Guest Post by Dr. Laura Burkhart

“Mom, Dad can I get a tattoo?”

It’s the question your teen may have already asked. Or maybe they haven’t yet, but your waiting for the day they will. In the past tattoos might have been seen as a rebellious sign of those looking for a counter culture marker to set themselves apart from mainstream society. However, the art of tattooing has over time begun to merge with the norm and it isn’t uncommon to see a spectrum of people show off their ink. However, just because permanent body art has become more common, it is not without risks. In this post I will go through the art of tattooing and scarification so you can start an open conversation with your teen.

First off, lets start with the most important piece of information. No one under the age of 18 can be tattooed or have scarification in Washington State. Period. Even if the teen has parental consent. The only exceptions to this are medical procedures by a licensed medical professional. Every state has its own laws regarding applying permanent body art to a minor, but in Washington State it is a misdemeanor. For more detail on the law RCW 26.28.085, visit

Although the technology of tattooing has advanced, the art of tattooing has been around for many years and is embedded in the rituals of many cultures.   Tattooing involves piercing the skin many times with one or more needles. It usually is done using a hand held machine similar to a sewing machine that deposits ink.

Scarification is the practice of purposely scarring the skin tissue in order to leave designs and marks. It has roots in ancient practices, where it was a symbol for different rites of passage and even a sign of beauty. Today, scarification is done for many different reasons that each person holds significant for them. Scarification involves a process where the skin is cut, grinded, burned or branded to create an inkless tattoo-like scar of different designs or symbols. Branding is done by heating or cooling (with liquid nitrogen) a piece of metal that then is pressed into the skin. Skin removal or peeling is another method of scarification where surgical scalpels are used to remove sections of skin. To enhance the scar, tattoo ink can be lightly rubbed into the fresh wound.

There are several risks involved with tattooing and scarification, with some risks not apparent till much later.

  • Infection: There is a possibility of infection of the tattoo or scarring site. Infection can be introduced through dirty equipment or from improper cleaning care afterward. Think of these as open wounds in the skin.
  • Disease Transmission: The transmission of disease is possible either by a contaminated needle, ink or objects such as sponges to wipe away blood. Infections such as hepatitis B, hepatitis C and HIV can be transmitted through unsterile technique.
  • Allergic Reaction: Some people can have allergic reactions to tattoo ink such as skin rashes. For additional information on tattoo ink visit,
  • Healing: Everyone’s body heals differently with some more prone to developing keloids, which are an overgrowth of scar tissue. This might alter the intended design that was placed.
  • Magnetic Resonance imaging (MRI) complications: This is a rare complication, but can happen. The inks in the tattoo can react during an MRI exam, causing temporary burning or swelling to the area or affecting the image quality. Always let the MRI tech know you have tattoos beforehand.

For more information, visit

Talking points:

  • Talk with your teen about what they think about permanent body art. This can offer a cool insight into their thinking, but also show you respect their thought process, which is incredibly important for teens.
  • Let your teen know about the law in Washington and your expectation of following it.
  • Empower your teen to advocate for their health if they choose to get a tattoo once old enough. They should voice right away if they have concerns to the artist. It is definitely worth it to go to a reputable parlor, although even at the best trained facility there can still be risks. Make sure the artist always wears clean gloves and if using non-disposable equipment, making sure it has been sterilized.
  • Instill the idea in your teen that if they are going to get permanent body art, they need to take responsibility for its care, as it is a body altering decision that can have serious complications.
  • Make sure your teen is up to date on all their vaccines especially Hepatitis B, which is a 3 dose series, and tetanus, which must be renewed every 10 years. Your teen will one day be responsible for staying on top of their healthcare and might not think vaccines are as important as an adult.
  • Tattoo removal by laser is possible, although not perfect and can be expensive and painful. As you can imagine, scarification removal is incredibly difficult and not possible in many situations.

So why am I writing a post about something that only legal adults can get anyway? As we know, just because something is illegal does not mean teenagers can’t still find a way to get it. Reputable tattoo parlors will follow the law, but there are people and places that might fly under the radar and work on minors. So the more well informed you are, the more open and honest conversations you can have with your teen now, that will be critical when they are faced with making a decision.