By Dr. Noreen Islam, and Dr. Brian Lee, pediatric residents at CHOC
Body modification such as tattoos and piercings is becoming more common, especially among teens and young adults. Some less common types of modification include tongue splitting, implants and scarification (also known as branding). People get body modifications for many reasons ranging from cultural to expressions of personality. If your child is interested in body modification, we recommend having an open and honest discussion with them before making any decisions, especially regarding the risks and potential complications that can come with these procedures.
Teens and tattoos
In California, tattoos are prohibited for anyone under the age of 18. Tattoos take about two weeks to heal. During those two weeks, it’s important to apply sunscreen and avoid things like direct sun exposure, swimming, soaking the area, direct shower jets to the area, tight clothing, or clothing that may stick to the tattoo. Tattoo ink may contain metals that can cause skin reactions. Anyone getting a tattoo should also expect some degree of pain, swelling, skin sensitivity or itching. Although there are options for tattoo removal, including laser therapy over multiple sessions, tattoo removal is not always successful, and this should be stressed to the adolescent.
Temporary henna tattoos carry their own safety concerns. Red henna may cause hemolysis, the breakdown of red blood cells, in patients with G6PD deficiency. If a family member has this disease, please consult your pediatrician before using red henna. Black henna, which is red henna mixed with the chemical paraphenylenediamine (PPD), can cause allergic reactions and in some cases, significant scarring. This substance is also found in many hair dyes. It is recommended to do patch testing in an subtle area on the skin for any product with PPD, including henna preparations.
Teens and piercings
Body piercing, except ear piercing, requires a parent or guardian’s consent for minors under age 18 in California. Anyone seeking a piercing must ensure that they are visiting a facility that uses disposable, sterile equipment. Reusable piercing guns are not sanitary and can lead to infection. Some physicians also perform ear piercings in their office, which can be a safe alternative. Many people’s skin is sensitive to nickel, which is a commonly used metal in jewelry. Even stainless-steel body jewelry may contain nickel which can lead to skin irritation.
With mouth or tongue piercings, a blood collection, called a hematoma, can form around the piercing site. These piercings can also damage teeth and gums. Piercings of any location can lead to a buildup of scar tissue. In some cases, this can lead to the formation of a keloid, which is a raised overgrowth of scar tissue. All piercings are also at risk for infection, so it is extremely important to follow after-care instructions. Any time skin becomes red, swollen, or tender to touch, be sure to see your doctor right away.
Teens and scarification
Although more extreme than tattoos and piercings, scarification is becoming more popular. Scarification is a long process and there are many possible complications. The skill of the artist performing the “scarring” and how your skin heals both affect the outcome. The entire process may take up to a few years. It can be a painful process, and the more scarification you receive, the more pain you may experience. Avoid tight-fitting clothing until the wounds close. Take the same precautions as you would for tattoos. Be aware that complications like infections may be much higher with scarification. Unlike tattoos, there is no way to “reverse” this process. Like piercings, keloid formation is possible, and is much more common if there are others in your family with a history of keloids. Pain or changes in how your skin feels can be permanent.
Changing tastes, styles
Despite the increase in popularity of body modification, there are still significant complications that both teens and their parents must be aware of before making any decisions. While social media is filled with examples of artistic body modifications, it is also filled with stories of unintended consequences. It is important to review potential outcomes and complications before making permanent changes to your body. Parents are encouraged to remind their children that their personal style may change in the future, and that a permanent body modification can affect future employment opportunities. Teen patients interested in any form of body modification should consult their doctor about safety precautions before making any decisions.