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Not too long ago, most Americans associated tattoos with sailors, bikers and sideshow artists. But tattoos have become more popular in recent years, and the people who get them are as diverse as the styles and designs they choose. And some people who would never think of tattooing pictures or symbols onto their bodies use permanent makeup -- a type of tattoo -- to emphasize their eyes and lips. In this article, we will look at how the tattoo process works and examine the safety and legal issues surrounding it.

Tattoo Basics

Artists create tattoos by injecting ink into a persons skin. To do this, they use an electrically powered tattoo machine that resembles and sounds like) a dental drill. The machine moves a solid needle up and down to puncture the skin between 50 and 3,000 times per minute. The needle penetrates the skin by about a millimeter and deposits a drop of insoluble ink into the skin with each puncture. When you look at a persons tattoo, you are seeing the ink through the epidermis, or the outer layer of skin. The ink is actually in the dermis, which is the second layer of the skin. The cells of the dermis are far more stable than the cells of the epidermis, so the tattoos ink will stay in place, with minor fading and dispersion, for a persons entire life.

The tattoo machine has remained relatively unchanged since its invention by Samuel O Reilly in the late 1800s. O Reilly based his design on the autographic printer, an engraving machine invented by Thomas Edison. Edison created the printer to engrave hard surfaces. O’Reilly modified Edison’s machine by changing the tube system and modifying its rotary-driven electromagnetic oscillating unit to enable the machine to drive the needle. Modern tattoo machines have several basic components: A sterilized needle A tube system, which draws the ink through the machine. An electric motor. A foot pedal, like those used on sewing machines, which controls the vertical movement of the needle.

A tattoo machine involves a magnetic vibrator driving the needle up and down.

Time and Money

A small tattoo -- under one inch -- should cost from $50 to $100. Custom tattoos and larger designs are more expensive, and elaborate pieces can require multiple sessions. Prices for elaborate designs are whatever the market will bear, according to tattoo artists. A Difference of Opinion Some Americans with tattoos say they feel sexier (34%) and more attractive (26%). Many who dont have tattoos, however, think people who do have them are less attractive (42%), more rebellious (57%) and less intelligent (31%)
[Source: Harris Interactive]

Creating a Tattoo: Sterilization & Prep Work

A tattoo machine creates a puncture wound every time it injects a drop of ink into the skin. Since any puncture wound has the potential for infection and disease transmission, much of the application process focuses on safety. Tattoo artists use sterilization, disposable materials and hand sanitation to protect themselves and their clients. To eliminate the possibility of contamination, most tattoo materials, including inks, ink cups, gloves and needles, are single use. Many single-use items arrive in sterile packaging, which the artist opens in front of the customer just before beginning work. Reusable materials, such as the needle bar and tube, are sterilized before every use. The only acceptable sterilization method is an autoclave -- a heat/steam/pressure unit often used in hospitals. Most units run a 55-minute cycle from a cold start, and they kill every organism on the equipment. To do this, an autoclave uses time, temperature and pressure in one of two combinations: A temperature of 250° F (121° C) under 10 pounds of pressure for 30 minutes A temperature of 270° F (132° C) under 15 pounds of pressure for 15 minutes Prior to sterilizing the equipment, the artist cleans each item and places it in a special pouch. An indicator strip on the pouch changes color when the items inside are sterile. Before working on customers, tattoo artists wash and inspect their hands for cuts and abrasions. Then, they should do the following: Disinfect the work area with an EPA-approved viricide. Place plastic bags on spray bottles to prevent cross-contamination. Explain the sterilization process to the client. Remove all equipment from sterile packaging in front of the client. Shave and disinfect with a mixture of water and antiseptic soap) the area to be tattooed.

Creating a Tattoo: Outline, Shading and Color

Clients work with artists to create custom tattoo designs, or they chose images from flash, which are tattoo designs displayed in the shop. The artist draws or stencils the design onto the persons skin, since the skin can stretch while the artist uses the tattoo machine. The artist must also know how deeply the needles need to pierce the skin throughout the process. Punctures that are too deep cause excessive pain and bleeding, and ones that are too shallow cause uneven lines.

Most tattoo shops display a large collection of flash.

The tattoo itself involves several steps:

Outlining, or black work: Using a single-tipped
needle and a thin ink, the artist creates a permanent line over the stencil. Most start at the bottom of the right side and work up (lefties generally start on the left side) so they dont smear the stencil when cleaning excess ink from the permanent line.

Shading: After cleaning the area with soap and water, the artist uses a thicker ink and a variety of needles to create an even, solid line. Improper technique during this step can cause shadowed lines, excessive pain and delayed healing.

Color: The artist cleans the tattoo and then overlaps each line of color to ensure solid, even hues with no holidays -- uneven areas where color has lifted out during healing or where the artist missed a section of skin.

Final cleaning and bandaging: After using a disposable towel to remove any blood and plasma, the artist covers the tattoo with a sterile bandage. Some bleeding always occurs during tattooing, but most stops within a few minutes.

The tattoo artist fills in a tattoo using a thicker needle.

How Much Does it Hurt? People describe the sensation of getting a tattoo as similar to bee stings, sunburn or being pinched. Some say they experience a slight tickling or pins and needles. Individual pain tolerance, the size and type of tattoo, and the skill of the artist all contribute to the amount of pain. Location also makes a difference -- skin that rests right over a bone is more sensitive.

Health Risks

Since tattoos involve needles and blood, they carry several risks. These include transmission of diseases like hepatitis, tuberculosis and possibly HIV. When tattoo artists follow all the correct sterilization and sanitation procedures, risks for disease transmission are relatively low. According to the Centers for Disease Control and Prevention (CDC), there has not been a documented case of HIV transmission from a tattoo. However, doctors warn that non-sterile tattooing practices can lead to the transmission of syphilis, hepatitis B and other infectious organisms. Infections can occur in new tattoos, especially without appropriate aftercare. Some people also experience allergic reactions to tattoo inks.

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