NARRATION
Getting inked is in, and not just with celebrities, athletes, and middle-class hipsters.
Ruben Meerman
Tattoos are trending across the country.
Woman 1
This is my dog.
Man 1
This is my Jim Morrison lizard king.
Man 2
This is a photo of my mother in her twenties.
Man 3
I got tattoos everywhere. I got them on my (Bleep) and everything. Ooh!
NARRATION
Even at the last count back in 2005, roughly one in seven Australian adults had a tattoo, including a quarter of those in their twenties.
Woman 2
I got it because I have English and Scottish heritage.
Woman 1
I like looking down and seeing something awesome on me.
Ruben Meerman
Are you happy with it?
Man 4
Oh, yeah. I love it.
Ruben Meerman
But how do tattoos stay in your skin? Are they safe, and if you change your mind, how easy are they to remove?
NARRATION
Now, there's nothing new about tattoos. This 5,000-year-old European mummy, known as Otzi the Ice Man, was found with 50 tattooed lines and crosses. In Otzi's case, charcoal was rubbed into incisions in his skin, but techniques like piercing and puncturing also have long traditions worldwide. These days, electromagnets are used to drive the needles into the skin about 6,000 to 12,000 times a minute.
Ruben Meerman
How are you feeling, Les?
Les Rice
It's fine, it's OK. It's more a scratchy discomfort than it is a pain. It has moments, though, I must admit, it does have moments, but this one's been fine.
NARRATION
Long-time tattooist Les Rice grew up in his father's studio. Today he's trusting colleague Jimmy Memento with a spider design.
Ruben Meerman
Roughly how deep are we going in millimetres?
Jimmy Memento
Yeah, probably about 1mm. What we wanna do is we wanna penetrate the epidermis, which is the surface area of the skin, so that's landing in the dermis layer.
NARRATION
The dermis sits between the epidermis, which sheds any inked skin, and the fatty hypodermis, where the ink will run and blur. It offers a target full of tough collagen fibres and elastin. They're woven like fabric, providing strength to our skin and a stable canvas for the ink. The ink remains there despite our immune system's response.
Dr Philip Bekhor
Yeah, this is an image - you can see the tattoo outline, and if you look carefully, the individual tattoo granules are probably these tiny little specks here, but white blood cells have collected them and gobbled them up and packaged them. You can't see the wall, but that's a little package sitting in a white blood cell.
NARRATION
The white blood cell fills up with ink particles and tries to clear them away, but, it's believed, like a bag full of marbles, it's too stiff to mould its way through the narrow entry points of the lymphatic system.
Dr Philip Bekhor
And so they get stuck.
NARRATION
But is it safe to have these inks sitting in our skin? The truth is we don't know. Neither the US, Europe, nor Australia has a list of safe tattoo inks that are approved for human use. The production of ink remains largely unregulated, particularly online, and some contain known and possible carcinogens, including heavy metals and polyaromatic hydrocarbons.
Professor Ian Olver
Well, the industry suggests it's about 5% of their inks, but other researchers have found up to 13 out of 22. So, we're not sure exactly.
Dr Philip Bekhor
A lot of different compounds are being used, and there is some evidence that they are carcinogenic, or could be carcinogenic, but the world is carcinogenic - the smoke that comes out of a diesel is carcinogenic, oestrogen is carcinogenic, alcohol is carcinogenic. So, the question is not whether it's carcinogenic, but what the risk of this exposure will be to produce cancer, and, to my knowledge, there are no published reports of cancer ever resulting from a tattoo.
Professor Ian Olver
This is a potential risk. We don't know, in the tattoo situation, what the dose or the duration would be to cause cancer.
NARRATION
One study found no evidence that tattoos increase your risk of skin cancer. But experts warn against the common misconception that tattoos can actually prevent such cancers.
Dr Adrian Lim
The perception by patients is that the tattoo is somehow protective.
Ruben Meerman
Ah!
Dr Adrian Lim
It's like a black shield, but that's a fallacy, because the tattoo pigment actually sits lower. It sits below the skin pigment layer...
Ruben Meerman
Right.
Dr Adrian Lim
..which is still vulnerable to ultraviolet damage. Patients are surprised that there's a skin cancer within the tattoo, and the other issue is a late diagnosis by doctors. Even a trained dermatologist will find it a challenge to try to diagnose a changing mole within a black tattoo.
NARRATION
The appearance of a tattoo isn't static. A suntan will tint the colour, while sun exposure will fade each colour at varying rates. The ink particles themselves also disperse as cells divide, die, or exit the body.
Ruben Meerman
How do you know what's gonna look good in 20 years?
Les Rice
The thing that will make a tattoo last is its really graphic qualities, which is black and lines, OK? So, the black linear element will always stand the test of time. When you see too many kind of subtle variations in colour, for instance, like, a peach colour next to a salmon colour, what may happen is you don't know if the peach colour might turn darker over time, the salmon colour may lighten up, so what once worked can look awful in years to come.
Ruben Meerman
So, you're saying that you do warn people, like, you know, this artwork's not gonna look like this when you hit 40?
Jimmy Memento
A perfect example is the writing on my arm.
Ruben Meerman
Yeah, right.
Jimmy Memento
Lots of people come in, they ask for really tiny writing, and I got writing on my arm really tiny, and it was really sharp when it started, and the whole reason why I got it was to sort of explain to people that it doesn't work, and when they're like, 'How old is it?', you're like, 'Two years.'
Ruben Meerman
Really, right? So you got that specifically to show people what happens.
Jimmy Memento
Yeah, that's half our job. You have to explain to them the biology of it. Some of them come to Earth and some of them go and get it somewhere else.
Ruben Meerman
OK.
Jimmy Memento
They can kick themselves in five years, you know?
Ruben Meerman
Right.
NARRATION
So, will the rise of the tattoo be followed by a rise in regret? Sabina Kelly is an international pin-up model and celebrity tattoo judge on TV. She also has her own tattoo removal business in Las Vegas.
Sabina Kelley
..inside the Hard Rock Casino...
Ruben Meerman
And how's business over there?
Sabina Kelley
Oh, it's great, especially with how big, like, the tattoo TV shows are, you know? Everyone's going and getting tattooed, and a lot of them aren't really thinking about it. You know, some are regretting it and then going, 'Oh, I wanna take these off...'
Ruben Meerman
Yeah.
Sabina Kelley
So, it's going good.
Woman 3
Why would you regret them? No, I don't understand that. It's like a page in your diary.
Man 1
I wouldn't have them taken off.
Woman 1
I haven't looked into it, and frankly I probably won't.
Sabina Kelley
Actually, I've been removing my ex-husband's name, this one right here. It was as dark as, like, this black here. It was black and green and, like, yellow highlight.
Ruben Meerman
OK.
Sabina Kelley
And this has been three times. This would be lightened enough to get something over it, but I want it completely gone...
Ruben Meerman
You want it completely gone.
Sabina Kelley
So I'm gonna keep going.
Ruben Meerman
Yeah, right.
NARRATION
The industry standard for removal is the Q-switched laser. It directs short pulses of laser light into the ink. One of the first to use them in Australia was Dr Philip Bekhor, a leading dermatologist, and director of the laser unit at the Royal Children's Hospital in Melbourne.
Dr Philip Bekhor
Now, we know that certain colours absorb certain lights. For example, if you're wearing a dark T-shirt and you stand in the sun, you feel warmer than if you were wearing a light
T-shirt. So, to treat something with a laser, you have to use a colour or wavelength that will be absorbed by the target. So, we put in a wavelength that's highly absorbed by this black. In fact, the heat goes in so quickly that the bigger particles explode into just dust.
NARRATION
It's believed the white blood cell is then better able to mould its way into the narrow entry points of the lymphatic system and leave the skin.
Dr Philip Bekhor
What we see visually is a sudden change to a white colour, which we think is due to the formation of steam within the cells.
NARRATION
It's painful at first...
Man 5
It was way worse than getting it done to start with. It was terrible!
NARRATION
..and takes a week or two to heal, but to avoid permanent injury, it's critical to heat the ink particles with a laser pulse of the right duration.
Dr Philip Bekhor
The heating time has to be short enough to heat the target, but not continue heating such that the surrounding tissue gets burnt. And objects that are smaller than the size of a cell, this time is in the billionth of a second range, and what a Q-switch laser can do is deliver the energy in billionths of a second.
NARRATION
That's why dermatologists warn against using intense pulsed light, or IPL, for tattoos. They deliver much longer pulses, in the millionth of a second range.
Dr Philip Bekhor
It's like a boiling kettle. If I touch a boiling kettle like that, it doesn't even feel hot, but if I leave my finger there for a minute, I'm going to burn my finger.
NARRATION
To remove a professionally inked tattoo requires at least ten sessions at six to eight week intervals. So, it can take several years and easily cost ten times more than the tattoo. Even then success isn't guaranteed. There can be pigmentation of the skin, and some colours have proven easier to remove than others.
Sabina Kelley
Black is actually the easiest colour to remove. It's the hottest colour, so it hurts the most, but green is actually one of the hardest colours to remove. Like, the teal colours and the greens, you can fade them, but I haven't been able to completely remove them yet.
NARRATION
But that might change with new technology. Dr Bekhor has one of the first picosecond lasers in the country. It delivers a pulse in the trillionth of a second range. Trials suggest it shatters the ink more effectively. That cuts the number of treatments, particularly for difficult light blue and green inks.
Dr Philip Bekhor
Traditionally, green, we dread it, but, nowadays, green with picolaser seems to be able to go within three or four sessions. Why that is, we don't know. The shape of the granules are different for different colours. So, it may be some characteristic that makes it very susceptible to fracturing with the shorter pulse.
NARRATION
Fortunately, allergic reactions to tattoo inks are rare. Professional tattooists say they mitigate the risk by sourcing inks from established manufacturers, and warn against buying ink on the internet for backyard tattoo parties. Banned inks can also be found on the European website, Rapex.
Ruben Meerman
As a tattoo removalist, what advice would you give someone considering getting a tattoo?
Sabina Kelley
Definitely don't get a tattoo thinking you can remove it. That's, like, number one thing, I'd say. And if it means something to you, you most likely aren't gonna get rid of it. So, if you get something random just on the spur of it, or 'cause it's cool, it's not gonna last.
Les Rice
Sadly, it's become fashionable these days, and it's not a particularly good mix, tattooing and fashion, because fashion has to change again and again, and to get a tattoo because it's fashionable is quite silly, because you're gonna be left with it when the fashion's not around.
- Reporter: Ruben Meerman
- Producer: Adam Collins
- Researcher: Wendy Zukerman
- Camera: Daniel Shaw
Peter Healy
Peter Sinclair
Tony Connors - Sound: Steve Ravich
Tim Parratt
Dafydd Cooksey - Editor: Vaughan Smith
Les Rice
Tattoist
LDF Tattoo
Sydney
Professor Ian Olver
CEO,Cancer Council Australia
Dr Philip Bekhor
Director, Laser Unit, Dept. of Dermatology,
The Royal Children's Hospital
Dr Adrian Lim
Dermatologist,
Sydney
Jimmy Memento
Tattooist
LDF Tattoo
Sydney
Risk assessment and regulation of tattoo inks in the EU
Chemical Substances in Tattoo Ink
ECTP 2013 1st European Congress on Tattoo and Pigment Research
Tattoo Manufacturers of Europe
RAPEX website: European Commission, Health and Consumers
US Food and Drug Administration
South Tyrol Museum of Archeology
To dye for? Jury still out on tattoo ink causing cancer
Epidemic of Ink: ABC Radio National, Ian Townsend
Consumer group Choice sounds warning on tattoo removal industry: ABC news
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