AAP's Tattoo Guidelines for Teens

Consider certain issues before letting your teen get a tattoo

Think twice before letting your teen get a tattoo.
Rosmarie Wirz / Moment / Getty Images

In the United States, each state has its own law that governs whether teens under the age of 18 can get a tattoo. Many states allow tattoos for a minor without the presence or written consent of a parent. In several states, however, tattoos are prohibited for any person under the age of 18.

If you have a teen who wants to get inked, you probably have many questions about the logistics and laws, as well as safety, of tattoos. Here are some of the key facts and figures about tattoos for minors you and your teen should know.

How Many Teens Have Tattoos?

The American Academy of Pediatrics addressed parental concerns about tattoos for minors in its 2017 clinical report, “Adolescent and Young Adult Tattooing, Piercing, and Scarification."

While you likely have your own opinions and personal preferences about tattoos, your teen may feel differently. You may be surprised that they are even considering a tattoo, especially if it feels like a "grown-up" decision to you. However, research has shown that teens are thinking about, and getting, tattoos.

According to the AAP's report, a study of high school students found that 10% had tattoos, while 55% of students were interested in tattooing.

A 2017 report published in the Journal of Pediatric Nursing outlined guidelines for clinicians on body modification practices in youth, citing statistics from the Pew Research Center that indicate 38% of millennials had at least one tattoo.

Health Concerns

While the AAP's report found that the overall rate of complications from proper tattooing practices is low, the risk of infection remains a concern for any body modification.

Contaminated tattoo ink and/or needles or inadequate disinfecting the skin increase the likelihood of bacterial contamination, which in turn increases the risk of infection.

While rare, potential infections such as Staphylococcus aureus (i.e., a staph infection) or Streptococcus pyogenes are serious and, in some cases, can be life-threatening.

It's important for teens and parents to know that an infection may not show up immediately. Signs of an infection (such as pustules along the lines of the tattoo) can appear anywhere from the fourth to the twenty-second day after tattooing.

Unclear or improper tattooing methods can also transmit viral infections caused by blood-borne pathogens. A 2011survey found that while teens were often aware of the risk of human immunodeficiency virus (HIV) transmission, they were less likely to know that unsafe tattooing practices could also lead to hepatitis B and hepatitis C infection.

What About Henna?

You might think that henna tattoos are a good substitute for traditional tattoos, as they are not permanent. Many parents assume that henna tattoos are a safe, fun way for a teen to experiment with having ink on their body.

The traditional form of body art, which dates back to the Bronze Age in the Middle East, does differ from tattooing but isn't without risk. According to the U.S. Food and Drug Administration (FDA), concerns may depend on the type of henna used.

According to the American Academy of Pediatrics, red henna is generally considered safe. Adverse reactions are usually caused by hypersensitivity to the pigment.

On the other hand, black henna does not exist naturally, which means a chemical called PPD is added to darken the color, enhance the design, speed up the dyeing and drying process, and make the tattoo look more realistic.

There’s no skin puncturing during henna tattooing, which means there’s no risk of blood-borne pathogens. However, there is a small risk of an allergic reaction and allergic contact dermatitis, which can be severe.

Social Acceptance

Teens don’t always think of the lifelong ramifications of their choices. The AAP recommends that parents discuss the reality of tattoos with their teens, including societal acceptance of body modification and the potential for visible tattoos to interfere with future employment opportunities.

The general public is increasingly accepting or approving of tattoos, but significant judgment still exists. The APA's report cited a 2014 survey from Salary.com which revealed that 76% of respondents believed that having a tattoo or piercing hurt a person's chances of getting a job.

A 2016 study published in the Journal of Retailing and Consumer Services found that customers demonstrated a preference for non-tattooed frontline staff, implying that the presence of visible tattoos could have an effect on the hiring manager's decisions.

Talk to a Pediatrician

If your teen is interested in body modification, you may want to discuss the decision with your teen's doctor. Based on recommendations in the advisory from AAP, you might anticipate these suggestions, guidelines, and concerns:

  • If your teen has a history of keloid formations, avoid body modifications that puncture the skin (including tattoos).
  • Take precautions when selecting a tattoo artist. The AAP recommends doing serious research on sanitary practices of both the tattoo parlor and the artist. Hygienic practices to look for include using disposable gloves and using new needles and equipment. It's also essential that you observe the artist taking the needle from a sealed, sterile package.

Tattoo Aftercare

If your teen gets a tattoo, proper aftercare is essential to prevent infection. You'll want to talk to the tattoo artist about the steps your teen needs to take, but here are some general infection-prevention guidelines to keep in mind:

  • After getting a tattoo, keep the bandage on for 24 hours. Then, wash it with soap and warm water.
  • Apply antibiotic ointments, skin cream, or vitamin E oil regularly.
  • Avoid using petroleum jelly, rubbing alcohol, or peroxide.
  • Skip swimming, sun exposure, hot tubs, and long baths until the area is healed.
  • If there’s any sign of infection, see a doctor (if possible, a dermatologist).

Making a Decision

It’s not an easy decision to allow your teenager to make a choice that lasts a lifetime. While tattoos can be removed if your teen later regrets their ink, the process is expensive, painful, and not always completely effective.

If you’re considering saying yes to your teen’s request to get a tattoo, take safety into account and be sure to discuss the other potential drawbacks with them as well.

If you’ve decided not to let your teen get a tattoo, discuss your concerns and the potential risks and ramifications which have guided your decision.

If your teen understands your reasoning, they're less likely to be tempted to find themselves in an unsafe, even illegal, situation. For example, finding a tattoo parlor that will ink underage teens without parental consent or getting a DIY ink from a friend with homemade equipment.

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Article Sources
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    Pediatrics Feb 2018, 141 (2) e20173630; doi:10.1542/peds.2017-3630

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  6. U.S. Food And Drug Administration (FDA). Temporary Tattoos May Put You At Risk. FDA Consumer Updates. Updated March 25, 2013.

  7. U.S. Food And Drug Administration (FDA). Temporary Tattoos, Henna/Mehndi, And “Black Henna”: Fact Sheet. FDA Safety and Regulatory Information. Updated September 10, 2018.

  8. Tattoos And Jobs: How Tattoos/Piercings Can Limit Your Career. Salary.com. Updated January 2019.

  9. Baumann C, Timming A, Gollan P. Taboo tattoos? A study of the gendered effects of body art on consumers’ attitudes toward visibly tattooed front line staffJournal of Retailing and Consumer Services. 2016;29:31-39. doi:10.1016/j.jretconser.2015.11.005

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