What the Health by Kylie

Triage, Trauma and Tattoos

“How can you be afraid of shots?? You have tattoos!”

-People who don’t have tattoos

As your resident tatted up nurse, it is pretty obvious that I love body ink. Clearly, I’m not alone. According to several sources floating around, anywhere from 20-40% of Americans are rocking tattoos today. With the stigma of tattoos disappearing and employers becoming more lenient with tattoos showing at work, more and more people are choosing to get inked.

Getting a tattoo is a HUGE decision and not one to be taken lightly. Many considerations need to be taken prior to getting a permanent piece of art placed onto you for the rest of eternity. In addition, several steps need to be followed in the aftermath of getting a tattoo to ensure your masterpiece turns out as high-quality as possible. Let’s start with the obvious:

Choosing a tattoo design…

  • Take your time choosing a design! Think about it thoroughly and make sure whatever you choose will still be relevant later on in life. Maybe reconsider prior to getting anything vulgar, offensive or containing someone’s name who isn’t related to you. Odds are, you’re going to regret it one day.
  • Think long and hard about the placement of your tattoo. My first tattoo is on my hip/side and, unless I’m naked, it is cut in half. Even in a bikini, it is still in an awkward place and cannot be displayed well. Looking back, I absolutely would have chosen a different location on my body or modified the size of it slightly.
  • Although employers are generally caring less and less about visible tattoos in the workplace, it is still worth thinking about. Some jobs, branches of the military or employers do not hire people with tattoos or require them to be covered up while at work. Wearing long sleeves in the summertime is not optimal for many people. Decide if it’s worth it or wait until you are better established in your career.
  • Consider the size of the tattoo and if the general shape of it will compliment the body part you put it on. For example, round designs look great on a shoulder cap or side.
  • Remember, ladies, our bodies change after having children. Perhaps a stomach tattoo won’t look the best after 3 children. Just saying…

Choosing a tattoo artist…

  • TAKE YOUR TIME with deciding your artist! The best way to choose an artist is by hearing about their reputation and seeing their work either on someone you know or by looking at their portfolio. These days most tattoo artists have an online portfolio in the form of an Instagram profile, Facebook or on another website. Check it out!
  • Not all artists can do every style well. Some specialize in water color, others in mandala, others in portraits, others in cover ups. Find an artist who is good at the specific style that you want. This matters way more than you’d imagine.
  • Word of mouth is sometimes even better than an amazing Instagram portfolio for one important reason. Instagram pictures and pictures in portfolios are often taken immediately after the tattoo is completed or immediately after it is healed. This is when the ink is the most vibrant and looks the best. Seeing someones tattoos in person months or years after they’ve had them will show you how well this artist’s work holds up. Because that’s kind of the point, right? To have this body art last forever and look phenomenal the ENTIRE time.
  • There is a true artistic talent to tattooing and you need to seek out an artist that has everything you want. My amazing tattoo artist in Memphis, TN who did my sleeve was incredible — she worked quickly but efficiently and she wasn’t too heavy handed (which can cause ink to bleed into your skin around where it is suppose to be and result in an almost blurry look…AKA not sharp lines). Her name is Rachel Ehemann and you can SHOULD check her out on her Instagram profile –> Click here! She is AMAZING if you are ever in the area.
  • Price is the LEAST important factor when determining an artist. No one with a quality tattoo will brag to you about how cheap their ink was. That’s absolutely NOT a bragging point. Bottom line is: you get what you pay for. This is something that will be with you for the rest of your life so treat it more like an investment and less like a spur of the moment spring break dare.

Before you go…

  • Have a consult appointment and get an approximation for length of time the piece will take as well as a rough price so you know what to expect. DO NOT NEGOTIATE PRICE!!! This is super offensive to the artist and is highly regarded as bad form. If you can’t afford the artist but they’re perfect for what you’re looking for, keep on saving. It is so worth it to have the right artist for your piece.
  • Plan to TIP your artist. This is a service as well as a product so tipping is required. I did a set extra amount with each session while I was getting my sleeve done (it took 4 or 5 sessions over several months to complete). Something around 20% and $20 minimum for small pieces is pretty standard.
  • Do not put any type of numbing cream on your skin prior to going for your tattoo. It could dramatically alter how the ink is able to be absorbed into your skin and cause all kinds of issues.
  • In the weeks before your appointment, up your moisturizing game. Keep your skin as healthy as possible so your tattoo will have a clean, healthy canvas to start on.
  • Several days before your appointment, start upping your water intake. This will help the healing process as well as help keep your skin healthy and hydrated.
  • Immediately prior to your apointment, EAT SOMETHING!! Don’t go to your appointment hungry. Mild nausea is a normal side effect of getting a tattoo and an empty stomach will not help your case. Don’t be the dork who passes out in the middle of the tattoo shop.
  • If you’re worried about pain or swelling, take 800mg of ibuprofen approximately 20 minutes prior to getting to your appointment. Continue taking 800mg of ibuprofen over the next 24-48 hours post tattoo if necessary.

Let’s do this thing…

The two biggest concerns when getting your tattoo is
1. Infection prevention
2. Optimal aesthetics of your new ink

Immediately after your tattoo is completed, your tattoo artist will likely let you take a couple pictures and then apply some sort of moisturizer and wrap the area in cling wrap and an external wrap to hold everything in place. This is to help the newly damaged skin [because tattoos are a specific type of WOUND] from experiencing:
-sun light
-bacteria
– friction

Leave this wrap on for AT LEAST 12 hours! I always left mine on throughout the rest of the day and overnight while I slept.

The morning after…

  • The next morning when you carefully unwrap your new ink, there will be a gooey layer of ink and moisturizer all over the place under the wrapping. This is normal!
  • Get in the shower and carefully, with luke warm water [because hot water is going to feel like Satan’s spit on your newly damaged skin] cleanse the area with light, circular motions using an unscented mild soap. Highly fragrant soap will burn like fire as well as irritate and dry out your new ink; a loofah or wash cloth is way too abrasive and can damage your skin and hurt a lot.
  • Color will come off during your first shower and can be seen in the water on the shower floor. THIS IS TOTALLY NORMAL. Your tattoo is not coming off.
  • Pat the area dry with a clean towel when your shower is done.
  • Expect REDNESS and SWELLING for the next 5-7 days that progressively becomes less and less noticeable.

So you’re fresh out of the shower with a brand new tattoo…now what?

  • The following instructions are what I personally have done for all of my tattoos, most recently my sleeve. I highly recommend this regimen but other tattoo artist and tattooed people may have alternate suggestions. All I’m saying is my entire sleeve NEVER peeled or even flaked much and it looks BRAND NEW to this day 2 years later. So, yes, I feel that my method is the best and you should follow it closely.

At night for the first 3-7 days post tattoo, I applied a thick layer of Aquaphor to the entire tattoo, gently wrapped it in saran wrap and put a long sleeve shirt on to hold it in place [since it was my arm…modify for whatever body part you’re working with].

During the day, I would wake up, shower as previously discussed, and apply a solid layer of unscented lotion to the area [Lubriderm or Aveeno are my go to] and leave it open to air. Throughout the day I continued to apply lotion very liberally and frequently to keep it thoroughly moisturized at all times.

The first week after…

  • Wash your tattooed skin daily in the shower with your hands and mild unscented soap only [or more often if it gets dirty throughout the day due to your job, hobbies or whatever]. Once a day is minimum. I usually did twice day for good measure.
  • Do not submerge the area in water ESPECIALLY if it is dirty. If the water may be dirty, don’t even let it get splashed [like a river or public pool or hot tub] onto your tattoo. Your skin is your body’s #1 defense system and in the area where your tattoo is, that defense system is currently broken. The integrity of your skin has been compromised and cannot block bacteria/infection from entering like it usually can. Protect it to avoid infection!
  • If you will be in a dirty or dusty environment, cover the tattooed area with clothing as a barrier.
  • You can use Tylenol or Ibuprofen [better because it also helps with swelling/inflammation] for pain control if necessary.
  • Expect some heat to the newly tattooed area–your body is attempting to heal itself by pushing blood flow to the area. Also expect some swelling. My elbow bone straight up disappeared from view for the first couple days after that portion of my sleeve was done. As long as the redness, heat and swelling is becoming less and less every day, you’re heading in the right direction and your body is simply healing itself.

On to week two…

  • Keep on moisturizing!!!
  • Avoid direct sunlight. Sun screen has too many chemicals to use on your tattoo at this point and a sunburn on top of already damaged skin could for sure make your tattoo look awful before it has even had a chance to heal.
  • Ideally, you won’t have much for flaking or scabbing BUT, if you do, DO NOT PICK!!! This will result in color potentially missing from areas and your tattoo needing touched up. Realize that color flakes off much more noticeably than black and white tattoos tend to. This is okay but keep moisturizing constantly for best outcomes.
  • EXPECT IT TO BE ITCHY! Your skin is healing and regenerating itself over and around the tattoo which often results in the area feeling itchy. DO NOT SCRATCH!! Pat at it if you have to but do not scratch.
  • Keep on cleaning the tattooed area with mild soap at least once per day, more often if it gets dirty. Continue to avoid submerging it in water and keep staying away from dirty water sources. It is still considered an open wound at this stage of healing.
  • You shouldn’t be requiring Tylenol/Ibuprofen for pain control at this point and the redness and heat coming from the area should be gone now. If it looks red and “angry”, you’ve spiked a fever or there is any drainage, you need to get your booty to the doctor for some antibiotics ASAP. These are the main signs of an infection.

Week 3 and beyond…

  • Your tattoo should be well healed by week 3. This was about the time when I would go back in to have the next part of my tattoo done when I was working on my sleeve.
  • Keep moisturizing. Forever. It will only help to keep your tattoo looking fresh and keep the colors vibrant and intact. This even applies to black and white tattoos…no one wants their black ink fading into that greenish prison tattoo color.
  • USE SUNSCREEN!! Not just when you’re laying out on the beach or by the pool. Use sunscreen on your tattoo any time it will be exposed to the sun, even in the winter or on cloudy days. One good sunburn can turn your tattoo into a mess instead of an art piece that lasts a life time. Just like your entire body, you have to take care of your tattoo if you want it to serve its purpose for the rest of your life!

In conclusion…

As a registered nurse with a sleeve, I am often asked about my tattoos being so visible and whether this decision has negatively impacted my career. The answer is no; having a sleeve has never negatively effected my work as an ER Trauma nurse. My tattoos have never stopped me from being hired somewhere. My tattoos have never stopped me from holding a scared elderly patients hand while they slipped closer and closer to their final moments. My tattoos have never stopped me from hugging a young would-be mother as she cries knowing she is having a miscarriage. My tattoos have never stopped me from rapidly calculating medication dosages to halt an infants seizures when their fever got too high. I love my tattoos and all they represent and I am very proud to be a tattooed registered nurse.

Artistic travels <3