Tattoo you — and piercings, too: Poke around before making your mark

If you don't already have one, you likely know someone who does.

The dental assistant with the dolphin on her lower back, the public-relations specialist with the tongue stud, the lawyer with the tribal band around her upper arm.

Around here, tattoos and piercings are as common as coffee shops and Thai restaurants. Nationwide, more than 20 million Americans have tattoos and even more have piercings, according to a recent Mayo Clinic report.

But how safe is it really? Shop owners and health officials say choosing a shop for your first — or 100th — piercing or tattoo requires more than a walk through the Yellow Pages. Finding a shop you trust is especially important because many state, city and county health officials — and even some artists themselves — say enforcement of state tattoo laws and regulation of the industry is lacking.

Plus, tattoos are pretty much forever. Make sure you want one in the first place — getting that Ashlee Simpson-band logo removed 15 minutes from now may cost thousands.

The local industry is not completely without rules. For instance, even with parental approval, kids under 18 can't get tattoos in Washington. Anyone who applies a tattoo to a minor is guilty of a misdemeanor under state law. And while there's no state-imposed age requirements on piercings, some shops require parent approval for kids under 16 or 18. Piercings other than ear, facial and navel must wait until age 18.

The bottom line: If you're going to get a tattoo or piercing, "do as much homework as possible on the place of business they plan to have the procedure done," said Dr. Martin Siegel, director of epidemiology (infection control) at Swedish Medical Center, reiterating the lack of regulations and citing the possible health risks.

Know what you want

Because that sketch is etched

It may seem like putting the cart before the horse, but you might start by deciding what design you want in a tattoo. Artists say that research is important because each one's work has a distinct look. Some are cartoonish; others are into realism. Look at photos of the artist's portfolio first.

"Most shops have Web sites you can go to before you even step out of the house," said Christopher Gay, a tattoo artist and owner of south Seattle's Artcore studios. "Find someone's work you feel is good and who's style fits the direction you want to go."

Also, talk to friends and acquaintances with tattoos about where they went and their experiences, or check in with the Better Business Bureau (thebbb.org or 206-431-2222) or county health departments (Public Health — Seattle & King County: www.metrokc.gov/health or 206-296-4632) to see if there's been complaints against certain shops.

Check out the place

Clean and well-lighted?

Once you've found the talent, check that your tattooist knows how to ink safely. A good tattoo and piercing studio should look much like a medical facility: clean and orderly. Employees should have a businesslike attitude.

"(Shops) should be well-lit and clean and bright, not dark and seedy looking," said Anne Alfred, a health and environmental investigator with Public Health — Seattle & King County. "Are you comfortable in the environment?"

Safety guidelines to consider and questions to ask:

• You should needle tattooists about sterilization procedures and equipment-isolation techniques. Reusable items should always be sterilized in an autoclave, which in turn should be cleaned and maintained regularly. Autoclaves should be spore-tested regularly to make sure they're killing all bacteria. Ask to see documentation of the maintenance; a good shop won't mind.

• Take time to observe your tattooist or piercer at work; inquire about their experience and qualifications. Have they done an apprenticeship or did they go to a tattoo school?

Have they taken additional health and safety courses, such as CPR, or attended any seminars on things like sterilization, microbiology or diseases?

• Make sure your artist dons a new pair of disposable gloves before setting up equipment.

• Insist on seeing your tattooist remove a new needle and tube set-up from a sealed envelope immediately before your treatment. They should not use reusable needles.

• Be certain that you see your tattooist pour a new ink supply into a new, disposable container. They should not be using ink that may have come in contact with a previous customer.

Little regulation

Business licenses required

While state laws establish standards for equipment-sterilization procedures and precautions for preventing the spread of diseases (modeled after "standard universal precautions"), some say they're hard to regulate.

"The challenge is even though there's laws and codes regarding tattoos and piercing, no authority is granted for anyone to uphold those laws," said Washington State Department of Health spokesman Tim Church.

The state Department of Licensing does not require tattoo artists and piercers to get a professional license. Nor is any specific medical training or other courses required by the Washington State Department of Health.

Artists say, however, the best way to learn the business is from someone with lots of experience. So, many tattoo artists and piercers spend a year-and-a-half or so in a shop as an apprentice or take additional first-aid and CPR courses. Employees who pierce at mall shops (Claire's and Afterthoughts, for example) typically go through about a week's worth of training.

In addition, most major cities, including Seattle, require tattoo artists and piercers to work at an establishment with a business license and tattoo-shop license. In Seattle, that license is issued upon approval by the police department and Public Health — Seattle & King County, and may be renewed annually for $530.

The Seattle tattoo-shop license, which must be posted in a conspicuous place, calls for sterilization and health-safety requirements comparable to the state's.

The Occupational Safety and Health Administration requires employees who work around blood and body fluids to be trained once a year by employers on the proper use of work and protective equipment.

Beyond design regret

Health risks do exist

Despite precautions, "there are real, potential consequences for both tattoos and body piercing, if the instrument you had them done on isn't appropriately sterilized," said Swedish's Siegel.

If a tattooist or piercer reuses a needle or doesn't properly sterilize one, Siegel said, there's potential — although minimal — of transmitting a blood-borne virus, such as HIV, hepatitis B or hepatitis C. Also, bacterial infections, such as staph or strep, can occur when the skin is pierced, especially in the mouth.

Most tattooists encourage customers to ask questions, said Christy Brooker, an artist at Apocalypse Tattoo on Capitol Hill, and if a customer's feeling uncomfortable they should feel free to turn around and walk out.

"If someone's not willing to give information, that's a sign you don't want to be (at that shop)," said Anne Alfred, a health and environmental investigator with Public Health. "You should ask questions. As a consumer, you want to be sure you're having a safe experience."

J.J. Jensen: 206-464-2761 or jjensen@seattletimes.com

This report contains information from Knight Ridder Newspapers.