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As for the actual tattoo process, most tattoo studios will first use a machine called a thermal-fax to create a stencil. The thermal-fax saves hours of tracing time by the artist as your tattoo design is inserted into the machine and it transfers onto a piece of thermal paper. The thermal paper will then be used to transfer the stencil onto your skin. Some artists will use soap or water to moisten your skin, and some will use stick deodorant to aid in making the transfer better and darker. When the paper is pulled away from your skin, you will be left with a purple-colored likeness of your future tattoo on your skin. The remainder of the procedure will be performed with a tattoo machine.

Tattooing machines operate somewhat like sewing machines. A needle bar moves up and down, penetrating your epidermis and dermis (the upper and middle layers of the skin). The needle is operated by a foot pedal. Inks are placed in small cups called “ink caps”, needles and tubes removed from their sterile pouches and placed in the machine. Clean, distilled water is poured into a cup to be used to change from one color ink to another. When the artist begins your tattoo, he or she places ointment over your transfer design to keep the transfer from accidentally rubbing off and to allow the needle to slide along the skin more smoothly. A small single needle is used to create the outline of your tattoo, and a row of needles are used for shading and filling in the tattoo. The length of time it will take to complete your tattoo depends on your skin and complexity of the design.

Tattoos can be painful, but the level of pain will be determined by the size and location of the tattoo. Areas closest to the bone tend to be more painful than fleshier areas, but your personal pain threshold will be the greatest determinant of the discomfort you experience. After the tattoo is finished, it must be properly cared for. Remember to follow the post procedure instructions that your tattoo artist has given you so that the area will heal quickly and without unwanted side effects. A bandage will be applied to your tattoo, which should be left on at least overnight. When you uncover you new work, you will most likely be advised to gently wash it with an anti-bacterial or anti-microbial soap while taking a bath or shower. The area is usually patted dry and a thin coat of antibiotic ointment, such as Bacitracin or Polysporin will be applied to aid in the healing process. While your tattoo is healing, avoid swimming in either public pools or the ocean and avoid soaking in a hot tub. Keep your hands off your new tattoo and do not pick the area; some skin will flake off naturally and a scab will form, but resist pulling it. If the area becomes dry, moisturizing creams or lotions can hydrate the area. Lastly, it is important to protect your tattoo from the sun. Initially, you will want to keep it covered when you are outdoors. After it heals, it will still be important to protect the area so use SPF 30 sunblock to prevent fading.

Skin Reactions
As demonstrated in the chart above, pigments in tattoo dyes have the potential for causing a number of skin reactions. Some of the reactions are immediate and others may be delayed for a number of years. The most common reactions are eczematous, lichenoid, or granulomatous. Additionally, photosensitive or phototoxic reactions may occur and keloidal scars may form. Sarcoidosis, which is a common disorder in women of color, may appear within tattoos.

Eczematous hypersensitivity reactions are localized, scaly, red patches at the tattoo site that are itchy. Swelling of the skin may also occur. These reactions are treated with topical steroid creams or ointments. Additionally, anti-itching creams or antihistamines may also be recommended by your doctor for relief of itching. Depending on the severity of the reaction, it may resolve spontaneously or ultimately require removal of the tattoo.

Lichenoid reactions present as small, skin-colored, flat-topped bumps in the area of the tattoo. Treatment is not usually necessary. Granulomatous reactions are round, firm collections of reactive tissue that form beneath your skin. These bumps are larger and much more noticeable than lichenoid bumps. Granulomatous reactions are the most common type of allergic reaction to a specific ink. They are difficult to treat and often cause redness, swelling and bumpiness of the skin. Your dermatologist will attempt to treat this allergic reaction with prescription topical steroids or injected steroids as the first line of treatment. However, if this doesn’t work, tattoo removal may be necessary.

Keloids, which are large, raised scars that sometimes form after tattooing, occur commonly in people with brown skin. They are actually an abnormal healing reaction of the skin caused by the puncturing of the tattoo needles. Since there are no easy treatments for keloidal scars, it is inadvisable to get a tattoo if you know you are prone to keloids. Keloids can sometimes be flattened with a series of steroid injections by your dermatologist.

Finally, in some tattoos, photosensitive or phototoxic reactions can be a problem. A photosensitive reaction is an allergic reaction due to a combination of the tattoo ink and the sunlight, which produces an itchy, scaly and red rash. In contrast, a phototoxic reaction, also due to a reaction between the ink and the sun, will results in blistering of the tattoo area or a sunburn-like reaction. Although reactions can be caused by a number of dyes, they are most commonly linked to yellow pigments. For this reason, it is important to protect your tattoo from the sun.

Because tattoos inject foreign matter into your body, it is important to discuss any allergies with your dermatologist and tattoo artist beforehand. Allergies need not mean avoiding tattooing altogether, as organic and other pigments may be available to you.

Tattoo Ink
It is important to realize that when you get a tattoo, you are inserting something foreign, the tattoo ink, into your body. It is a good idea to know exactly what goes into most tattoo inks. Ink starts as a pigment that your artist will mix. Most tattoo pigments are derived from metals, and these metals may cause some people to have an allergic skin reaction. Fortunately, several pigments have non-metallic alternatives for those who are concerned about allergic reactions. Please refer to the chart below, which details the most common ink colors and their ingredients. It will also show you which colors are most likely to cause reactions.