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Tips for safer tattoos
•Ask the artist what kind of ink he or she uses and if the inks have been formulated and processed to ensure they are free from harmful pathogens.
•Ask whether the ink has been or is going to be diluted. Ask whether sterile water was or is going to be used.
•Make sure ink is not past its expiration date and/or how long the artist has had it.
•Ask whether sterile water is used in other tattoo-related procedures or cleaning.
•Ask to see an artist and an establishment’s permits and/or enforcement records.
•Ask what sanitary practices an artist uses.
•Follow post-tattoo instructions.
•Report suspected infections to your doctor, the tattoo artist, MedWatch at 1-800-332-1088 or and the Fort Wayne-Allen County Department of Health at 449-7126.
Sources: Food and Drug Administration, Centers for Disease Control, Fort Wayne-Allen County Department of Health and area tattoo artists
Cathie Rowand | The Journal Gazette
A tattoo is applied at Artisan Tattoo Co. in Fort Wayne. There have been no known Mycobacteria infections locally.

Tattoo research vital

Officials, artists say risk of infection can’t be avoided

A nontuberculosis Mycobacteria infection appears as a red rash and may include bumps at the site of the tattoo.

Since the beginning of the year, Allen County tattoo artists and the shops in which they work have been required to have permits to be legal, and health officials inspect the establishments twice a year.

But there’s one health problem local inspectors might not catch – the potential for a bacterial infection recently traced to contaminated tattoo ink.

The organism is known as nontuberculosis Mycobacteria. Since late 2011, strains have been linked to five clusters of post-tattoo skin infections in New York, Colorado, Iowa and Washington, according to a Food and Drug Administration warning to consumers issued in August.

Infections appear as a raised, red rash that might include pus-filled bumps at the site of the tattoo. The rash, which can be itchy and/or painful and accompanied by swelling, usually appears one to three weeks after tattooing.

According to federal health officials, even scrupulously hygienic tattooists can’t always prevent or detect the problem because contamination isn’t readily apparent.

Overall, Mycobacteria infections are rare, officials say, but they still are urging those who suspect infection to consult a doctor, alert their tattooist and report any unexpected adverse reactions to MedWatch, a federal database of medical side effects.

Ann Applegate, director of the food and consumer protection division of the Fort Wayne-Allen County Department of Health, says consumers also should alert local health officials.

She says she knows of no infections in the Fort Wayne area. State law requires tattoo inks, dyes and pigments to come from professional suppliers and be only used for tattooing human skin but inspectors don’t check for contaminated inks, she says.

“We locally don’t regulate the manufacturing of those,” Applegate says. “Tattoo inks are subject to federal regulation under the cosmetic provisions.”

Because tattoo inks are considered cosmetics by the FDA, they aren’t required to be sterile. But officials at the Centers for Disease Control and Prevention are recommending that manufacturers be held to a higher standard.

Local tattooists say their ability to curb risk from contaminated inks is limited.

Although federal officials have linked four brands of ink to the infections, officials haven’t identified the brands, says Don Cora, owner of Artisan Tattoo Co. in Fort Wayne.

In addition, he says, federal officials say some infections have resulted from diluting ink after manufacture or performing other tattoo procedures with non-sterile water – not from the ink itself.

The FDA has advised tattooists to avoid non-sterile water, which includes tap, bottled, filtered, distilled or water treated by reverse osmosis. But as a matter of practice, that can be difficult, says Cora, the Indiana representative for the Alliance of Professional Tattooists.

“You can’t buy sterile water. I’ve tried. It’s not available over the counter in Indiana,” he says. “Two pharmacists and a medical supply company told me you need a prescription.”

Believing it to be safest, many tattooists use distilled water, but even it can contain spores that reactivate, he says. “They’re not distilling it to kill microbes,” Cora says. “They’re trying to remove sediments and minerals.”

Contaminated ink has no off-odor or appearance or performance change that a tattooist could notice, Cora says.

“Ten years ago, it was neat to go to a convention somewhere and see someone mixing their own ink and coming up with a really neat color, but we know now it’s not safe,” says Dave Pitcher, an artist at Wildman’s Tattoo and Piercings in Fort Wayne.

“One of the main things that most professional tattooists take from this is we need to be sure we’re dealing with very good, well-respected companies when we purchase inks. These companies don’t sell to the general public, only licensed professional tattooists.”

CDC epidemiologist Tara MacCannell, a co-author of the Morbidity & Mortality report, told National Public Radio that ink companies were not identified because, “Our sense is that this is a problem that’s fairly widespread in the industry.”

She added, referring to individual tattooists: “It’s unfortunate that they can do everything right, but if the manufacturer doesn’t supply them with sterile ink product, it still results in them giving their clients infections.”

Ryan Hadley, a Fort Wayne tattooist with a studio on Broadway, says that when infections occur after tattoos, it’s usually because of staphylococcus bacteria, which commonly exist on surfaces. That’s why it’s important for clients to pay attention to instructions on proper post-tattoo care, he says.

And, he says: “Every client has the right to ask what kind of ink we use. I think most people overlook doing their research.”