Tattoos and body piercings

There are several types of tattoos and make-up available, including some that are permanent and others that are temporary. 

• A permanent tattoo is when a needle inserts coloured ink into your skin. Permanent tattoos are there for life. It'll cost a lot of money and you'll need a specialist to remove them.
• Permanent makeup is also known as cosmetic tattooing. A needle inserts coloured ink into your skin to look like eyeliner, lip liner, eyebrows or other make-up. Some specialists offer 3D areola and nipple tattoos which can be an option following breast reconstruction.
• Henna (or mehndi) plant dye can be used to stain your skin. A henna tattoo lasts from 3 days up to a few weeks.
• Black henna contains a substance called paraphenylenediamine (PPD), found in hair dyes, to make temporary tattoos last longer. Black henna can be dangerous, causing severe skin reactions. It can also leave you with a lifelong sensitivity to PPD.
• Temporary (stick on or decal) tattoos are generally safe and non-toxic. Some are transfers with a backing that's peeled off once they've been attached to your skin using water. Others have a transparent backing that sticks to your skin with the image on top. Decal tattoos may last for a day or up to a week or more and can be removed with baby oil. Some people can get a reaction to the ink or the adhesive. 

The image below shows temporary tattoos on hands. 

Image credit: Canva

Tattooing has been part of Māori and Pasifika cultures for hundreds of years. Bone was traditionally used for piercing the skin and sometimes still is. However, it’s more common for tattoo artists to use needles. A traditional Māori tattoo artist is called the tohunga ta moko which means moko specialist.  

Image credit: NZ Story (NZStory_5932)

In Samoa, customary tattooing or tatau has been part of the culture for more than 2000 years. The tattoo artist is known as a tufuga.

As for any tattoo artist, make sure you choose an experienced operator with a good reputation. Ask to see their equipment and check that it’s sterilised. Customary Tattooing Guidelines for Operators(external link) are provided by the Ministry of Health and it's recommended that all cultural groups follow them when tattooing.

In general, getting a tattoo or body piercing is safe, but both can have health risks. Be aware that when you break the skin’s surface you’re at risk of infection.

Some blood-borne infections you can get are:  

• hepatitis C which can cause long-term illness, liver damage and liver cancer  
• hepatitis B  which can result in long-term illness, liver damage and liver cancer 
• HIV – the virus that causes AIDS 
• STIs – genital piercing may increase your risk of sexually transmitted infections 
• common bacteria (eg, staphylococcus) which can lead to nasty skin infections. 

Read more about these risks below.

Other complications include:

• infections and serious illness form unclean tattoo tools, practices or products
• allergic reactions to the inks or stains (eg, rashes)
• other skin problems, eg, increased chance of sunburn
• swelling and burning of some permanent tattoos if you get an MRI. 

The video below provides information and health advice (including avoiding infections) for young people thinking about getting body piercing and tattooing done. It's in New Zealand Sign Language (NZSL) with English translation.

Video: Body Piercing and Tattooing NZSL Translation: Full resource

This video may take a few moments to load.

(HealthEd New Zealand, 2014)

Committing to a tattoo or piercing is a big deal. Make sure you ask plenty of questions before you decide. Do you feel comfortable with this place, the operator? Has the place been recommended, what are its reviews like? Are you confident that this is what you want?   

Before you commit yourself, check that:  

• the area is clean and tidy 
• the operator is wearing new, clean gloves 
• sterile needles are opened just before use 
• there is equipment  to sterilise instruments (eg, a high-pressure steam cleaner)
• used needles are disposed of in a special container 
• the ear-piercing gun is only used for ears and is sterilised between uses 
• all body-piercing jewellery is made of high-quality 14 or 18 carat gold, surgical grade stainless steel, titanium, niobium, platinum or inert plastics 
• full after-care instructions are provided. 

 A responsible operator will also ask about your health status and may ask for your consent. If you are under 16 years of age, you should have a parent or caregiver with you. 

The operator who does your tattoo or piercing should give you after-care advice. Ideally it should be written advice for you to take home. Follow their instructions very carefully.  

Tattoos 

While your tattoo heals, you’re still at risk of infection, scarring or disfigurement. Tattoo care includes keeping it out of water (apart from gentle washing) and out of sunlight while it heals. It will take up to 2 weeks for your skin to heal. You can reduce the risk of infection by not touching the tattoo until it heals. Some tattooists sell special after-ink cream to help the healing process.  

Piercings 

Depending on where your piercing is, it might take weeks or months to heal, especially if it’s under the skin (eg an eyebrow or bellybutton piercing). There are also specific cleaning techniques for different piercings, eg, the care of oral (mouth) piercings is different than for face, ear and body piercings. A trustworthy operator will give you a full after-care guide. Always wash your hands thoroughly before touching your piercing. Don’t remove or share any jewellery until your piercing has completely healed to avoid infection. 

If you’re worried about your piercing or tattoo, get advice from the person who did it, or see your healthcare provider. 

Skin infection

Any tattoo means that the surface of your skin has been broken (like having a small operation) and the broken skin needs to heal. After getting a tattoo, it’s normal to see some redness and swelling. Your skin will feel sore, and you may see clear fluid oozing from your new tattoo. As your skin heals, it can itch and flake. Scabs may form. All of this can be part of the normal healing process.

Signs of an infection

An infection can happen immediately after getting inked, or days or months later. If an infection develops, your skin reacts a bit differently. You may notice one or more of the following:

• redness becomes darker or spreads instead of getting fainter and smaller
• pain continues or worsens instead of getting better
• a rash of itchy, red and painful bumps within the tattoo
• fever (high temperature), chills and shivering
• pus in the tattoo
• open sore(s) in the tattoo.

If you have any signs or symptoms of an infection, see your healthcare provider immediately. The sooner treatment is started, the less damage and infection can do – to your health and your tattoo.

Read more about skin infections. 

Allergic reactions 

Some people may get allergic reactions to the inks or stains, causing rashes and swelling. You can develop an allergic reaction at any time. It can happen immediately or weeks or years later.    

• Red tattoo pigments cause the most reactions, particularly those made from mercury sulfide (cinnabar). Hypersensitivity reactions to pigments used to make black, blue, purple and green tattoos are much less common. 
• Allergic reactions can also occur with henna tattoos. Henna itself should be safe, but the dye is often mixed with paraphenylenediamine (PPD), a chemical substance that is well known for causing allergic reactions in people sensitive to it. In this case, the dye is black in colour, so it's called black henna. 
• Some reactions may only happen when the tattoo is exposed to sunlight. This is most common with yellow tattoos created from cadmium sulfide but can also occur in red tattoos, because trace amounts of cadmium are added to brighten red tattoo pigment. 

Read more about dermatitis. 

Hepatitis

Hepatitis is a viral infection that causes inflammation of your liver. The hepatitis B and C viruses are carried in blood and can only be passed to someone through blood-to-blood contact. This happens when the blood of an infected person enters the bloodstream of an uninfected person. The most common way this occurs is through sharing needles. If you are not careful about how and where you get your tattoo, you can become infected. 

Read more about hepatitis B and hepatitis C. 

MRI burn

Although it's rare, a few people have developed a burn on tattooed skin during an MRI scan. These are mostly mild, but a few serious burns have been reported. If you have a tattoo or permanent makeup, you can still get an MRI. Tell the technician who is giving you the MRI that you have tattooed skin or permanent make-up and ask them to stop the MRI if you feel burning or stinging in that area. Read more about an MRI scan. 

Infection

Each new piercing is essentially a wound. Most of the time you’ll be able to tell if your piercing is infected. It might be red, swollen and painful, or oozing pus. You might also feel hot and shivery or just unwell.  

If you have any concerns, contact your healthcare provider right away.

Allergy

Some people react to the metals in jewellery causing allergic contact dermatitis(external link). Nickel in cheap jewellery is the most common cause, that’s why the use of hypoallergenic metal ware is recommended. Sometimes the cleaning solution itself can cause dermatitis or skin irritation. Treatment involves removing or changing the jewellery or adornment and avoiding cleaning solutions.  

Piercings and scars 

With delayed wound healing there can be an increased likelihood of scarring. Keloid scars are thick, raised scars that keep growing and become bigger than the original wound. Hypertrophic scars usually occur just at the site of the wound or piercing. See a dermatologist if scarring is an issue after piercing. 

Diabetes and infection

If you have diabetes, there are things you should consider before getting a tattoo or body piercing. It’s important that your glucose levels are under control and that you’re feeling well. You will need to look after your skin really carefully afterwards and get urgent help if there are any signs of infection. Read more about tattoos, body-piercing and diabetes(external link).