Monday, May 27, 2013

Tattoo After-care

  So, you just got your tattoo.  You've been sitting in an uncomfortable position being pricked by a needle 100 plus times a second for several hours.  You are light-headed, sore, and a little giddy about your new artwork.  You probably cannot wait to hit the bar, get a few drinks, and show off your new ink. 

 Your tattoo artist is saying something, and he seems to be very serious about it, like it is important or something.  A few words leak in to your awareness... 2 weeks to heal... wash... no swimming... after-care...

 The source of most tattoo problems; from fading and ink "falling out" to infections, is not the tattoo studio, tattoo equipment, or the tattoo artist.  It is the customer who fails to care for their tattoo properly, especially during the first 2 weeks.  A tattoo is an investment.  The more you do to protect that investment, the more pleasure you will get out of your tattoo.

 The tattoo process basically abrades the skin.  The resulting wound is more akin to a friction burn than any other kind of wound.  The needle enters the skin, going only a few layers deep, depositing ink.  For a time, this leaves the area of the tattoo open.  Your body has a natural healing process, and most after-care instructions try to make the most of that process.

 Every tattoo artist has their own variation of proper tattoo after-care.  This is typically a mix of what we were trained to do by our own mentors, what we have learned through our own research, and what we have experienced with our own tattoos.  While you should follow your artist's after-care instructions as closely as possible, it is ultimately a guide.  It is up to YOU how you take care of your tattoo, as you are the one at risk.

 A tattoo generally takes 6 months to heal completely.  This means that during the first 6 months, the skin where the tattoo is located tends to remain tender (this is why touching-up a new tattoo tends to hurt more than the original tattoo process).  It tends to be more prone to damage, and to take longer to recover from damage.  6 months is also a general figure; your skin might be completely healed in 4 months, or it may take 8 months.  It just depends on your own internal chemistry.  During the first 6 months, things you can do to help take care of your tattoo are the same things that help your tattoo all your life; take care of your skin and keep that tattoo out of the sun as much as possible.

 The initial healing phase lasts roughly 2 weeks.  This is also a general figure, the initial phase lasts until all the skin has stopped peeling, and all the scabs have fallen off.  This period can be longer or shorter, depending on the person.  It is normally at least 2 weeks before a tattoo can be "touched-up", or before the area where the tattoo is located can be tattooed again without serious risk to the skin.  Tattooing over an existing tattoo during this period increases the likelihood of the tattoo being over-worked.  Over-worked skin is more seriously damaged than a normal tattoo.  The skin is basically ground-up when it is over-worked.  It takes longer to heal, does not hold ink as well, and has an increased likelihood of scarring and infection.  A tattoo can be over-worked during the initial tattoo application, but is less likely with more experienced artists (even though experienced artists can occasionally over-work the skin).  Most artists will not touch up a tattoo that still has skin pealing or scabbing, even if the 2 weeks have past, simply because the tattoo is not healed enough to work on safely.

 During the 2 weeks that the tattoo heals, it is going to scab and peel.  An initial layer of skin will grow over the tattoo where the tattoo does not scab.  This initial layer is meant to protect the wound only, and dies almost as soon as it is formed.  Like a sunburn, this skin will peel off.  The skin will itch as a part of this process, engaging the instinctive urge to scratch.  The itching is meant to encourage you to work this layer of dead skin off your body, but must be avoided.  Peeling the skin or picking the scabs can lead to bleeding, which will carry ink out of the tattooed area, and can increase the likelihood of infection.  This layering and peeling process may happen repeatedly during the first 2 weeks.

 During the first 2 weeks, you should keep the tattoo out of the sun as much as possible, and avoid submerging the tattoo under water.  This is because of the nature of the skin over the tattoo during this time.  Since this skin is either dead and peeling or alive but fresh, ultraviolet light is more dangerous to the area.  It also tends to fade the tattoo.  Submerging the tattoo underwater removes the layer of dead skin prematurely, revealing new skin and an open wound, inviting both the ink to be drawn out of the skin by the water and the increased possibility of infection.  Showering under running water for short periods of time is acceptable.

 From this point, there are 2 schools of thought regarding tattoo after-care.  One school recommends letting the tattoo "dry-heal", meaning you use no moisturizers or ointments during the healing process.  You simply keep the tattoo clean, abide by the above precautions, and allow the body to heal normally.  The "dry-heal" process is not as favored as the ointment healing (I am tempted to call it "wet-heal", but it is probably just the standard healing process).  Adherents of "dry-healing" point our that when the skin is abraded or damaged normally you typically do not apply moisturizer to the wound (although dermatologist may say otherwise).  They also suggest that the resulting tattoo will heal faster and have a sharper appearance.

 The other school of thought on after-care involves keeping the tattoo liberally moisturized during the healing process.  Adherents of this process also believe that it helps the tattoo heal more quickly while not so quick that the tattoo does not hold (dry healing results in scabbing, and scabbing tends to draw ink out of the tattoo).  They also believe that this helps prevent that tattoo from becoming infected, as tattoos that dry heal may also lead to fissures in the skin (cracks from being without moisture).  Lightly moisturizing the skin reduces the amount of trauma to the area during the healing process. 

 The process I recommend involves cleaning the tattoo 3 times daily.  You clean the tattoo by getting a thin lather from soapy water (much more water than soap) and patting the suds onto the tattoo.  You avoid rubbing the tattoo, as this could accidentally lift or remove peeling skin or scabs prematurely.  You pat the tattoo dry with a clean paper-towel or a clean towel.  Finally, you apply a very thin layer of ointment onto the tattoo.

 For the first 2 days, I recommend using bacitracin ointment.  It is a very mild topical antibiotic that can be purchased over-the-counter at any pharmacy.  For the remaining period while the tattoo heals after the first 2 days, apply a thin layer of skin moisturizer.  I recommend Lubriderm, but any moisturizer is sufficient as long as it includes no dyes, no perfumes, no medications, and no vitamins.  These can either irritate the tattoo or interfere with the body's natural healing process.  Another alternative is to apply Aquafore to the tattoo, a water-based product designed for babies and very mild on the skin.

 Applying a "thin layer" means that these ointments are not rubbed into the tattoo.  The resulting layer should not be so thick as to actually be visible, and should dry almost immediately.  Over-moisturizing the tattoo can seal in bacteria, increasing the likelihood of an infection.  If you cannot achieve a thin layer of ointment, you are better off dry healing your tattoo.

 Bacitracin, Lubriderm, and Aquafore are the only ointments I recommend.  Ointments specifically for tattooing can be used, but I find that they are generally over-priced when bacitracin and Lubriderm work just as well.  DO NOT USE A&D ointment, triple-antibiotic, Neosporin, or other fast-healing ointments, as this can interfere with the healing process as cause the ink not to hold in the skin.  DO NOT USE Vasiline or other similar ointments, as these can sap in out of the tattoo.  If bacitracin is not available, you are better off to only use a moisturizer as described above or nothing at all.

 When you first get your tattoo, your artist may bandage your tattoo or wrap your tattoo with clean plastic-wrap.  This is meant only to keep the blood-plasma and excess ink from staining your clothes and contaminating other surfaces.  Typically, you are instructed to remove the bandage or wrap within the first 2 hours of it being applied, if a bandage or wrap is even offered.  A bandage is obviously more sterile than plastic-wrap.  The reason that plastic wrap is used is because you can show off the tattoo without removing the wrap.  Anecdotal experience suggests that there is a tendency to remove and re-apply your bandage in order to show your tattoo, trapping potentially infections materials each time you do it.  However,  plastic wrap allows excess blood plasma and ink to seep out from under it.  It also creates an ideal environment for pathogens that may be present on the skin under the wrap not cleansed by the tattoo artist.  While plastic wrap for a short period of time may be sufficient, a proper sterile bandage is ideal.  It is up to the artist to tell the client to not remove the bandage for at least an hour, and up to the client to follow those instructions.   

 Once you have removed your bandage or wrap (if it was applied), do not re-bandage the tattoo afterward.  Other than the ointment applied, the tattoo should be exposed to the open air.  A bandage may actually trap bacteria that is attracted to the wound, providing a dark, moist environment that can lead to infection.  Simply keep the tattoo clean and try to avoid touching the tattoo or making contact between the tattoo and other surfaces. 

 Slight puffing and redness around the tattoo is normal, along with the feeling of heat or the area being fevered, especially during the first several days.  If the redness becomes brighter, "veins" out from the tattoo, or the tattoo becomes more swollen and painful, see a doctor.  If the tattoo has puss or oozes anything other than a thin, watery liquid, see a doctor.  Your tattoo artist may be able to differentiate between "normal" healing and something abnormal, but an artist may not be experienced with unusual skin conditions or may be concerned about reprisals due to an issue with a tattoo.  A professional artist always places the health and welfare of his client first, and will recommend that if you are overly concerned about the tattoo or if the tattoo appears to be healing abnormally that a doctor be consulted.

 You may also notice, especially during the first few days, seepage from your tattoo, both of ink and of a thin, watery liquid (blood plasma).  This is normally, will happen most often while you shower, and may leave reversed impressions of your tattoo on your bed-sheets   The tattoo is open for several days, allowing ink and blood-plasma to escape.  If, however, you have any doubts, it is always best to consult a doctor.  It again is your body and your risk... better to be overly cautious than to risk a serious infection.

 After all the skin has stopped peeling, and all the scabs have fallen off, you can begin caring for your skin as normal.  Keeping the tattoo out of direct sunlight as much as possible will help prevent fading (and the more pale the skin is over the tattoo, the brighter it will look).  Some moisturizers and ointments may help keep the appearance of your tattoo looking brighter and sharper with time, but in my experience are probably not worth the money.

 If someone insists on slapping your tattoo as a matter of "tradition" or to "encourage healing", punch them in the mouth as a way to discourage stupidity.
  
Jason Sorrell is a writer, tattoo artist, satirist, artist, and generally nice guy living in Austin, TX.  He loves answering questions about tattoos.  Shoot him an email at tattoonerdz@gmail.com

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