BLOOMINGTON — Before getting a tattoo, understand the risks, medical professionals and tattoo artists agree.

Tattooing does involve breaking the skin, one of the body's main protective barriers, putting people at greater risk of skin and blood infections, said Dr. Lamont Tyler, regional director of specialty care for the OSF HealthCare Eastern Region.

Risks include allergic reactions, such as an itchy rash, to the ink; scaring such as keloids (a growth that forms when scar tissue grows excessively) and granulomas (bumps around the border of the tattoo) in reaction to the ink; skin infections from non-sterile equipment, re-used ink or improper care by the individual after getting inked; and blood borne diseases (hepatitis C, hepatitis B and HIV) if equipment used to do the tattoo is contaminated with someone else's blood.

"It does happen," Tyler said. "But it's not common."

The reason is the body art industry has become more professional in the past decade because of better artists and business people and Illinois Department of Public Health (IDPH) regulations.

"All establishments providing body art services such as tattooing, piercing, branding or scarification are required to be registered with us," said Divya Mohan Little, IDPH public information officer. "After we get a completed application, we conduct an inspection to monitor compliance with the program. Renewal inspections are conducted periodically."

Among requirements are sterilization of all reusable items and protocols to prepare the procedure site, after care instructions for the client and how to handle emergencies.

There are steps clients can take to reduce their risk of complications. What follows are tips from Tyler; Dr. Christopher Hughes of Advocate Medical Group, Eureka; body art client Sarah Bauer; tattoo artists Caitlyn Gagliano and Dre Willis; body piercer Jamie Holtfreter; and Vicki Tilton of Vicki Tilton LLC, which performs cosmetic tattooing as part of breast reconstruction:

Don't rush

"Once you have an idea for a tattoo, wait a year," Bauer advised. Spend that time considering your tattoo, where you want it and researching and interviewing artists.

"This is permanent," Hughes said. "You want to be absolutely certain this is what you want."

Consider your health

"If you're going to get a tattoo, you should be healthy," Hughes said.

"If you have a higher risk of infection (for example, if you've had a heart valve replacement, knee replacement or congenital heart disease), talk with your primary care doctor first about whether it's appropriate for you to have a tattoo," Hughes said. "An infection could lead to complications."

"It's important for customers to fully disclose their health background," Tilton said. "If your immune system is compromised, if you have a high risk of infection, if you're undergoing chemo or you're HIV positive, if you are at a higher risk of scarring, you shouldn't get a tattoo."

Research the artist

If you're OK to get inked, research artists, suggested Gagliano, Holtfreter and Willis. Talk with people whose tattoos you like and ask who inked them. Check artists' online portfolios.

Meet artists at their studios. Tell them the type of tattoo you're considering and ask whether they are comfortable working with that style.

"The style of the artist needs to fit with your vision of what you want in a tattoo," Gagliano said. And you and the artist need to have a good vibe, Willis said.

"It's your body," Gagliano said. "You shouldn't have to settle with art on your body because it is permanent."

Check the studio

The studio should be licensed with IDPH and the license should be on display, body artists said, pointing to their studios' licenses. Check the facility. It should be clean.

Make sure that needles, bottles of ink and the topical used to prepare the area for the tattoo are single use and that other equipment is sterile. An artist should use gloves when tattooing.

Ask about price

While price isn't the most important consideration, people should have an idea of what they will be paying. The amount varies depending on the detail of the tattoo and how many hours it will take and can range from $60 to thousands of dollars.

"The hourly rate is $100 to $150," Willis said. "But remember: Good work isn't cheap and cheap work isn't good."

Do your after care

After your tattoo is done, follow after-care instructions that include using hypoallergenic soap, antibacterial ointment and moisturizer; not immersing in water (including no baths or swimming) for at least two weeks; and using sunscreen.

If you have an allergic reaction or another complication, contact your doctor, but also let your tattoo artist know.

If you change your mind

If you want the tattoo removed, the main option is laser removal by a dermatologist or plastic surgeon, Tyler said. Ask your primary care physician for a recommendation.

But know that insurance won't cover the cost and you will have a scar.

Follow Paul Swiech on Twitter: @pg_swiech

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Health Editor for The Pantagraph.

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