Photo Challenge
Painful Skin Lesions on the Hands Following Black Henna Application
A 14-year-old adolescent girl presented with painful skin lesions on the dorsal aspect of the hands of 10 days’ duration.
Tattoos have been viewed as one of the most exotic forms of art for thousands of years. In ancient times, tattoos were used mainly for therapeutic and status purposes. According to British archeologist Joann Fletcher, the oldest evidence of tattoo use was found on the famous “Iceman,” a 5200-year-old frozen mummy that was discovered more than 20 years ago.1 Tattoos were thought to be a form of therapy used to decrease joint pain. On the other hand, the ancient Egyptians used tattoos as symbols of wealth and high status; surprisingly, only women were tattooed. Fletcher also reported that tattoos were used as a form of therapy during pregnancy in upper-class women.1
Tattoos have served different purposes in the last few centuries, making their way to the United States at the start of the 20th century.2 New York City became the tattoo capital of the country. During this early period, male artists often would tattoo their wives so that they could advertise their work. After the Prohibition era, tattoos became widely used within the US Military, becoming a way to show pride and patriotism.2
Due to the permanent nature of tattoos, we sought to understand the reasons for obtaining this particular genre of body art. The purpose of this study was to provide a greater understanding of the current demographics of individuals who get tattoos, looking at specific trends in age and level of education of those who get tattoos as well as the motivation for tattoo placement. As dermatologists, it is essential to understand this patient population to be able to provide services (ie, tattoo removal) in the safe setting of a physician’s office.
Methods
The study was conducted at a private dermatology clinic in the Chicago (Illinois) metropolitan area with no institutional review board approval. Between January 2011 and December 2012, local patients with at least 1 tattoo were asked, with assumed consent, to fill out an investigator-developed survey containing 18 multiple-choice questions regarding age, educational and family background, and other factors. The race and gender of the respondents as well as the number of patients who declined to complete the survey were not recorded.
Results
A total of 363 patients completed the in-person survey. Responses were tabulated and converted into percentages for comparison (N=363). Data analysis was divided into 3 parameters: education level, health concerns, and motivation for getting a tattoo. Figure 1 shows that 70% of respondents had obtained a college degree or higher.
Figure 1. Highest level of education completed by survey respondents (N=363).
With regard to health concerns associated with tattoos, the majority of respondents (71%) claimed they were not concerned with the health risks (eg, infection with human immunodeficiency virus or hepatitis C virus) associated with getting a tattoo. Also, only 6% of respondents admitted to being under the influence of drugs or alcohol at the time of getting a tattoo. Of 21 respondents who claimed drugs and/or alcohol were part of their tattoo experience, the highest level of education was high school in 7 respondents and 2 got their first tattoo when they were younger than 14 years.
Survey results revealed that the majority of respondents got a tattoo as an act of rememberance (Figure 2). For example, one respondent reported getting a tattoo for religious purposes, while another got a tattoo to celebrate and mark each level of completed education (ie, high school, college, graduate school). However, a high percentage of respondents (26%) got a tattoo for fun.
Figure 2. Self-reported reasons for getting a tattoo among survey respondents (N=363).
