August 5, 2013

St. Vincent Charity Medical Center doctor’s book conveys risks of tattoos and piercings

Gregory L. Hall, MD, a physician at St. Vincent Charity Medical Center, has published a book about tattoos and piercings titled Teens, Tattoos and Piercings: The health and social impact of permanent body art. As an internist, Dr. Hall said he began exploring the world of tattoos and piercings as a result of seeing patients who expressed regret about having a tattoo or piercing.

Dr. Hall discusses his book and the risks that he says can be both socially and medically life changing in the latest issue of Caritas, the quarterly newsletter of St. Vincent Charity Medical Center.

As seen in Caritas:

Inked—Doctor’s book articulates risks of tattoos and piercings

One-third of the working population has tattoos. While many first got them in their teens or early 20s, Gregory L. Hall, MD, says by the early 30s, tattoo regret sinks in. That cute chubby devil on the bicep may reflect a sassy 18-year-old girl, but it doesn’t fit with the image of a 40-year-old church deacon.

As an internist, Hall said he began exploring the world of tattoos and piercings as a result of seeing patients who expressed regret in his office, but not necessary to their family and friends. Though he originally sought to find resources for his patients to share the pros and cons of tattoos and piercings, he was not satisfied with the selection and decided to write his own.

The first edition was titled, “Tattoos: Should I or Shouldn’t I.” Hall took the book to the Cleveland Metropolitan School District (CMSD) to promote as an educational tool. Upon their recommendation, he added piercings and revised the book to cater to younger students.

Meeting the need of educators
The head school nurse at CMSD said that upon graduation more than half the student body had at least one tattoo. “They are piercing each other in the restroom, sharing needles and in some cases doing their own tattoos,” he said. Hall decided that his book should be visual and had the help of an editor to ensure it was edited for the seventh-grade reading level. The result is a book that can be read quickly—in one or two sittings. He also wrote a teachers’ guide as a supplement with quizzes and handouts that can be photocopied as classroom supplements.

Since he published the latest version, “Teens, Tattoos and Piercings: The health and social impact of permanent body art,” Hall has spoken about tattoos in media stories and at Parmadale, East Cleveland Schools, University Schools in Hunting Valley, Wilberforce University and at the Ohio Public Health Conference, and in September at Multi-ethnic Advocates for Cultural Competence. The book has been overwhelmingly well received in part Hall believes because he doesn’t tell people not to get tattoos. Rather he suggests they become informed about the risks before getting them.

Know the risks
The risks both social and medical can be life changing, according to Hall, who has special interests in public health and health disparities. Certain professions, such as the FBI, CIA and covert operations will not consider applicants with tattoos for the sheer fact that they can identify individuals. Even the military has cracked down on obvious tattoos.

The U.S. Navy updated its policy on tattoos and body art in 2013 to include no tattoos, body art, brands on the head, face, neck or scalp and elsewhere on the body that are “prejudicial to good order, discipline and morale or are of a nature to bring discredit upon the Navy.” It further requires no gang art and nothing that is visible through dress whites.

Google “personal appearance guidelines” to see the endless list of companies that prohibit obvious body art, including UPS, Cedar Point, health care organizations and higher educational institutions. St. Vincent Charity Medical Center’s policy requires that visible tattoos be covered and body piercings appear only in the ear with maximum of two piercings per ear.

Patients turn to the painful and costly option of removal when the tattoo interferes with employment or their future plans. In a study conducted by The Patient’s Guide, the number of tattoo removal procedures grew by 32 percent from 2011 to 2012; the majority of people having tattoos removed cited “employment reasons” as their motivation for having the procedure. Other reasons included the removal of the name of a former spouse or partner, a change of beliefs, and being unhappy with the appearance of the tattoo. Hall, who has seen an uptick in the number of laser tattoo removal procedures he performs in his Richmond Heights office, hopes that his book will help illuminate the potential social risks before the first needle pierces the skin. “Teens don’t know what they are setting themselves up for,” said Hall.

Aside from the aesthetic and social reasons for understanding tattoos and piercings, there is now solid medical evidence linking tattoos with Hepatitis C. In a study published in the January 2013 issue of The Journal of Hepatology, researchers found a disproportionate occurrence of Hepatitis C in participants with tattoos. The study controlled for such links to Hepatitis C as IV drug use and blood transfusions prior to 1992.

“This study is big because now it explains a rationale for the social and health costs of tattoos,” said Hall. There’s also evidence of increased risk of certain skin cancers, staph or other bacterial skin infections, heavy metal poisoning and permanent scarring. Pathologists are also seeing tattoo ink in lymph node biopsies.

“I believe the overwhelming adoption of excessive tattooing is a fad. Tattoos are not going away, there will always be those who get them, but I believe the fad of a excessive body art will fade in time.”

Body art by the numbers

  • The tattoo industry in the United States is a $1.65 billion-dollar industry
  • 36% of U.S. adults ages 18 to 25 have at least one tattoo.
  • 40% of U.S. adults ages 26 to 40 have at least one tattoo.
  • High school students are acquiring tattoos at a very high rate. In urban settings some estimates are that nearly half of all high school students have a tattoo by graduation.
  • Studies show that one-quarter to one-third of people have tattoos that they regret.
  • Women were least likely to regret their tattoo if they got it after age 21.
  • Men were three times more likely to regret their tattoo if they got it before the age of 16.
  • Tattoos on the upper body were the most likely to be regretted.

St. Vincent Charity Medical Center is a ministry of the Sisters of Charity Health System.

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