Disclaimer: I have gotten 2 tattoos infected. There, I said it. I didn’t properly care for a tattoo, not once, but twice. The first time I was 19 years-old, partying, and blatantly disregarded the “liquid soap” part of the after-care instructions I had been given. I later found out bar soap is a breeding ground for bacteria. The second time I was much older, wiser, and I had my healing routine down, but I was traveling abroad and wasn’t prepared to heal a tattoo in a hot and humid climate.
Whenever clients call to question whether or not their tattoo is infected, I ask them to describe the issues they’re experiencing. Infected tattoos are usually extremely painful, any swelling in the area will linger or get much worse. Cysts, pustules, or red streaking are also symptoms of a bacterial infection. It is rare for a client to describe these symptoms, but in the few instances when they have, I recommended getting to urgent care or the emergency room ASAP. Some strains of Staphylococcus aureus can be extremely dangerous. From what I can tell the general public seems to be aware of this. Remember the Texas man that died of sepsis last summer, after swimming with his fresh tattoo?* Or the MRSA outbreak among tattoo recipients in Vermont, Ohio, and Kentucky in 2004-2005 ?** While, these two instances are extreme, they illustrate the importance of visiting a licensed professional, in a licensed tattoo shop, and following their healing instructions. Tattoo shops are usually regulated by the local government. It’s common for the department to require the establishment and artist to display their licenses in plain view, so there’s no need to call inquiring about sterilization techniques and practices. The City of Denver requires tattoo shops to go over healing instructions after the tattoo is complete and provide written instructions.
Since bacterial and viral tattoo infections are a widely discussed topic of concern, I will be reviewing other types of healing issues that I’ve experienced. These issues aren’t life threatening, just uncomfortable. They are issues that occur when after-care instructions aren’t followed or they are issues that are a normal part of the healing process, so most artists don’t even think of mentioning them. Tattoo healing is different for everyone. What works for one person could cause another person to break out or get scabs. I now know that any tattoos I get below my waist will swell like crazy and ooze plasma for a several days. My after-care has been honed, tweaked, and adjusted after getting tattooed for 17 years, so what works for me, will not work for everyone.
We recommend using Aquaphore ointment to prevent the tattoo from drying out too much and scabbing. Colorado has a very dry climate, so keeping the
tattoohydrated is very important, but many people over-apply Aquaphore. When your skin is healing the regeneration is accererated which leaves more dry, flakey skin on the surface. If a thick sticky moisturizer is applied to the congested skin, with the help of a little body heat, the skin’s pores will open up to get a big ol dose of ointment and dead skin, clogging the pores.This also known as Heat Rash. Heat rash looks like pimples and they tend to be very itchy an pop up on or around the tattoo (that’s all the dead skin in your pores that you’re feeling). When your artist recommends switching to a lighter moisturizer after a few days this is why. If you do give your self heat rash stop moisturizing immediately, no lotion, no Aquaphore. Use a new, clean loofa to gently exfoliate when washing with liquid anitbacterial soap. And do not, I repeat DO NOT pick at or pop the bumps. This can cause an infection. If the tattoo gets itchy ice it until the itching subsides. If the heat rash doesn’t improve or gets worse in a week go to a doctor or dermatologist.
I was super nervous about getting my knees tattooed, but I was pleasantly surprised when the artist started tattooing me and the pain was only slightly uncomfortable. “Wow, that was so easy!” I though as I walked out of the shop. The next day I woke up and my knee was the size of a large cantaloupe and remained that way for a week. I couldn’t bend my knee, stairs were a nightmare, and I limped around like an idiot for the better part of two weeks. I was more prepared when I got my second knee tattooed. I was sure to ice and elevate as much as possible, the night after my tattoo was done and I soaked my knee (yes soaked) in the hottest water I could stand, I used Tegaderm. “What’s that you say?! You soaked your knee? After getting a tattoo? But you’re not supposed to submerge a tattoo in water. When I worked with, my friend and tattooer, Jason Boatman, he told me that immediately after getting tattooed, Japanese gangsters would soak in hot springs to help heal their tattoos. The hot water opens your pores and allows any excess blood, plasma, and pigment to leave your skin. It also feels 100 times better than hot water beating down onto your skin in a shower. I usually let my tattoo bleed in a bandage over night and then soak, rinse, and wash with liquid soap first thing in the morning the day after I’ve gotten my tattooed. I make sure my bath tub is clean and that I wash the tattoo with my bare hand until the soap lathers in the shower after I soak for 5-10 minutes. My the swelling lasted a couple of days and no scabs formed on the tattoo whatsoever. This is also a result of using Tegaderm in addition to this after-care method.
Tegaderm and Saniderm are occlusive (wicking and breathable) bandages that were originally developed to heal severe burns, as well as, keep IVs and ports sterile. The bandage wicks plasma out of the skin which adheres to the bandage, preventing any scabbing. It also breaths, allowing the tattoo to dry out, while protects it from any bacteria, dirt, debris, and even air. If you so much as walk quickly with a painful tattoo the wind resistance can aggravate the tattoo and cause more swelling. Tegaderm and Saniderm should not be used if you are allergic or sensitive to adhesives, since the whole bandage sticks to the skin and the tattoo.
The other issue I often get calls about is itching, swelling, and the tattoo becoming raised long after the tattoo has healed. People often mistake this issue with a pigment allergy. By the time an adult is of age to get tattooed they will have been exposed to hair dye, clothing pigment, and food dye and will know if they have an dye or pigment allergy. The plant glycerin in pigments acts like plastic and when the temperature of the skin increases the pigment expands. If the area is fairly saturated the pigment will have nowhere to expand to and cause swelling and itching. I have tattoos that healed over 10 years ago that still do this. My thigh tattoos raise up when I cross my legs for too long and my arm will get itchy if I’m in the sun for too long. The easiest fix is to lower the temperature of the skin using a cool compress or ice pack.
In most cases following the advice of a knowledgable artist will insure that tattoos will heal with out issue. However, it’s difficult to predict how your body will react when injecting a foreign object into it, so when in doubt always contact your shop or artist.
*CNN “Man Dies After Swimming With New Tattoo”
Jun. 2, 2017. Tinker, Ben.
**CDC “Methicillin-Resistant Staphylococcus aureus Skin Infection Among Tattoo Recipients — Ohio, Kentucky, and Vermont, 2004–2005″
Jun. 23, 2006.