Cultural Practice - Tattoos Jason Cain Cross University of Mary

History of Tattoos Tattoos date back at least 5,000 years. All known civilizations have used tattoos in one form or another since that time. Early uses were for treatment of pain, enhancing fertility, badges of honor, spiritual guides, and simply as decoration (Franklin- Barbajosa, 2004). Tattoos were illegal in Japan, which drove the use of them underground, which is why their Yakuza prize them so highly. Egyptians used tattoos in 2000 B.C., for the most part on females to denote their status as concubines, prostitutes, or to protect them from sexually transmitted diseases. (Lineberry, 2007). Romans at first dimissed tattoos, believing in keeping the human form pure, though Roman soldiers eventually started wearing them as badges of honor (Franklin- Barbajosa, 2004).

History of Tattoos Ötzi Chinchorro Body Art Earliest known tattoo, found on the frozen remains of this Copper Age “Iceman.” Discovered in 1991, this was carbon dated to 3250 B.C. (Scallon, 2015). The tattoos found on his body were along areas of injury, suggesting a therapeutic use. This mummy was discovered in El Morro, Chile with a pencil thin mustache tattoo that is thought to be for cosmetic purposes. This mummy was found to be from about 2750 B.C. (Scallon, 2015). Full body tattoos can be found in examples from many civilizations over the centuries. Uses of full body tattoos have been for describing a warrior’s battles during the Crusades, to merely being for decoration today here in the United States (Franklin-Barbajosa, 2004) (Crum, 2015).

Public Health Indications – Impact on Health Therapy Markers Body Image Boosting Immunity Tattoos are used to help radiation therapists accurately aim radiation at the treatment area over the course of weeks (Stephan, 2016). Tattoos can help to heal the mental scars that typically go along with the traumatic experinces that created the physical ones (“Tattoos Covering Scars,” 2015). A 2016 study showed a significant correlation between the number of tattoos a person received, and how fast they heal from illness (Lynn, Dominguez, & Decaro, 2016).

Public Health Indications – Risks and Concerns General Risks Dye Impurities MRI Burns As with any invasive procedures, there is always the risk of infection. Tattoos also present the risk of allergic reactions, scarring, and granulomas (“Think Before You Ink: Are Tattoos Safe,” 2009). A significant but not well-known concern is the use of non-sterile water in mixing ink, which can cause Mycobacterial infections (“The Hidden Dangers of Getting Inked,” 2012). Another concern not well- known is the use of metallic inks in tattoos, and how they can cause severe burns in the skin after an MRI (Miller, 2014).

Health Promotion – Interventions & Recommendations Advise patients, especially the very young, about the risks and concerns related to getting new tattoos. Also advise on the importance of using a license tattoo artist, and insist on seeing them open new equipment in front of them. Talk about the importance of keeping a fresh tattoo clean and dry during the first two weeks, in order to help reduce risk of infection. Educate patients on the importance of letting health care workers about their tattoos if they are getting an MRI. Advocate for your patient and help them to maintain good health, even if you do not agree with their lifestyle choice.

References Crum, M. (2015, June 30). The Prickly History Of Tattooing In America. Retrieved from http://www.huffingtonpost.com/2015/06/30/america-tattoo- history_n_7690424.html Cuyper, C. D., & Luisa, P. S. (2010). Dermatologic complications with body art: Tattoos, piercings and permanent make-up. Berlin: Springer. Franklin-Barbajosa, C. (2004, December 1). Tattoo: Pigments of Imagination. Retrieved from http://ngm.nationalgeographic.com/ngm/0412/online_extra.html The Hidden Dangers of Getting Inked (2012). Retrieved from https://blogs.cdc.gov/publichealthmatters/2012/08/the-hidden-dangers- of-getting-inked/

References Lineberry, C. (2007, January 1). Tattoos. Retrieved from http://www.smithsonianmag.com/history/tattoos-144038580/?no-ist Lynn, C. D., Dominguez, J. T., & Decaro, J. A. (2016). Tattooing to “Toughen up”: Tattoo experience and secretory immunoglobulin A. American Journal of Human Biology, 28(5), 603-609. Miller, S. G. (2014). Strange Designs: 5 Weird Ways Tattoos Affect Your Health. Retrieved from http://www.livescience.com/52334-how-tattoos- affect-health.html Scallan, M. (2015, December 9). Ancient Ink: Iceman Otzi Has World's Oldest Tattoos. Retrieved from http://insider.si.edu/2015/12/debate-over-worlds- oldest-tattoo-is-over-for-now/

References Stephan, P. (2016). What Are Radiation Therapy Tattoos? Retrieved from https://www.verywell.com/what-are-radiation-tattoos-430384 Tattoos Covering Scars. (2016). Retrieved from http://www.inkedmag.com/tattoos-covering-scars/ Think Before You Ink: Are Tattoos Safe? (2009). Retrieved from http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048919.htm