Staying Healthy Behind the Walls: Tattooing, Piercing and You

If you’re going to get a tattoo or piercing in prison, it is important to do it as safely as possible. You need to know the risks and the steps you can take to protect yourself and others from infections.

What are the risks of getting hepatitis C or HIV from a tattoo or piercing in prison?

Hepatitis C (Hep C) and HIV can pass from person to person when the blood of someone with Hep C or HIV gets into the bloodstream of another person.

Because tattooing or piercing involves breaking the skin, they carry a high chance of infection with Hep C, HIV and other germs if equipment is being re-used and not sterilized properly.

Rates of Hep C and HIV in prison are higher than in the general population. Hep C is much more common in prison than HIV.  

How can you protect yourself and others?

It is not currently possible to sterilize tattooing and piercing equipment in prison in the same way as in a professional tattoo or piercing shop. But there are things you can do to reduce the chance of getting or passing on Hep C, HIV or other infections while getting a tattoo or piercing in prison. This page explains some of these things.

Before you get a tattoo or piercing check out the artist’s previous work

Talk to other people who have had work done by the artist. Ask to see the artist’s work on someone else. Look at how well the tattoo or piercing has healed. Also, make sure the artist knows how to take precautions to prevent infection and transmission of infectious diseases.

Tattoos

Use safer tools for tattooing

In general, the more new equipment that is used each time, the safer it is. Use as many new items as you can, including needles, ink and ink pots.

Prepare and bring your own equipment if you can. That way you can be sure that everything is new or it has only been used by you.

If you are doing more than one sitting, ask the artist to give you the equipment so you can clean it between sittings.  Also, that way you know you are the only 
person using it.

If you don’t have your own equipment, ask the artist to prepare the equipment in front of you.

Preparing needles

A guitar string (thicker E string) is a good option for making a needle. A pack of guitar strings can make a lot of needles. 

If you don’t have a guitar string, beading needles are better than sewing needles because they are thinner and less likely to snap.

Needles need to be sharp. They can be sharpened with fine sandpaper.  Finer sand paper is better than coarse because coarse sandpaper may cause pockets where blood can get stuck on the needle. The needles should also not be too pointy because you don’t want them to penetrate too deeply in the skin, which can cause scarring. If you are using a sewing or beading needle, do NOT sharpen it. It is already sharp enough and the plating can come off during sharpening.

Getting or making ink

Using any kind of ink that has been used by someone else carries a high risk for spreading infection. Try to get your own ink or make your own ink.

Try to get real India ink, which is less toxic to the body.

Some people make ink by burning paper and mixing the ashes with water to make a paste.  Some people think thin paper with lots of words printed on it is best and may be less toxic.

Charcoal mixed with water can also be used.   

If real ink is not available and ink needs to be made, have the artist make the ink in front of you to be sure it is fresh. 

DO NOT use ink from a pen, including gel pens. Your body may reject the ink and it can cause serious infections or chemical burns. Also, if you are thinking about burning substances other than paper to make ink, consider the risk of the materials you’re putting into your body.

Ink pots

Try to use a new toothpaste cap, plastic pop bottle cap or Styrofoam cup to hold the ink.

 If you can’t get a new container, clean a used one with soapy water before disinfecting it with alcohol or a 9:1 bleach (9 parts water: 1 part full strength bleach) solution. If you use bleach and water, let it sit for 10 minutes.

Cleaning used tattooing or piercing equipment

If you cannot get new tattooing or piercing equipment, following these steps may reduce the amount of Hep C or HIV on the equipment but is not guaranteed to kill Hep C or HIV.

• Clean and disinfect equipment before use to reduce the risk of infection.  First, wash the equipment with warm, soapy water and then rinse it with clean water. Next, boil the equipment in water for 5 minutes. Then wipe it down with rubbing alcohol. Use the equipment right away.
• Immediately after a sitting, wipe equipment with alcohol. Before the next use, repeat the washing, boiling and wiping with alcohol steps.
• It might not be possible to access rubbing alcohol in some institutions.
• Some people may heat a needle on a stove element to try to sterilize it but this can be dangerous because it makes the metal more brittle and likely to snap.

Getting the tattoo

• The person doing the tattooing should wash their hands with soap and water before they start.
• You or the artist should clean and disinfect the work surface. If possible, the work surface can be covered with plastic wrap. The tattoo machine and cord can be covered in plastic wrap too.
• All the equipment should be new (or as clean as possible), including the ink, ink pots, water and rag. Vaseline can be placed in a smaller clean container.
• The artist should wear new latex or vinyl gloves when doing your tattoo. Ideally, gloves should be changed every time they touch anything besides the tattooing machine or spot where the tattooing is happening. This includes after cleaning and prepping the work area and after cleaning and prepping the site on the body.
• The artist should clean the part of your body that will be tattooed.
• During the session, make sure the equipment that touches you, such as a needle or a rag doesn’t come into contact with other equipment that could spread infection, like a tattoo machine cord.
• You should safely dispose of the equipment if you are not planning to get another tattoo (see “Getting rid of used tattooing and piercing equipment safely”).

Tattooing after-care

Put a dressing over the tattoo for at least four to six hours to stop germs from getting into the wound.

Then, clean the tattoo. First, wash your hands with soap and water. Then wash the tattoo with your fingers and mild unscented soap. Do not use a washcloth on the area.

Pat the area dry firmly with a clean towel. You may need to do this a few times if the tattoo is still releasing fluid.

Put on a thin layer of cream right after washing, if you can get it. Some prisoners make a cream by mixing Preparation H and vitamin E. Over the next few days, you can keep using the cream, especially when the skin is dry and flaky.

If you don’t have cream, it’s best not to apply anything at all. Vaseline can be useful during the tattooing process to reduce bleeding, but should not be used during healing.

Try to keep clothing clean and loose around the fresh tattoo and try to limit how much you move the tattooed part over the first few days. This will help with the healing.

The area around the tattoo will usually be tender, red and swollen for up to 24 hours.  This is normal. 

If after a day or two the tattoo is bright red and irritated, use antibacterial cream twice a day for two weeks. 

If you experience redness, tingling, itching, swelling, tenderness, pain, greenish-yellow pus, rashes and fever after a few days, you may have an infection and will need to seek medical attention.

Getting rid of used tattooing and piercing equipment safely

After the work is done, you might save your equipment if you think you will want another tattoo or piercing. If not, safely dispose of everything that was used to do the tattoo or piercing.  You will have to throw it in the garbage or flush it down the toilet. Consider putting it in a water bottle or pop bottle with the lid on before putting it in the garbage, so someone else doesn’t get accidentally stuck by it.  Carefully disposing of everything and NEVER re-using someone else’s equipment will prevent infections.

Piercing

Use safer tools for piercing

• It is safest to use new piercing needles and jewellery.
• Only nontoxic metals should be used for body piercings, such as surgical steel, solid 14-karat or 18-karat gold, titanium or platinum. 
• If you cannot get new needles, tools or jewellery, clean everything prior to use. (See “Cleaning used tattooing or piercing equipment”).

Getting the piercing

• The person doing the piercing should wash their hands with soap and water before they get started.
• The work surface should be cleaned and disinfected. It can also be covered with plastic wrap.
• The piercer should wear latex or vinyl gloves when doing the piercing.
• The area you’ve chosen to be pierced (except for the tongue) should be cleaned with a soap specifically made to kill germs, such as Betadine, before the piercing happens. For tongue piercings, rinse the mouth with a non-alcohol mouthwash for 30 seconds before getting the piercing
• You should dispose of the piercing needle if you are not planning to get another piercing (see “Getting rid of used tattooing and piercing equipment safely”).

Piercing after-care

The pierced area should be cleaned right after the piercing. The only thing covering the piercing should be clean clothing.

The best time for the first wash of the piercing is the morning after the piercing. This is to give the wound time to close. 

Wash your hands with soap and water before touching the piercing.

Wash the area around the piercing with soap and water once or twice a day for the first two weeks after the piercing and then once a day after that.

Dry gently with clean paper towel.

Do not use alcohol or hydrogen peroxide on the area because it can break down the skin.

If you have a mouth piercing, brush your teeth and use an alcohol-free, antibacterial mouthwash after eating. Rinse thoroughly to get rid of all the mouthwash.

It is normal for a piercing to produce off-white fluid while it heals. This often forms scabs around the hole. Soak these scabs and gently remove them when you wash the piercing.

Try not to pick or tug at the piercing.

Do not expose any new piercing to the saliva or body fluids of other people until it has healed.

If you experience bleeding that won’t stop, scarring, an allergic reaction to the jewellery, abscesses, boils (pus that forms under your skin at the site of the piercing), inflammation or nerve damage, seek medical attention.

Getting tested for Hep C and HIV

If you are worried that you may have contracted an infection such as hepatitis C or HIV through a tattoo or piercing, you can access testing through health care. You can get tested right after getting a tattoo or piercing, but you should get tested again three months later because it can take three months for the test to be accurate.

If you find out you have Hep C, there are treatments that can cure the virus. If you find out you have HIV, there are treatments that can help you stay healthy for a long time. 

PASAN can help you if you need support and information about Hep C or HIV. You can call PASAN at 1-866-224-9978. CATIE also has information about Hep C and HIV, call 
1-800-263-1638.

© 2018, PASAN and CATIE.