Pediatricians may be the Rx for rising tide of tats, piercings, scars in youths

tats-300x192Could pediatricians accomplish what many parents cannot? Can they talk to rebellious youths about the body adornments that are  all the rage now, and get kids to consider the health risks and long-term issues surrounding trendy tattoos, piercings, and body scarring?

In case you’ve fallen like Rip Van Winkle into a long doze or you’re senior enough to even understand the Washington Irving reference, tats and body jewelry worn in created openings and roughing up the skin to make interesting patterns all have become so common among the young that those who go without such au trendy beauty measures may now even be the outliers among their peers.

There isn’t good data on body scarring but the public opinion experts at the Pew Research Center found in 2010 that 38 percent of 18- to 29-year-olds had at least one tattoo, and 23 percent had “piercings in locations other than an earlobe.”

The American Academy of Pediatricians has just advised its members that they can play important roles with young people and their parents in discussing contemporary mores about beauty and body enhancement. Doctors could open their minds, reflect on history, and not automatically connect tats and piercings, for example, with criminality, aberrant behavior, or mental health woes, the academy advises.

The group, in a scholarly article in its member publication Pediatrics, notes that tattoos and piercings date back 2,000 and more years. They have waxed and waned in popularity, including in long stretches of the 20th century when they were associated with gangs, bikers, toughs, and women of ill repute.

Pediatricians are advised that they may get further talking with young patients than their parents do about body decorations, notably by focusing on issues of hygiene and disease risk. The pediatricians are told:

Reported complications of tattoos are inflammation, infections (bacterial and viral), neoplasms, and rare reports of vasculitis. Inflammation is caused by sensitivity to tattoo pigments leading to focal edema, pruritus, papules, or nodules at the site. Pathologically, the reactions include lichenoid, eczematoid, sarcoidal, and pseudolymphomatous reactions as well as foreign-body granulomas. Preexisting conditions can lead to other reactions; psoriasis, systemic lupus, and sarcoidosis may demonstrate the Koebner phenomenon, leading to new lesions at the site of the tattoo. Even temporary henna tattoos have been associated with inflammatory reactions.

Hepatitis and blood infections can occur with tats, and reactions to skin inks can occur with tattooing and in designs involving henna.

Similar issues can arise with piercings and the adornments used to keep those open, especially in the nose and tongue. Pediatricians can try to warn young patients and their parents about finding operators and providers who follow local regulations, especially health laws, and who demonstrate not only artistry but hygienic rigor. A pediatrician who helped formulate the professional group’s new information on tattooing has said that she had to follow her own recommendations when her daughter sought skin art. The doctor was pleased to learn the tattoo artist had once been a surgical technician.

If pediatricians build good relationships with young patients with body modifications, this also will let them explore to ensure that any tats, piercings, or scarring aren’t suggestive of mental health or social adjustment concerns. It also can open a door so the patients more readily will seek medical care if they run into problems with their bod-mods.

It also may be that, as trusted advisors, they can help educate and enlighten young people that what’s hot today may not be tomorrow, and they should carefully consider that sleeves (shoulder to wrist tattooing), piercings outside the ear, and other beauty approaches fashionable today may not be so in the future. And some of them aren’t easy, cheap, or pain free to reverse.

In my practice, I certainly see the harms that patients suffer while seeking medical services and the terrible travails that occur due to injuries to babies and children.  Experience tells that the quest for beauty that’s skin deep can foster lots of ugliness, especially with health harms. The young in every generation do crazy things, oftentimes just to aggravate their elders. Young people now may not realize how much skin changes over time, losing its plasticity and succumbing to decades of gravitational pull. They may fancy how they have dressed up their epidermis now without considering the toll that years take on the human canvas. They’ll see. We can only try to ensure their health isn’t compromised and their eyes are wide open to now and their future.

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