Infections that can theoretically be transmitted by the use of unsterilized tattoo equipment or contaminated ink include surface infections of the skin, herpes simplex virus, tetanus, staph, fungal infections, some forms of hepatitis, tuberculosis, and HIV. People with tattoos are nine times more likely to be infected with hepatitis C, according to a study by Robert Haley, MD, chief of epidemiology at the University of Texas Southwestern Medical Center in Dallas.

No person in the United States is reported to have contracted HIV via a commercially-applied tattooing process. needed] Washington state’s OSHA studies have suggested that since the needles used in tattooing are not hollow, in the case of a needle stick injury the amount of fluids transmitted may be small enough that HIV would be difficult to transmit. Tetanus risk is reduced by having an up-to-date tetanus booster prior to being tattooed. According to the Centers for Disease Control and Prevention no data indicates an association between tattooing in the United States and increased risk for HCV infection.[citation needed] In 2006, the CDC reported 3 clusters with 44 cases of methicillin-resistant staph infection traced to unlicensed tattooists.

Because it requires breaking the skin barrier, tattooing may carry health risks, including infection and allergic reactions. In the United States, for example, the Red Cross prohibits a person who has received a tattoo from donating blood for 12 months (FDA 2000), unless the procedure was done in a state-regulated and licensed studio, using sterile technique.. Not all states have a licensing program, meaning that people who receive tattoos in those states are subject to the 12-month deferral regardless of the hygienic standards of the studio. Similarly, the UK does not provide certification for tattooists, and so there is a six month waiting period without exception.

Modern western tattooers reduce such risks by following universal precautions, working with single-use items, and sterilizing their equipment after each use. Many jurisdictions require that tattooists have bloodborne pathogen training, such as is provided through the Red Cross and OSHA.

General consensus for care advises against removing the scab that forms on a new tattoo, and avoiding exposing one’s tattoo to the sun for extended periods; both of these can contribute to fading of the image. Furthermore, it is agreed that a new tattoo needs to be kept clean. Various products may be recommended for application to the skin, ranging from those intended for the treatment of cuts, burns and scrapes, to cocoa butter, salves, lanolin, A&D or Aquaphor. Oil based ointments are almost always recommended to be used in very thin layers due to their inability to evaporate and therefore over-hydrate the already perforated skin. In recent years, specific commercial products have been developed for tattoo aftercare. Although

opinions about these products vary, there is near total agreement that either alone or in addition to some other product, soap and warm water work well to keep a tattoo clean and free from infection. Ultimately, the amount of ink that remains in the skin throughout the healing process determines, in large part, how robust the final tattoo will look. If a tattoo becomes infected (uncommon but possible if one neglects to properly clean their tattoo) or if the scab falls off too soon (e.g., if it absorbs too much water and sloughs off early or is picked or scraped off), then the ink will not be properly fixed in the skin and the final image will be negatively affected.

Before the tattooing begins the client is asked to approve the final position of the applied stencil. After approval is given the artist will open new, sterile needle packages in front of the client, and always use new, sterile or sterile disposable instruments and supplies, and fresh ink for each session (loaded into disposable ink caps which are discarded after each client). Also, all areas which may be touched with contaminated gloves will be wrapped in clear plastic to prevent cross-contamination. Equipment that cannot be autoclaved (such as counter tops, machines, and furniture) will be wiped with an approved disinfectant.

Membership in professional organizations, or certificates of appreciation/achievement, generally helps artists to be aware of the latest trends. However, many of the most notable tattooists do not belong to any association. While specific requirements to become a tattooist vary between jurisdictions, many mandate only formal training in bloodborne pathogens, and cross contamination. The local department of health regulates tattoo studios in many jurisdictions.

For example, according to the health department in Oregon and Hawaii, tattoo artists in these states are required to take and pass a test ascertaining their knowledge of health and safety precautions, as well as the current state regulations.

Performing a tattoo in Oregon state without a proper and current license or in an unlicensed facility is considered a felony offense. Tattooing was legalized in New York City, Massachusetts, and Oklahoma between 2002 and 2006.

carbon black, azo dyes, and acridine, quinoline, phthalocyanine and naphthol derivates, dyes made from ash, and other mixtures. The current trend for tattoo pigment favors Acrylonitrile butadiene styrene (ABS plastic) as seen by the widespread popularity of Intenze, Millennium and other ABS pigmented brands. Iron oxide pigments are used in greater extent in cosmetic tattooing. Many pigments were found to be used in a survey of professional tattooists.[citation needed] Recently, a blacklight-reactive tattoo ink using PMMA microcapsules has surfaced.

The technical name is BIOMETRIX System-1000, and is marketed under the name “Chameleon Tattoo Ink”. This same ink can also be found as “The Original Blacklight Inks by NEWWEST Technologies”. Modern tattooing inks are carbon based pigments that have uses outside of commercial tattoo applications. Although the United States Food and Drug Administration technically requires premarket approval of pigments it has not actually approved the use of any ink or pigments for tattooing (because of a lack of resources for such relatively minor responsibilities).  As of 2004 the FDA does perform studies to determine if the contents are possibly dangerous, and follow up with legal action if they find them to have disallowed contents, including traces of heavy metals (such as iron oxide) or other carcinogenic materials (see CA lawsuit). The first known study to characterize the composition of these pigments was started in 2005 at Northern Arizona University (Finley-Jones and Wagner). The FDA expects local authorities to legislate and test tattoo pigments and inks made for the use of permanent cosmetics. In California, the state prohibits certain ingredients and pursues companies who fail to notify the consumer of the contents of tattoo pigments. Recently, the state of California sued nine pigment and ink manufacturers, requiring them to more adequately label their products.Acrylonitrile butadiene styrene (ABS plastic) ground down to an average diameter of slightly less than 1 micrometer is used as the colorant in the brighter tattoo pigments. The tattoo pigments that use ABS result in very vivid tattoos. Many popular brands of tattoo pigment contain ABS as a colorant. ABS colorants produce extremely vivid tattoos that are less likely to fade or blur than the traditional pigments, but ABS tattoo pigment is also harder to remove because it is so much less reactive to lasers.

There has been concern expressed about the interaction between magnetic resonance imaging (MRI) procedures and tattoo pigments, some of which contain trace metals. Allegedly, the magnetic fields produced by MRI machines could interact with these metal particles, potentially causing burns or distortions in the image. The television show MythBusters tested the hypothesis, and found no interaction between tattoo inks and MRI. Professional tattooists rely primarily on the same pigment base found in cosmetics. Amateurs will often use drawing inks such as low grade India ink, but these inks often contain impurities and toxins which can lead to illness or infection. Although “greywork” is often done with a better quality pelikan #17 or Talens drawing ink mixed with a darker lining ink to optain a softer grey.

In the United States many prisoners and criminal gangs use distinctive tattoos to indicate facts about their criminal behavior, prison sentences, and organizational affiliation. Tear tattoo, for example, can be symbolic of murder, with each tear representing the death of a friend. At the same time, members of the U.S. military have an equally well established and longstanding history of tattooing to indicate military units, battles, kills, etc., an association which remains widespread among older Americans. Tattooing is also common in the British Armed Forces.

Insofar as this cultural or subcultural use of tattoos predates the widespread popularity of tattoos in the general population, tattoos are still associated with criminality. Although the general acceptance of tattoos is on the rise in Western society, they still carry a heavy stigma among certain social groups, such as conservative Evangelical Protestants.

Because members of these groups tend to have more conservative views, they often look upon the very practice of decorative tattooing as rather sinful in and of itself. A mixing of culture and religion plays a role here, as tattoos are associated with negative stereotypes like the drunk sailor or the outlaw biker. Therefore, now such groups view an activity as sinful, (even one that is objectively neutral in it’s inherit morality), simply because it was first popularized among those with a lifestyle generally contrary to their own moral values.

The prevalence of women in the tattoo industry, along with larger numbers of women bearing tattoos, is changing negative perceptions. A study of “at-risk” (as defined by school absenteeism and truancy) adolescent girls showed a positive correlation between body-modification and negative feelings towards the body and self-esteem; however, it also illustrated a strong motive of body-modification as the search for “self and attempts to attain mastery and control over the body in an age of increasing alienation.”