A tattoo is a form of body modification where a design is made by inserting ink, dyes and pigments, either indelible or temporary, into the dermis layer of the skin to change the pigment. The art of making tattoos is tattooing.

Tattoos fall into three broad categories: purely decorative (with no specific meaning); symbolic (with a specific meaning pertinent to the wearer); pictorial (a depiction of a specific person or item).

In addition, tattoos can be used for identification such as ear tattoos on livestock as a form of branding.^[1]

The word tattoo, or tattow in the 18th century, is a loanword from the Samoan word tatau, meaning "to strike".^[2][3] The Oxford English Dictionary gives the etymology of tattoo as "In 18th c. tattaow, tattow. From Polynesian (Samoan, Tahitian, Tongan, etc.) tatau. In Marquesan, tatu." Before the importation of the Polynesian word, the practice of tattooing had been described in the West as painting, scarring or staining.^[4]

The etymology of the body modification term is not to be confused with the origins of the word for the military drumbeat or performance — see military tattoo. In this case, the English word tattoo is derived from the Dutch word taptoe.^[5]

Copyrighted tattoo designs that are mass-produced and sent to tattoo artists are known as "flash", a notable instance of industrial design.^[6] Flash sheets are prominently displayed in many tattoo parlors for the purpose of providing both inspiration and ready-made tattoo images to customers.

The Japanese word irezumi means "insertion of ink" and can mean tattoos using tebori, the traditional Japanese hand method, a Western-style machine or any method of tattooing using insertion of ink. The most common word used for traditional Japanese tattoo designs is horimono.^[7] Japanese may use the word tattoo to mean non-Japanese styles of tattooing.

British anthropologist Ling Roth in 1900 described four methods of skin marking and suggested they be differentiated under the names "tatu", "moko", "cicatrix" and "keloid".^[8]

The American Academy of Dermatology distinguishes five types of tattoos:^[9] traumatic tattoos, also called "natural tattoos", that result from injuries, especially asphalt from road injuries or pencil lead; amateur tattoos; professional tattoos, both via traditional methods and modern tattoo machines; cosmetic tattoos, also known as "permanent makeup"; and medical tattoos.

A traumatic tattoo occurs when a substance such as asphalt or gunpowder is rubbed into a wound as the result of some kind of accident or trauma.^[10] Coal miners could develop characteristic tattoos owing to coal dust getting into wounds.^[11] These are particularly difficult to remove as they tend to be spread across several layers of skin, and scarring or permanent discoloration is almost unavoidable depending on the location. An amalgam tattoo is when amalgam particles are implanted in to the soft tissues of the mouth, usually the gums, during dental filling placement or removal.^[12] Another example of such accidental tattoos is the result of a deliberate or accidental stabbing with a pencil or pen, leaving graphite or ink beneath the skin.

Many tattoos serve as rites of passage, marks of status and rank, symbols of religious and spiritual devotion, decorations for bravery, sexual lures and marks of fertility, pledges of love, amulets and talismans, protection, and as punishment, like the marks of outcasts, slaves and convicts. The symbolism and impact of tattoos varies in different places and cultures. Tattoos may show how a person feels about a relative (commonly mother/father or daughter/son) or about an unrelated person.^[13] Today, people choose to be tattooed for artistic, cosmetic, sentimental/memorial, religious, and magical reasons, and to symbolize their belonging to or identification with particular groups, including criminal gangs (see criminal tattoos) or a particular ethnic group or law-abiding subculture. Popular texts include the Biblical verses John 3:16, Philippians 4:13, and Psalm 23.^[14]

Extensive decorative tattooing is common among members of traditional freak shows and by performance artists who follow in their tradition.^[15]

People throughout history have also been forcibly tattooed for means of identification.

A well-known example is the Nazi practice of forcibly tattooing concentration camp inmates with identification numbers during the Holocaust as part of the Nazis' identification system, beginning in fall 1941.^[16] The SS introduced the practice at Auschwitz concentration camp in order to identify the bodies of registered prisoners in the concentration camps. During registration, guards would pierce the outlines of the serial-number digits onto the prisoners' arms. Of the Nazi concentration camps, only Auschwitz put tattoos on inmates.^[16] The tattoo was the prisoner's camp number, sometimes with a special symbol added: some Jews had a triangle, and Romani had the letter "Z" (from German Zigeuner for "Gypsy"). In May 1944, the Jewish men received the letters "A" or "B" to indicate particular series of numbers.

Tattoos have also been used for identification in other ways.

As early as the Zhou, Chinese authorities would employ facial tattoos as a punishment for certain crimes or to mark prisoners or slaves. During the Roman Empire, gladiators and slaves were tattooed: exported slaves were tattooed with the words "tax paid", and it was a common practice to tattoo "Stop me, I'm a runaway" on their foreheads.^[18] Owing to the Biblical strictures against the practice,^[19] Emperor Constantine I banned tattooing the face around AD 330, and the Second Council of Nicaea banned all body markings as a pagan practice in AD 787.^[20]

In the period of early contact between the Māori and Europeans, the Māori people hunted and decapitated each other for their moko tattoos, which they traded for European items including axes and firearms.^[21] Moko tattoos were facial designs worn to indicate lineage, social position, and status within the tribe. The tattoo art was a sacred marker of identity among the Māori and also referred to as a vehicle for storing one's tapu, or spiritual being, in the afterlife.^[22]

Tattoos are sometimes used by forensic pathologists to help them identify burned, putrefied, or mutilated bodies. As tattoo pigment lies encapsulated deep in the skin, tattoos are not easily destroyed even when the skin is burned.^[23]

Tattoos are also placed on animals, though rarely for decorative reasons.

Pets, show animals, thoroughbred horses, and livestock are sometimes tattooed with identification and other marks. Tattooing with a 'slap mark' on the shoulder or on the ear is the standard identification method in commercial pig farming. Branding is used for similar reasons and is often performed without anesthesia, but is different from tattooing as no ink or dye is inserted during the process, the mark instead being caused by permanent scarring of the skin.^[24] Pet dogs and cats are sometimes tattooed with a serial number (usually in the ear, or on the inner thigh) via which their owners can be identified. However, the use of a microchip has become an increasingly popular choice and since 2016 is a legal requirement for all 8.5 million pet dogs in the UK.^[25]

Permanent makeup is the use of tattoos to enhance eyebrows, lips (liner and/or lipstick), eyes (liner), and even moles, usually with natural colors, as the designs are intended to resemble makeup.^[26]

A growing trend in the US and UK is to place artistic tattoos over the surgical scars of a mastectomy. "More women are choosing not to reconstruct after a mastectomy and tattoo over the scar tissue instead... The mastectomy tattoo will become just another option for post cancer patients and a truly personal way of regaining control over post cancer bodies..."^[27] However, the tattooing of nipples on reconstructed breasts remains in high demand.^[28]

Functional tattoos are used primarily for a purpose other than aesthetics.

One such use is to tattoo Alzheimer patients with their names, so they may be easily identified if they go missing.^[29]

Medical tattoos are used to ensure instruments are properly located for repeated application of radiotherapy and for the areola in some forms of breast reconstruction. Tattooing has also been used to convey medical information about the wearer (e.g., blood group, medical condition, etc.). Additionally, tattoos are used in skin tones to cover vitiligo, a skin pigmentation disorder.^[30]

SS blood group tattoos (German: Blutgruppentätowierung) were worn by members of the Waffen-SS in Nazi Germany during World War II to identify the individual's blood type. After the war, the tattoo was taken to be prima facie, if not perfect, evidence of being part of the Waffen-SS, leading to potential arrest and prosecution. This led a number of ex-Waffen-SS to shoot themselves through the arm with a gun, removing the tattoo and leaving scars like the ones resulting from pox inoculation, making the removal less obvious.^[31]

Tattoos were probably also used in ancient medicine as part of the treatment of the patient.

In 1898, Daniel Fouquet, a medical doctor, wrote an article on "medical tattooing" practices in Ancient Egypt, in which he describes the tattooed markings on the female mummies found at the Deir el-Bahari site. He speculated that the tattoos and other scarifications observed on the bodies may have served a medicinal or therapeutic purpose: "The examination of these scars, some white, others blue, leaves in no doubt that they are not, in essence, ornament, but an established treatment for a condition of the pelvis, very probably chronic pelvic peritonitis."^[32]

Preserved tattoos on ancient mummified human remains reveal that tattooing has been practiced throughout the world for many centuries.^[33] In 2015, scientific re-assessment of the age of the two oldest known tattooed mummies identified Ötzi as the oldest example then known. This body, with 61 tattoos, was found embedded in glacial ice in the Alps, and was dated to 3250 BCE.^[33][34] In 2018, the oldest figurative tattoos in the world were discovered on two mummies from Egypt which are dated between 3351 and 3017 BCE.^[35]

Ancient tattooing was most widely practiced among the Austronesian people. It was one of the early technologies developed by the Proto-Austronesians in Taiwan and coastal South China prior to at least 1500 BCE, before the Austronesian expansion into the islands of the Indo-Pacific.^[36][37] It may have originally been associated with headhunting.^[38] Tattooing traditions, including facial tattooing, can be found among all Austronesian subgroups, including Taiwanese Aborigines, Islander Southeast Asians, Micronesians, Polynesians, and the Malagasy people. Austronesians used the characteristic hafted skin-puncturing technique, using a small mallet and a piercing implement made from Citrus thorns, fish bone, bone, and oyster shells.^[2][37][39]

Ancient tattooing traditions have also been documented among Papuans and Melanesians, with their use of distinctive obsidian skin piercers. Some archeological sites with these implements are associated with the Austronesian migration into Papua New Guinea and Melanesia. But other sites are older than the Austronesian expansion, being dated to around 1650 to 2000 BCE, suggesting that there was a preexisting tattooing tradition in the region.^[37][40]

Among other ethnolinguistic groups, tattooing was also practiced among the Ainu people of Japan;^[41] some Austroasians of Indochina;^[42] Berber women of Tamazgha (North Africa);^[43] the Yoruba, Fulani and Hausa people of Nigeria;^[44] Native Americans of the Pre-Columbian Americas;^[45][46][47] and Picts of Iron Age Britain.^[48]

In 1565, French sailors abducted a Inuit woman with facial tattoos and her daughter from Canada. They put them on public display in Antwerp, the Netherlands, drawing crowds for money.^[49] Sir Martin Frobisher, an English privateer, also abducted an Inuit man from Baffin Island, putting him on display in London before he died from European diseases. Frobisher returned to Baffin Island and abducted a man, a woman, and a child, also taking them back to London for public display. They also died from illness shortly afterwards.^[50]

Perhaps the most famous tattooed "curiosity" in Europe prior to the voyages of Captain Cook, was the "Painted Prince" - a slave named "Jeoly" from Mindanao, Philippines. He was initially bought with his mother (who died shortly afterwards) from a slave trader in Miangas Island in 1690 by the English explorer William Dampier. Dampier described Jeoly's intricate tattoos in his journals:^[51]

Jeoly told Dampier that he was the son of a rajah in Mindanao, and told him that gold (bullawan) abounded in his island. These were likely embellishments told by Jeoly in an effort to convince Dampier to free him. He also mentions that the men and women of Mindanao were also tattooed similarly, and that his tattoos were done by one of his five wives.^[51]

Dampier brought Jeoly with him to London, intending him to be a puppet prince for the British venture into the Spice Islands. He promised Jeoly that he would be paid well and allowed to return home. He invented a fictional backstory for him, renaming him "Prince Giolo" and claiming that he was the son and heir of the "King of Gilolo." Instead of being from Mindanao, Dampier now claimed that he was only shipwrecked in Mindanao with his mother and sister, whereupon he was captured and sold to slavery. Dampier also claimed that Jeoly's tattoos were created from an "herbal paint" that rendered him invulnerable to snake venom, and that the "royal" tattooing process was done naked in a room of venomous snakes.^[51][52][53]

Dampier initially toured around with Jeoly, showing his tattoos to crowds.

Despite pretending to care for the "prince", Dampier eventually sold Jeoly to the Blue Boar Inn in Fleet Street. Jeoly was displayed as a sideshow by the inn, with his likeness printed on playbills and flyers advertising his "exquisitely painted" body. By this time, Jeoly had contracted smallpox and was very ill. He was later brought to the University of Oxford for examination, but he died shortly afterwards at around thirty years of age in the summer of 1692. His tattooed skin was preserved and was displayed in the Anatomy School of Oxford for a time, although it was lost prior to the 20th century.^[51][52][54]

It is commonly held that the modern popularity of tattooing stems from Captain James Cook's three voyages to the South Pacific in the late 18th century.

Certainly, Cook's voyages and the dissemination of the texts and images from them brought more awareness about tattooing (and, as noted above, imported the word "tattow" into Western languages).

On Cook's first voyage in 1768, his science officer and expedition botanist, Sir Joseph Banks, as well as artist Sydney Parkinson and many others of the crew, returned to England with tattoos, although many of these men would have had pre-existing tattoos.

Banks was a highly regarded member of the English aristocracy that had acquired his position with Cook by co-financing the expedition with ten thousand pounds, a very large sum at the time.

In turn, Cook brought back with him a tattooed Raiatean man, Omai, whom he presented to King George and the English Court. On subsequent voyages other crew members, from officers, such as American John Ledyard, to ordinary seamen, were tattooed.^[55]

The first documented professional tattooist in Britain was Sutherland Macdonald, who operated out of a salon in London beginning in 1894.^[56] In Britain, tattooing was still largely associated with sailors^[57] and the lower or even criminal class,^[58]%20%28London%29%2C%203%20April%201879%2C%20p.%209%3A%20%22Crime%20h]]but by the 1870s had become fashionable among some members of the upper classes, including royalty,^{[[4]](https://openlibrary.org/search?q=%22tattoo%22.%20} [[CITE|4|https://openlibrary.org/search?q=%22tattoo%22.%20*The%20Hutchinson%20Unabridged%20Encyclopedia%20)^[59][60][61] the practice continued for some time in Britain.^[62] Recently, a trend has arisen marketed as 'Stick and Poke' tattooing; simple designs are tattooed either on oneself or by another person using 'DIY' kits that usually contain needles, ink, and often sample designs.^[63]

As most tattoos in the United States were done by Polynesian and Japanese amateurs, tattoo artists were in great demand in port cities all over the world, especially by European and American sailors.

The first recorded professional tattoo artist in the US was a German immigrant, Martin Hildebrandt. He opened a shop in New York City in 1846 and quickly became popular during the American Civil War among soldiers and sailors of both Union and Confederate militaries.

Hildebrandt began traveling from camp to camp to tattoo soldiers, increasing his popularity and also giving birth to the tradition of getting tattoos while being an American serviceman.

Soon after the Civil War, tattoos became fashionable among upper-class young adults.

This trend lasted until the beginning of World War I. The invention of the electric tattoo machine caused popularity of tattoos among the wealthy to drop off.

The machine made the tattooing procedure both much easier and cheaper, thus, eliminating the status symbol tattoos previously held, as they were now affordable for all socioeconomic classes.

The status symbol of a tattoo shifted from a representation of wealth to a mark typically seen on rebels and criminals.

Despite this change, tattoos remained popular among military servicemen, a tradition that continues today.

In 1975, there were only 40 tattoo artists in the country, mostly tough curmudgeons who spent years learning their trade and hours perfecting a tattoo.

In 1980, there were more than 5,000 self-proclaimed tattooers.

They appeared overnight to meet a booming popularity in the skin mural trade.^[64] Many studies have been done of the tattooed population and society's view of tattoos.

In June 2006, the Journal of the American Academy of Dermatology published the results of a telephone survey of 2004. It found that 36% of Americans ages 18–29, 24% of those 30–40, and 15% of those 41–51 had a tattoo.^[65] In September 2006, the Pew Research Center conducted a telephone survey that found that 36% of Americans ages 18–25, 40% of those 26–40 and 10% of those 41–64 had a tattoo. They concluded that Generation X and Millennials express themselves through their appearance, and tattoos are a popular form of self-expression.^[66] In January 2008, a survey conducted online by Harris Interactive estimated that 14% of all adults in the United States have a tattoo, slightly down from 2003, when 16% had a tattoo. Among age groups, 9% of those ages 18–24, 32% of those 25–29, 25% of those 30–39 and 12% of those 40–49 have tattoos, as do 8% of those 50–64. Men are slightly more likely to have a tattoo than women.

Richmond, Virginia has been cited as one of the most tattooed cities in the United States.^[67] That distinction led the Valentine Richmond History Center to create an online exhibit titled "History, Ink: The Tattoo Archive Project ^[132]." The introduction to the exhibit notes, "In the past, western culture associated tattoos with those individuals who lived on the edge of society; however, today they are recognized as a legitimate art form and widely accepted in mainstream culture."

Since the 1970s, tattoos have become a mainstream part of Western fashion, common among both genders, to all economic classes and to age groups from the later teen years to middle age.

For many young Americans, the tattoo has taken on a decidedly different meaning than for previous generations.

The tattoo has undergone "dramatic redefinition" and has shifted from a form of deviance to an acceptable form of expression.^[68]

As of November 1, 2006, Oklahoma became the last state to legalize tattoos, having banned them since 1963.^[69]

Protection papers were used by American sailors to prevent themselves from being taken off American ships and impressed into the Royal Navy. These were simple documents that described the sailor as being an American sailor. Many of the protection certificates were so general, and it was so easy to abuse the system, that many impressment officers of the Royal Navy paid no attention to them. In applying for a duplicate Seaman's Protection Certificate in 1817, James Francis stated that he 'had a protection granted him by the Collector of this Port on or about 12 March 1806 which was torn up and destroyed by a British Captain when at sea.' ^[70] One way of making them more specific was to describe a tattoo, which is highly personal, and thus use that description to identify the seaman. As a result, many of the later certificates carried information about tattoos and scars, as well as other specific information. This also perhaps led to an increase and proliferation of tattoos among American seamen. Frequently their 'protection papers' made reference to tattoos, clear evidence that individual was a seafaring man; rarely did members of the general public adorn themselves with tattoos.^[71]

In the late eighteenth and early nineteenth centuries, tattoos were as much about self-expression as they were about having a unique way to identify a sailor's body should he be lost at sea or impressed by the British navy.

The best source for early American tattoos is the protection papers issued following a 1796 congressional act to safeguard American seamen from impressment.

These proto-passports catalogued tattoos alongside birthmarks, scars, race, and height. Using simple techniques and tools, tattoo artists in the early republic typically worked on board ships using anything available as pigments, even gunpowder and urine. Men marked their arms and hands with initials of themselves and loved ones, significant dates, symbols of the seafaring life, liberty poles, crucifixes, and other symbols."^[72]

Because these protection papers were used to define freemen and citizenship, many black sailors and other men also used them to show that they were freemen if they were stopped by officials or slave catchers. They also called them "free papers" because they certified their non-slave status. Many of the freed blacks used descriptions of tattoos for identification purposes on their freedom papers.^[73]

Branding was used by European authorities for marking criminals throughout the seventeenth and eighteenth centuries.^[74] The practice was also used by British authorities to mark army deserters and military personnel court-martialed in Australia.

In nineteenth century Australia tattoos were generally the result of personal rather than official decisions but British authorities started to record tattoos along with scars and other bodily markings to describe and manage convicts assigned for transportation.^[75] The practice of tattooing appears to have been a largely non-commercial enterprise during the convict period in Australia.

For example, James Ross in the Hobart Almanac of 1833 describes how the convicts on board ship commonly spent time tattooing themselves with gunpowder.^[75]

By the beginning of the twentieth century, there were tattoo studios in Australia but they do not appear to have been numerous.

For example, the Sydney tattoo studio of Fred Harris was touted as being the only tattoo studio in Sydney between 1916 and 1943.^[77] Tattoo designs often reflected the culture of the day and in 1923 Fred's small parlour experienced an increase in the number of women getting tattoos.

Another popular trend was for women to have their legs tattooed so the designs could be seen through their stockings.^[78]

By 1937 Fred was one of Sydney’s best-known tattoo artists and was inking around 2000 tattoos a year in his shop.

Sailors provided most of the canvases for Fred's work but among the more popular tattoos in 1938 were Australian flags and kangaroos for sailors of the visiting American Fleet.^[79]

Tattooing involves the placement of pigment into the skin's dermis, the layer of dermal tissue underlying the epidermis. After initial injection, pigment is dispersed throughout a homogenized damaged layer down through the epidermis and upper dermis, in both of which the presence of foreign material activates the immune system's phagocytes to engulf the pigment particles. As healing proceeds, the damaged epidermis flakes away (eliminating surface pigment) while deeper in the skin granulation tissue forms, which is later converted to connective tissue by collagen growth. This mends the upper dermis, where pigment remains trapped within successive generations of macrophages, ultimately concentrating in a layer just below the dermis/epidermis boundary. Its presence there is stable, but in the long term (decades) the pigment tends to migrate deeper into the dermis, accounting for the degraded detail of old tattoos.^[80]

Some tribal cultures traditionally created tattoos by cutting designs into the skin and rubbing the resulting wound with ink, ashes or other agents; some cultures continue this practice, which may be an adjunct to scarification. Some cultures create tattooed marks by hand-tapping the ink into the skin using sharpened sticks or animal bones (made into needles) with clay formed disks or, in modern times, actual needles.

The most common method of tattooing in modern times is the electric tattoo machine, which inserts ink into the skin via a single needle or a group of needles that are soldered onto a bar, which is attached to an oscillating unit. The unit rapidly and repeatedly drives the needles in and out of the skin, usually 80 to 150 times a second. The needles are single-use needles that come packaged individually.

Tattooing is regulated in many countries because of the associated health risks to client and practitioner, specifically local infections and virus transmission.

Disposable plastic aprons and eye protection can be worn depending on the risk of blood or other secretions splashing into the eyes or clothing of the tattooist.

Hand hygiene, assessment of risks and appropriate disposal of all sharp objects and materials contaminated with blood are crucial areas.

The tattoo artist must wash his or her hands and must also wash the area that will be tattooed.

Gloves must be worn at all times and the wound must be wiped frequently with a wet disposable towel of some kind.

All equipment must be sterilized in a certified autoclave before and after every use. It is good practice to provide clients with a printed consent form that outlines risks and complications as well as instructions for after care.^[81]

The Government of Meiji Japan had outlawed tattoos in the 19th century, a prohibition that stood for 70 years before being repealed in 1948.^[82] As of 6 June 2012, all new tattoos are forbidden for employees of the city of Osaka. Existing tattoos are required to be covered with proper clothing. The regulations were added to Osaka's ethical codes, and employees with tattoos were encouraged to have them removed. This was done because of the strong connection of tattoos with the yakuza, or Japanese organized crime, after an Osaka official in February 2012 threatened a schoolchild by showing his tattoo.

Tattoos had negative connotations in historical China, where criminals often had been marked by tattooing.^[83][83][84]

The Romans tattooed criminals and slaves, and in the 19th century released U.S. convicts, Australian convicts and British army deserters were identified by tattoos. Prisoners in Nazi concentration camps were tattooed with an identification number. Today, many prison inmates still tattoo themselves as an indication of time spent in prison.^[4]

Native Americans also used tattoos to represent their tribe. Catholic Croats of Bosnia used religious Christian tattooing, especially of children and women, for protection against conversion to Islam during the Ottoman rule in the Balkans.^[86]

Tattoos are strongly empirically associated with deviance, personality disorders and criminality.^[87][88] Although the general acceptance of tattoos is on the rise in Western society, they still carry a heavy stigma among certain social groups.^[89] Tattoos are generally considered an important part of the culture of the Russian mafia.^[90]

Current cultural understandings of tattoos in Europe and North America have been greatly influenced by long-standing stereotypes based on deviant social groups in the 19th and 20th centuries.

Particularly in North America, tattoos have been associated with stereotypes, folklore and racism.^[22] Not until the 1960s and 1970s did people associate tattoos with such societal outcasts as bikers and prisoners.^[91] Today, in the United States many prisoners and criminal gangs use distinctive tattoos to indicate facts about their criminal behavior, prison sentences and organizational affiliation.^[92] A teardrop tattoo, for example, can be symbolic of murder, or each tear represents 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 that remains widespread among older Americans. In Japan, tattoos are associated with yakuza criminal groups, but there are non-yakuza groups such as Fukushi Masaichi's tattoo association that sought to preserve the skins of dead Japanese who have extensive tattoos. Tattooing is also common in the British Armed Forces. Depending on vocation, tattoos are accepted in a number of professions in America. Companies across many fields are increasingly focused on diversity and inclusion.^[93] Mainstream art galleries hold exhibitions of both conventional and custom tattoo designs, such as Beyond Skin, at the Museum of Croydon.^[94]

In Britain, there is evidence of women with tattoos, concealed by their clothing, throughout the 20th century, and records of women tattooists such as Jessie Knight from the 1920s.^[95] 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 low self-esteem; however, the study also demonstrated that a strong motive for body modification is the search for "self and attempts to attain mastery and control over the body in an age of increasing alienation".^[96] The prevalence of women in the tattoo industry in the 21st century, along with larger numbers of women bearing tattoos, appears to be changing negative perceptions.

Former sailor Rowland Hussey Macy, who formed Macy's department stores, used a red star tattoo that he had on his hand for the store's logo.^[97]

Tattoos have also been used in marketing and advertising with companies paying people to have logos of brands like HBO, Red Bull, ASOS.com and Sailor Jerry's rum tattooed in their bodies.^[98] This practice is known as "skinvertising".^[99]

B.T.'s Smokehouse, a barbecue restaurant located in Massachusetts, offered customers free meals for life if they had the logo of the establishment tattooed on a visible part of their bodies. Nine people took the business up on the offer.^[100]

Because it requires breaking the skin barrier, tattooing carries health risks including infection and allergic reactions.

Tattooing can be uncomfortable to excruciating depending on the area and can result in the person fainting.

Modern tattooists reduce risks by following universal precautions working with single-use items and sterilizing their equipment after each use.

Many jurisdictions require that tattooists have blood-borne pathogen training such as that provided through the Red Cross and OSHA. As of 2009 (in the United States) there have been no reported cases of HIV contracted from tattoos.^[101]

In amateur tattooing, such as that practiced in prisons, however, there is an elevated risk of infection.

Infections that can theoretically be transmitted by the use of unsterilized tattoo equipment or contaminated ink include surface infections of the skin, fungal infections, some forms of hepatitis, herpes simplex virus, HIV, staph, tetanus, and tuberculosis.^[102]

Tattoo inks have been described as "remarkably nonreactive histologically".^[80] However, cases of allergic reactions to tattoo inks, particularly certain colors, have been medically documented.

This is sometimes due to the presence of nickel in an ink pigment, which triggers a common metal allergy.

Occasionally, when a blood vessel is punctured during the tattooing procedure, a bruise/hematoma may appear. At the same time, a number of tattoo inks may contain hazardous substances, and a proposal has been submitted by the European Chemicals Agency (ECHA) to restrict the intentional use or concentration limit of approximately 4 000 substances when contained in tattoo inks.^[103] According to a study by the European Union Observatory for Nanomaterials (EUON ^[133] ), a number of modern day tattoo inks contain nanomaterials.^[104]

Certain colours - red or similar colours such as purple, pink, and orange - tend to cause more problems and damage compared to other colours.^[105] Red ink has even caused skin and flesh damages so severe that the amputation of a leg or an arm has been necessary. If part of a tattoo (especially if red) begins to cause even minor troubles, like becoming itchy or worse, lumpy, then Danish experts strongly suggest to remove the red parts.^[106]

In 2017, researchers from the European Synchrotron Radiation Facility in France say the chemicals in tattoo ink can travel in the bloodstream and accumulate in the lymph nodes, obstructing their ability to fight infections. However, the authors noted in their paper that most tattooed individuals including the donors analyzed do not suffer from chronic inflammation.^[107]

Tattoo artists frequently recommend sun protection of skin to prevent tattoos from fading and to preserve skin integrity to make future tattooing easier.^[108][109]

While tattoos are considered permanent, it is sometimes possible to remove them, fully or partially, with laser treatments.

Typically, black and some colored inks can be removed more completely than inks of other colors.

The expense and pain associated with removing tattoos are typically greater than the expense and pain associated with applying them.

Pre-laser tattoo removal methods include dermabrasion, salabrasion (scrubbing the skin with salt), cryosurgery and excision—which is sometimes still used along with skin grafts for larger tattoos. These older methods, however, have been nearly completely replaced by laser removal treatment options.^[110]

A temporary tattoo is a non-permanent image on the skin resembling a permanent tattoo. As a form of body painting, temporary tattoos can be drawn, painted, airbrushed, or needled in the same way as permanent tattoos, but with an ink which dissolves in the blood within 6 months.

Decal (press-on) temporary tattoos are used to decorate any part of the body. They may last for a day or for more than a week.^[111]

Foil temporary tattoos are a variation of decal-style temporary tattoos, printed using a foil stamping technique instead of using ink.

The foil design is printed as a mirror image in order to be viewed in the right direction once it is applied to the skin.

Each metallic tattoo is protected by a transparent protective film.

Although they have become more popular and usually require a greater investment, airbrush temporary tattoos are less likely to achieve the look of a permanent tattoo, and may not last as long as press-on temporary tattoos.

An artist sprays on airbrush tattoos using a stencil with alcohol-based cosmetic inks.

Like decal tattoos, airbrush temporary tattoos also are easily removed with rubbing alcohol or baby oil.

Another tattoo alternative is henna-based tattoos, which generally contain no additives. Henna is a plant-derived substance which is painted on the skin, staining it a reddish-orange-to-brown color. Because of the semi-permanent nature of henna, they lack the realistic colors typical of decal temporary tattoos. Due to the time-consuming application process, it is a relatively poor option for children. Dermatological publications report that allergic reactions to natural henna are very rare and the product is generally considered safe for skin application. Serious problems can occur, however, from the use of henna with certain additives. The FDA and medical journals report that painted black henna temporary tattoos are especially dangerous.

Decal temporary tattoos, when legally sold in the United States, have had their color additives approved by the U.S.

Food and Drug Administration (FDA) as cosmetics – the FDA has determined these colorants are safe for "direct dermal contact".

While the FDA has received some accounts of minor skin irritation, including redness and swelling, from this type of temporary tattoo, the agency has found these symptoms to be "child specific" and not significant enough to support warnings to the public.

Unapproved pigments, however, which are sometimes used by non-US manufacturers, can provoke allergic reactions in anyone.

The types of airbrush paints manufactured for crafting, creating art or decorating clothing should never be used for tattooing.

These paints can be allergenic or toxic.

The FDA regularly issues warnings to consumers about avoiding any temporary tattoos labeled as black henna or pre-mixed henna as these may contain potentially harmful ingredients including silver nitrate, carmine, pyrogallol, disperse orange dye and chromium. Black henna gets its color from paraphenylenediamine (PPD), a textile dye approved by the FDA for human use only in hair coloring.^[112] In Canada, the use of PPD on the skin, including hair dye, is banned. Research has linked these and other ingredients to a range of health problems including allergic reactions, chronic inflammatory reactions, and late-onset allergic reactions to related clothing and hairdressing dyes. They can cause these reactions long after application. Neither black henna nor pre-mixed henna are approved for cosmetic use by the FDA.

Egyptians originally used tattoos to show dedication to a god. This also showed protection. Jehovah’s Witnesses “must not make tattoo markings” on themselves. In other religions like Hinduism and Neopaganism, tattoos are accepted. Christianity remains one of the religions without a definitive answer on tattoos.^[113]

Judaism generally prohibits tattoos among its adherents based on the commandments in Leviticus 19. Jews tend to believe this commandment only applies to Jews and not to gentiles. However, views amongst Rabbis are divided,^[114] and an increasing number of young Jews are getting tattoos either for fashion, or an expression of their faith.^[115]

There is no specific rule in the New Testament prohibiting tattoos, and most Christian denominations believe the laws in Leviticus are outdated as well as believing the commandment only applied to the Israelites, not to the gentiles. While most Christian groups tolerate tattoos, some Evangelical and fundamentalist Protestant denominations believe the commandment applies today for Christians and believe it is a sin to get one.

Many Coptic Christians in Egypt have a cross tattoo on their right wrist to differentiate themselves from Muslims.^[116]

Tattoos are considered to be haram in Sunni Islam, based on rulings from scholars and passages in the Sunni Hadith. Shia Islam does not prohibit tattooing, and many Shia Muslims (Lebanese, Iraqis, Yemenis, Iranians) have tattoos, specifically with religious themes.

Southeast Asia has a tradition of protective tattoos variously known as sak yant or yantra tattoos that include Buddhist images, prayers, and symbols. Images of the Buddha or other religious figures have caused controversy in some Buddhist countries when incorporated into tattoos by Westerners who do not follow traditional customs regarding respectful display of images of Buddhas or deities.