Getting yourself “inked” or tattooed does not seem to be a complicated decision. In just a few hours, you can be the proud bearer of whatever tattoo design you want. But the consequences could mean a lifetime of regret.

You could have allergic reactions, skin infections, blood-borne diseases like hepatitis B and C and HIV (human immune deficiency virus) infection, to name a few.

Should you need an MRI (magnetic resonance imaging) later to diagnose whatever problem you have in your body, tattoos might cause swelling or burning in the affected areas during the scanning. Let your doctor know you have a tattoo and where your tattoo is, should he request for an MRI.

A radiologist colleague told me once about his dilemma concerning those with big tattoos, especially those with almost whole-body designs on the chest, at the back and extremities. Apparently, tattoo pigments could interfere with the quality of MRI images. For example, it would be difficult to say if the haziness is due to a tumor, a swelling or just a distortion of the MRI image due to the tattoos.

Time was when having a tattoo was taboo. Now, it’s a strong expression of one’s identity. It’s so popular that nearly 50 percent of millennials have one, and a third of Gen X members have it. Some doctors I know proudly display the inked parts of their bodies during outings.

In an article he wrote in the July issue of Health & Lifestyle (H&L) magazine, Dr. Thaddeus “Thad” Hinunangan, a resident-in-training at the University of the Philippines-Philippine General Hospital, shares his exciting experience of having a tattoo.

Thad, then 17, walked into a tattoo shop on Recto Avenue to have one. “The walls were covered with sketches and there were full ashtrays everywhere,” he recalled. “I was greeted by a long-haired tattooed fellow with piercings, who led me to a seedier room upstairs.”

He confidently gave the scarab beetle design with its wings outstretched, from an Egyptian book. The tattoo artist promptly worked on it and Thad didn’t even notice if the artist changed needles.

Seven years later, Thad realized his folly because he couldn’t be admitted into the nursing school—his preparatory course for medical school—unless he removed his tattoo. “The cost and pain of removing the tattoo was a hundred times more than having one,” he wrote.

He paid only P1,500 for his beetle tattoo more than 15 years ago, but spent a hefty sum and three sessions to have it removed through laser by a dermatologist: P100,000 for the first session, P50,000 for the second and P30,000 for the third.

Since having a tattoo appears to be that popular, we’ll just have to make people aware of the health hazards and what precaution to take.

1) Make sure you’re ready.
Think carefully about it. If you feel unsure, it’s not a good time to have one done. Never decide to have one done when you’re under the influence of alcohol or drugs.

2) Don’t scrimp on design/ cost.

Thad gave this as an important advice. Make sure it’s a reputable tattooing studio that employs only properly trained artists. Check their licenses and registration and other certifications that they comply with all the regulations on the safety of the procedure. Tattoo artists should have a certification from the Department of Health, said Thad, and they were usually members of professional organizations of legitimate tattoo artists.

3) Insist on safety precautions.

The tattoo artist should wash his or her hands and wear a fresh pair of protective gloves before the start of each procedure. Make sure you see the tattoo artist removing in front of you the needle and tubes from sealed packages and that all pigments, trays or containers should be newly opened.

The artist uses some non-disposable equipment, which should have been sterilized before using an autoclave (heat sterilization device) and is neatly kept sterile in small towels like the ones used in surgical clinics. The tattoo artist opens the pack of the sterilized equipment only when he or she is ready to wear the gloves.

“Look around the shop,” said Thad. “If the place looks seedy and if you don’t see them open a fresh, sterile needle, say NO!”

4) Know that some areas are more painful than others for tattooing.

“The pain in tattooing feels like someone hitting you continuously with a small hot rubber band,” Thad said. It varies, depending on the skin area, with less pain in fatty tissues since the fat under the skin serves as cushion. Pain is more intense in bonier areas like the nape of the neck or near bony prominence spots.

“A good trick on how to test the sensitivity of the area is to finely pinch it with your fingers,” advised Thad.

5) Observe proper after-tattoo care.

The bandage can usually be removed after 24 hours, but if it still looks red and swollen, put antibiotic ointment on the tattooed skin until there’s no evidence of swelling.

The tattooed skin must be kept clean, with plain soap and water. Yes, you can wet it when you shower. But avoid direct streams of water on the newly tattooed skin because it can be painful. After showering, just pat gently to dry the area, don’t rub.

Bathing is fine, but stay out of pools, hot tubs, rivers, lakes and other bodies of water to avoid getting your tattooed skin infected.

A mild moisturizer, applied several times a day on the tattooed skin, can help soothe the pain and promote healing.

Avoid direct sun exposure of the tattooed skin for a few weeks.

When it starts to heal, scabs may form. Resist the urge to pick at these scabs, which can also cause infection, damage the tattoo design and cause scarring.

And just when you think you’re really decided and ready to be the proud owner of a tattoo, think of the sixth reminder from Thad.

6) Removing a tattoo will cost more and be much more painful.

Those applying to be seafarers realize this lesson. Some hiring agencies don’t accept applicants with any tattoo on the body. And don’t think that you can hide it. Some agencies do a thorough, whole-body examination so even small tattoos in private areas could be seen. Applicants have no choice but to have their tattoos removed. They sometimes spend more money on the tattoo removal than on their job application.

Complete removal without scarring may be impossible. So, if you’re really itching to have a tattoo done, “think hard before you ink.”

There are other safer ways to express yourself.