I’m not a big fan of tattoos in general, although I recognize that some people are very happy with the results. But as a dermatologist, I’ve also seen many with complications. This recent New York Times article talks about the risk of getting HIV, hepatitis, staph and strep infections, and allergic reactions, all of which I have certainly treated in my practice. But it doesn’t mention sun reactions, which are surprisingly common with tattoos, especially those with yellow ink. The pigment reacts to the sun, leading to nast- looking blisters which can be serious enough to leave deep scars.

The potential for allergic reactions is so great, in fact, that anybody who is even mildly allergic should think long and hard before getting inked. That includes people with asthma.

Tattoos don’t age well. With the years, they blur and the colors run. This is a big problem with permanent makeup, because who wants to be stuck with bleary-looking eyes and smudged lips? Permanent makeup can be removed, but it is a lengthy and expensive process which entails repeated laser treatments.

Having said all this, I do recognize that there are valid reasons for tattoos. In fact, we actually do them in my office for breast reconstruction patients who get their nipples tattooed, people who have alopecia and have lost their eyebrows, and even patients with Parkinson’s or rheumatoid arthritis, who cannot use their hands well enough to apply makeup. The results are very good and the patients are always grateful. But the difference is that these tattoos are done in a physician’s office under sterile conditions.

Whether you get a tattoo or permanent makeup, please think it through carefully and weigh the risks. And always have it done by someone who is well-trained, certified and recommended by a doctor.