What Exactly Is a Tattoo?

A tattoo is a puncture wound, made deep in your skin, that's filled with ink. It's made by penetrating your skin with a needle and injecting ink into the area, usually creating some sort of design. What makes tattoos so long-lasting is they're so deep — the ink isn't injected into the epidermis (the top layer of skin that you continue to produce and shed throughout your lifetime). Instead, the ink is injected into the dermis, which is the second, deeper layer of skin. Dermis cells are very stable, so the tattoo is practically permanent.

Tattoos used to be done manually — that is, the tattoo artist would puncture the skin with a needle and inject the ink by hand. Though this process is still used in some parts of the world, most tattoo shops use a tattoo machine these days. A tattoo machine is a handheld electric instrument that uses a tube and needle system. On one end is a sterilized needle, which is attached to tubes that contain ink. A foot switch is used to turn on the machine, which moves the needle in and out while driving the ink about 1/16 inch or less (about 1 millimeter) into your skin.

Most tattoo artists know how deep to drive the needle into your skin, but not going deep enough will produce a ragged tattoo, and going too deep can cause bleeding and intense pain. Getting a tattoo can take about 15 minutes to several hours, depending on the size and design chosen.

Does It Hurt to Get a Tattoo?

Getting a tattoo can hurt, but the level of pain can vary. Because getting a tattoo involves being stuck multiple times with a needle, it can feel like getting a bunch of shots or being stung by a hornet multiple times. Some people describe the tattoo sensation as "tingling." It all depends on your pain threshold, how good the person wielding the tattoo machine is, and where exactly on your body you're getting the tattoo. Also, keep in mind that you'll probably bleed a little.

If You're Thinking About It

If you're thinking about getting a tattoo, there is one very important thing you have to keep in mind — getting it done safely. Although it might look a whole lot cooler than a big scab, a new tattoo is also a wound. Like any other slice, scrape, puncture, cut, or penetration to your skin, a tattoo is at risk for infections and disease.

First, make sure you're up to date with your immunizations (especially hepatitis and tetanus shots) and plan where you'll get medical care if your tattoo becomes infected (signs of infection include excessive redness or tenderness around the tattoo, pus, or changes in your skin color around the tattoo).

If you have a medical problem such as heart disease, allergies,diabetes, skin disorders, a condition that affects your immune system, or a bleeding disorder — or if you are pregnant — ask your doctor if there are any special concerns you should have or precautions you should take beforehand. Also, if you're prone to getting keloids (an overgrowth of scar tissue in the area of the wound), it's probably best to avoid getting a tattoo altogether.

Avoiding Infection

It's very important to make sure the tattoo studio is clean and safe, and that all equipment used is disposable (in the case of needles, gloves, masks, etc.) and sterilized (everything else). Some states, cities, and communities set up standards for tattoo studios, but others don't. You can call your state, county, or local health department to find out about the laws in your community, ask for recommendations on licensed tattoo shops, or check for any complaints about a particular studio.

Professional studios usually take pride in their cleanliness. Here are some things to check for:

• Make sure the tattoo studio has an autoclave (a device that uses steam, pressure, and heat for sterilization). You should be allowed to watch as equipment is sterilized in the autoclave.
• Ask if they use one-time ink cartridges that are disposed of after each customer
• Check that the tattoo artist is a licensed practitioner. If so, the tattoo artist should be able to provide you with references.
• Be sure that the tattoo studio follows the Occupational Safety and Health Administration's Universal Precautions. These are regulations that outline procedures to be followed when dealing with bodily fluids (in this case, blood).

If the studio looks unclean, if anything looks out of the ordinary, or if you feel in any way uncomfortable, find a better place to get your tattoo.