Be the point person when it comes to tattoos and piercings

Tattoos and piercings aren’t decreasing in popularity among young adults, and it’s up to parents and pediatricians to guide them to safe body modification choices.

If you ask most people aged younger than 18 years if they want a tattoo or piercing, most will say yes, and that they are just waiting until the they old enough to legally get one, says Cora Collette Breuner, MD, MPH, a clinician in the division of adolescent medicine, orthopedics, and sports medicine at Seattle Children’s Hospital and a professor of pediatrics at the University of Washington School of Medicine.

Maybe it’s the teenagers today or maybe it’s an increasing acceptance of body art and modification in younger generations-either way, it’s increasingly important to talk to children and teenagers about tattoos and piercings, and how to safely make choices about both, says Dr. Breuner, who discussed the this and more in the session titled, “To the Point: Talking to Patients and Parents About Tattooing and Piercing,” presented on October 27, 2019 and repeated again on October 28, 2019, at the 2019 American Academy of Pediatrics (AAP) Annual Conference and Exhibition in New Orleans, Louisiana.

Dr. Breuner, who helped draft AAP’s guidance on adolescent and young adult tattoos, piercing, and scarificantion in 2017, says tattoos and piercings are something pediatricians need to start talking about in well-child visits. Demographics play a role, as adolescent tattoos and piercing are strictly against the law in some states, but permitted with parental permission in others. A major issue to discuss and one of the biggest concerns people have with tattoos and piercings, Dr. Breuner says, is infection risk. It’s difficult to know what the infection rate secondary to body art is, because infections are not always documented in medical records as related to tattoos and piercings, she says. What’s important to know is that most clinicians and parents don’t realize how sterile most tattoo parlors are, but it’s still good to check out local establishments.

“What I tell people when I talk about this is to make sure the parlor is clean, and that they’re using sterile equipment and sterile gloves,” Dr. Breuner says. The circumstances under which a parlor will perform a tattoo or piercing is also important. “I counsel providers to tell parents and teenagers that it’s okay to ask someone if they will tattoo someone who is high or drunk-and don’t let them if they do.”

Another safety consideration to educate parents and patients about is immunizations, she adds. Tetanus, and hepatitis A and B vaccines should be up-to-date, Dr. Breuner says, and clinicians about also take some time to discuss tattoo and piercing placement. Generational differences of opinions aside, considering their future goals and whether a workplace will be accepting of body art is important, as are other health issues. Pregnancy and breastfeeding should be discussed in terms of being aware that navel piercings will stretch during pregnancy, and that hardware must be removed before breastfeeding, Dr. Breuner says. In terms of healing and the care of new body art, Dr. Breuner says the artists who do the work are often the best resource.

Overall, Dr. Breuner says pediatricians need to be open minded when it comes to talking about body art, and visiting local tattoo parlors to put together a list of sterile, recommended establishments doesn’t hurt.

“We need to make sure we are aware of the laws. It’s okay to encourage parents to go do a field trip with their young adult,” Dr. Breuner says. “Be open minded. Recognize that while you might not in your own personal purview agree or have enough knowledge, we are the ones people will turn to with questions.”