Safer tattooing & piercing

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Body piercing and tattoo studios are not always inspected by public health departments. Studios should be inspected and public health units try and visit each shop at least once a year, but some piercing and tattoo businesses fall through the cracks and are missed. For public health purposes, it’s important to find an artist who:

has a good reputation
has lots of experience (and portfolio) in their particular field
has an inspection certificate from the local public health department
has an autoclave spore test calendar
follows infection control procedures to prevent the spread of hepatitis C and HIV

Infection Control Procedures

New sterile needles every time – Sharing needles can transmit infections, like Hep C. Reusing needles also makes them dull and the piercing or tattoo will hurt more.
New latex or vinyl gloves every time – Gloves should be changed every time they touch anything besides the sterile equipment and spot where the tattoo or piercing will be. This includes changing gloves after cleaning and prepping the work area and the site on the body.
New ink and ink pots – With tattoos, ink and ink pots can transmit Hep C if they are reused. A good artist knows that disposable cups can be filled with just the right amount of ink. They are an inexpensive and effective way to prevent the spread of disease.
New support equipment – Corks, razors, markers, swabs, cotton, dental bibs (for mouth piercings), stencil paper and other supplies should only be used once per person and then disposed of.
Autoclave for metal equipment – Clamps, tongs, and other metal equipment must be sterilized. Some places also buy new, single-use needles in bulk and must use the autoclave to sterilize them before use. The best way is in a steam-heat autoclave and a spore test calendar should be visible to certify that the autoclave is working.
Cleaning the site – The artist should use an alcohol swab followed by a topical surgical disinfectant to clean the area, working from the centre outwards.
Work area – The work surface and area should be clean, disinfected and non-porous so it doesn’t hold any fluids or infectious disease agents.
Stainless steel – Initial jewellery should be sterilized stainless steel or titanium and not changed until the piercing is fully healed.
Choosing a site on the body – The tattoo artist or piercer should have experience and skills that match the desired procedure, as different areas of the body require different skills to tattoo or pierce.
Providing aftercare instructions – Preventing infection goes beyond the procedure in the studio and involves educating clients on aftercare instructions so they can prevent infections themselves once they leave the shop.

Non-professional Settings

Piercing or tattooing in non-professional settings increases the risk of infections, both blood-borne (like Hep C) and skin infections.

Piercing needles are hollow and cause a surgical cut to create an appropriate space in the skin for the jewellery, while safety pins or sewing needles just push the flesh out of the way and are more likely to scar. Proper needles are not very expensive and can sometimes be obtained through needle exchange programs.

Non-professional tattooing is a strong part of certain cultures, including prison settings. If professional shops are not available, people may still pursue tattooing. This presents the challenge of disease and infection because of reused equipment, shared ink and little or no infection control procedures. Often, the quality of work is different and can be compromised if the job is rushed or if an infection develops. A tattoo is a lifetime commitment, so waiting for access to a professional and reputable shop may be the best option. Following infection control procedures and aftercare instructions is essential whenever a person gets a tattoo.

Signs of Skin Infections

Skin infections can wreck piercings and lead to excessive build-up of scar tissue; they can also ruin a tattoo’s look and texture. If a piercing or tattoo looks red, swollen, blistered, oozes pus or hurts for longer than the standard healing time, it may not be healing properly and could be infected. It should be looked at right away by a doctor or at a clinic.

Piercing Aftercare

People with new piercings are advised to follow the aftercare instructions provided by their piercer. They generally include the following points:

Wash hands with soap and water before cleaning the piercing and jewellery. Wash the piercing twice a day for the first two weeks with mild soap and then once a day after that.
Do not expose any fresh piercing to the saliva or body fluids of other people until healing is complete. This will help prevent major skin infections, sexually transmitted infections (STIs), HIV and Hep C.

Exterior Piercings

A piercing is an open wound and needs time to heal or it could become infected. As an open wound it also is a place where Hep C or HIV could enter the body. For example, a new genital piercing can bleed during sex making it easier to transmit Hep C or HIV. These aftercare instructions are meant to help people stay healthy and apply to piercings that involve the skin on the outside of the body, like ears, nose, nipple or belly button.

Remove any crusty build-up with cotton swabs and warm water.
Use soap and warm water to clean the holes and jewellery. Once the jewellery is soapy, gently move it back and forth in the hole to clean the inside. Rinse the jewellery and piercing using the same technique to remove all the soap, and then pat dry.
If a piercing is in contact with clothing, make sure the clothing is clean and loose.
Avoid bathtubs, hot tubs, lakes and pools while healing.
Over-cleaning will dry out a new piercing.
If a piercing gets infected, have it looked at by a doctor. Apply cream-based Polysporin twice a day after cleaning to help with minor infections. Put the cream on the jewellery and rotate in. Do not use a medicated cream unless you have an infection.

Oral Piercings

These instructions apply to piercings that involve the inside of the mouth, like tongue piercings.

For the first two weeks, rinse with salt water or a non-alcohol-based mouthwash for 60 seconds every time you eat or drink (in the second week you can dilute 50/50 with water).
Avoid smoking, spicy foods, active yeast, beer, and alcohol for the first week.
Antibacterial mouth rinse can help with healing or mild infections. Signs of infection are long-term or excessive swelling, yellow or green coating of the tongue, pus, localized hardness or bumps, and bleeding.
Suck on ice cubes to reduce swelling.
Brush your teeth and tongue twice a day as part of your regular oral hygiene.

For piercings that are both external and oral (labret or lip) follow both exterior and oral aftercare instructions.

Tattoo Aftercare

Tattoo artists should provide aftercare instructions. These will usually involve the following points:

Leave the bandage on for four to six hours after getting the tattoo. Once the tattoo has stopped bleeding, the bandage can be gently removed after hands are washed. If it sticks, wet it with warm water.
Wash hands, then wash the tattoo with the fingers and mild soap, rinse and pat dry.
If using healing ointments (vitamin A & D or vitamin E), put a thin layer on the tattoo twice a day for two days. Some shops provide this ointment for their clients.
Apply a non-scented body lotion (Lubriderm) when the tattoo becomes dry and flaky. Some scabbing and peeling will occur. Do not pick or scratch or you risk scarring, infections and losing ink.
Keep clothing clean and loose around the fresh tattoo.
Stay out of pools, lakes, hot tubs and direct sunlight until fully healed, about 10–14 days.
If infected, use a non-corticoid cream-based topical antibiotic twice a day for 10 days. Have it looked at by a professional. Apply sunscreen when healed.