, potential complications, and behavioral factors associated with tattoos and piercings.


Tattoos are increasingly popular, with a 2012 Harris poll indicating that 1 in 5 adults has at least 1 tattoo [6], up from 14% in 2008 [7]. In the 2012 poll, adults aged 30 to 39 are most likely to have a tattoo (38%) compared to both those younger (30% of those 25–29 and 22% of those 18–24) and older (27% of those 40–49, 11% of those 50–64 and just 5% of those 65 and older). Women are slightly more likely than men, for the first time since this question was first asked, to have a tattoo (23% versus 19% in men). Current US body piercing rates are approximately 36% [3]. Body piercing is more popular among women than in men [8]. Among adolescents, body piercing is performed considerably earlier than tattooing [9]. The head area is the favored location for piercing, while the most common location for a tattoo is the limb [10].


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