A Tattoo Guide

Tattoo: A Guide to Getting Inked

A friend of mine once shared to me the reason why she got herself inked. It wasn’t any sort of rebellion which is how society always frames the concept of tattoo or just a hasty decision of decorating her body. To her, each tattoo is meaningful – a celebration of her life and achievements and an expression of herself. The tattoos were art as much as the concept and depth behind every one of those. They were beautifully crafted in permanent ink, a reminder of struggles won and memories she had always wanted to keep.

For so long, stories of tattoos have been edited out of the narrative, instead people focused on the idea of tattoos as a disregard of the holy temple of the soul. Stigma surrounds inked individuals and they are easily subjects of stereotypes as outcasts and rebels, violence-lovers, or freaks. But slowly, the society has been more embracing of this art culture and more people have been more open to the idea and beauty of tattoos.

Mainstream media has caught on with the hype springing shows based on the tattoo industry just like the successful 2005 show “Miami Ink”. Miami Ink is a legendary tattoo shop on the South Beach which featured its talented tattoo artists. Ami James, the owner of the shop, linked up with a major network and opened the door of his shop to showcase the amazing tattoo works done. This has raked in viewership ratings and continued to air for six seasons in 160 countries. 

This show has put in a celebrity status for its tattoo artists and those who appeared in the show just like Ami James, Tommy Montoya, Kat von D, and Megan Massacre and has put the tattooing industry under incredible limelight. Even celebrities themselves namely Rihanna, David Beckham, Angelina Jolie, and Adam Levine got inked by these tattoo artists. In social media platforms, the tattoo culture has also been gaining consistently increasing following with inked people getting more comfortable sharing photos of their tattoos while getting more positive reactions from it. 

In studies conducted, they found out that four in every ten adults aged 18 to 39 years old have at least one tattoo. Consequently, half of those with tattoos have more than two tattoos. In the US, the statistics show that one out of every five adult Americans has gotten inked once. In 2019, thirty (30%) percent of Americans have one tattoo which is a 9% jump from the 2012 data.

A little bit of trivia, the world record in number of tattoos is held by Gregory Paul McLaren whose skin is 100% covered with tattoos closely followed by Tom Leppard who is 99.9% covered in tattoos. This growing community of inked people has also translated to online interest with a reported 147 million searches on Google every month!

What are tattoos?

Tattoo is a form of body modification art using ink, dye, or pigment and is usually referred to as permanent or indelible but also caters to temporary ones (e.g. henna tattoos). The general process of tattooing involves the puncturing of skin with needles either manually or through a machine and entering the dermis layer (unlike the epidermis, this layer does not grow new skin cells everyday) of the skin and injecting pigment. The wound then scabs over and the skin heals exposing a design under a new layer. It is also loosely applied to the concept of cicatrization or the inducement of scars.

The development of tattoos observed in this era is the apparent safer process using (1) non-reactive pigments, (2) sterile, disposable needles, and lastly (3) sterile work environment. Previously, tattoos were done manually by dipping needles in ink and performing each prick by hand and has gradually evolved with the invention of tattoo machines enabling artists to “tattoo as fast as he could draw.” 

The word tattoo is derived from the 18th century terminology tattow borrowed from the Tahitian word tatatau or tattau meaning “to hit or strike”. The first exposure of Europeans to this ancient art can be traced back in 1769 when British Captain James Cook led an expedition to Tahiti. But tattoos existed way before 1769. Historical records date tattoos back to 5200 B.C. with the discovery of an iceman on the Austria-Italy border and was discovered in 1991. The body had several tattoos: “a cross on the inside of the left knee, six straight lines 15 centimeters long above the kidneys and numerous parallel lines on the ankles.” The tattoo placement has led researchers to believe that these tattoos were mainly for therapeutic benefits.

In 2000 BC, there were several female mummies observed with tattoos though in ancient images, both male and female Egyptians were found with the same body art. These tattoos were also presumed to be for therapeutic purposes though there were first assumptions of that the body art found on the females were indications of prostitutions and sexually-transmitted diseases (STDs) but contradicted with the fact that these mummies were found buried in an elite and royal burial site, Deir el- Bahari. 

Tattoos have emerged in different countries independently at the same time hinged on varying meanings, processes, and styles. In the Greek and Roman culture, tattoos or then called “stigmata” was a form of identification of status and religion and by extension a sign of worship and devotion. In 221 to 205 BC of ancient Egypt, a pharaoh named Ptolemy IV covered his body in a tattoo of ivy leaves showing his commitment to the Greek god of wine, Dionysus, who is also the patron deity of his royal house.

But with the prominence of Christianity in the Roman Empire in time, these tattoos lost their earned popularity and role as it was viewed to be a desecration of the body imaged from God himself. Consequently, Emperor Constantine also restricted the use of the ancient art during his rule. 

The Maori culture of New Zealand also used tattoos as an identifier of status, rank, ancestry and abilities. “Moko” or facial tattoos were the most highly-regarded kind as it indicated high status with the concept of the head as the most significant body part.

Moreover, these tattoos also signified achievements and rites of passage for men. More tattoos translated to more attractiveness in their culture. On the other hand, women also wore facial tattoos but in a different context. They believed that these tattoos retained their youthful look and also reduced (or showed less) their wrinkles. 

In the Americas, Canadian tribes practised the ancient art in the same meaning of identification, achievement, and ritual of passage though people who did not share the same values were eluded as to why these tribes would willingly subject themselves to such pain. Most tattoos were designs of animals and other creatures. Additionally, many North American tribes practised tattooing as an effort to relieve pain like the Ojibwa tribe who tattooed temples, foreheads, and cheeks to alleviate headache and toothache. 

In 1862, tattoos became an indicator of status in England which started when the Prince of Wales who would then inherit the throne as King Edward VII had tattooed a Jerusalem Cross on his arm after his trip from the Holy Land. Upon his insistence, his two sons also received tattoos upn their visits in Japan and Jerusalem. This has created tattoos to signify not only status but also wealth.

The British Army encouraged this practice to promote “esprit de corps” or morale among members adding to its functional use in identifying corpses. This status symbol has then been incorporated into the US where members of the exclusive New York Racquet Club got identifying tattoos. 

Aside from the most common and popular meanings put into tattoos, some cultures celebrate it as a form of magical protection against sickness and misfortunes or to mark special events and pay honor and respect. And since the Neolithic era, tattoos had also been applied to cosmetic use (e.g. lip color, eyebrows, and eyeliner). 

What are the types of tattoos?

The American Academy of Dermatology has acknowledged five (5) different types of tattoos namely traumatic or natural tattoos, subcultural connotation, identification, cosmetic, and functional. 

Traumatic tattoos

Traumatic tattoos or also called natural tattoos are results of injuries and occur when foreign bodies (e.g. asphalt, dust, fireworks, glass, graphite, gunpowder, petroleum, sand, etc.) are forcibly embedded into the dermis creating a tattoo. These can then be trapped beneath the layers of dermis and epidermis or in a collapsed entry wound. This kind of tattoos are characterized with unavoidable scarring and discoloration. Furthermore, these are difficult to remove as they are already embedded or spread across layers of skin. Most common example of traumatic or natural tattoos is accidental stabbing with a pen and pencil leaving marks of ink and graphite on the skin. 

There are two types of traumatic tattoos. The more common is traumatic abrasions which are pigment deposits in the superficial layer of the skin while the other one is traumatic explosions which are deeply embedded detritus with superficially placed articles surrounding it originating from a central focus. 

Subcultural Connotation

This type is more common and has been well-illustrated in the history of tattoos. Subcultural connotations are not generalizations of meaning but are guided by specific cultures though it overlaps in almost the same meanings. Most cultures value tattoos as a rite of passage, celebration of achievements, and indicators of religion (and devotion), status, and wealth. Tattoos, in some cultures, reflect more definitions. For example, some use tattoos in sexual connotations, as marks of fertility, or pledges of love. Some even use tattoos as a form of talisman against misfortunes. 

In a study titled From Cellblocks to Suburbia: Tattoos as Subcultural Style, Commodity and Self-expression by Erin Teffs, she explored the concept of tattoos concerning the subculture. Subcultural trends tend to start on a bricolage, a term introduced by Hebdige, which refers to “the use of something for something other than its original intended use.”

In this context, it talks about the countercultural revolution of tattoos from a widely-banned idea stereotyped to outcasts of the society like criminals and gang members to a concept generally accepted by the mass culture yet still retaining a distinction between the subculture from the mass culture. Authentic members of a subculture are described as those who “dedicate their lifestyle to the values set forth by the subculture” – originality, creativity, beating the system, honesty among peers – whereas those who are not part of the culture or who are called ‘posers’ or ‘hangers-on’ only commit to the appearance.

Additionally, authentic members are identified as those who can tell the details of the tattoo just by looking at its craftsmanship and someone who knows the tattoo scene in and out. 

Today, subcultural connotations tattoos have evolved into symbolisms of artistic expression, sentimental or memorial, or cosmetic reasons. 


Identification through tattoos is one that has existed through time and has evolved in many ways throughout history. The earliest records of tattoos as identification were during the Roman Empire wherein both gladiators and slaves were tattooed with the words “tax paid”. Fugitive tattoos labeled “FUG” on the foreheads of runaway slaves were also common practice during this time. Though later on with the rule of Emperor Constantine, these facial marking practices were banned and the Second Council of Nicea also declared all body markings as pagan practices. In China during the Zhou dynasty, there were similar practices of prisoner and slave identification using facial tattoos as punishment terms. 

Another historical use of tattoos in identification rooted from the early contact between the Māori and Europeans. Moko tattoos or facial tattoos highly regarded in the Māori culture bestowing high status among its peers. Following this, Māori people hunted and decapitated each other to win an honor of a moko tattoo and as trade for European items like axes and firearms. 

Branding, common to most folks in religious sects and cults (or mostly depicted in films as such), is also classified under this though its stark difference with tattoos as it employs permanent scarring rather than injecting ink or dye into the skin. 

During the period of the Holocaust, tattoos as means of identification were common. Camp inmates were forcibly tattooed with identification numbers as part of the Nazi’s identification system in 1941 introduced and implemented at the Auschwitz concentration camp. During registration, guards pierce the assigned serial-number digits onto a prisoner’s arm. The tattoos are usually the prisoner’s camp number with special coded designations. For example, Jews were identified through triangle symbols, Romani with the letter “Z” from the German Ziguener for “gypsy”. And in 1944, Jewish men were tattooed with either “A” or “B”. 

The practice of tattoo was not limited to humans but also to animals. Oftentimes, pigs are tattooed with a ‘slap mark’ either on the shoulder or the arm for commercial farming identification purposes. Cats and dogs were also subjected to the same practices for owner identification though this is becoming an obsolete practice with the UK legally requiring the use of microchips for dogs in 2016. 

Nowadays, identification tattoos are used by forensic pathologists to help identify corpses that have been burned, putrefied, or mutilated. As tattoos are embedded into the dermis of the skin, they are not easily and completely destroyed when skin is burned. 


Cosmetic tattooing or also called permanent makeup (PMU) has recently become a trend especially among women employing the use of a cosmetic tattooing machine which gently implants pigments onto the skin by a variety of fine needles. Although machines are generally used with tattooing in general, cosmetic tattoos can also be applied manually depending on the area of the face. 

Most common cosmetic tattoos are applied on the eyebrow, eyeliner, and lip and use pigments instead of inks to make it less permanent and prone to fading. This is because cosmetic tattoos are done to enhance natural face features which are inevitably changing through time. 

Its wide benefits have made it a trend as it’s very time-saving since you don’t have to apply makeup daily and it also provides a long-lasting effect counted in years. It’s also very helpful for people who struggle putting makeup on due to poor vision and other eye conditions. Lastly, these are used to correct physical issues or flaws with certain areas of the face. Though cosmetic tattooing also extends to surgical scars like in mastectomy which has been a growing trend in the US and the UK. Most women opt to tattoo over the scar tissue instead of going through reconstructive surgery. This also reflects options for women and a feeling of regained control over their post-cancer bodies. 


In 1898, Daniel Fouquet, a medical doctor, wrote about the medical tattooing practices discovered in the 5200 BC old female mummies buried at the Deir-el Bahari site and suggested that these were of therapeutic or medical purposes. In the article, Fouquet said, “The examination of these scars, some white, others blue, leaves in no doubt that they are not, in essence, ornament, but an established treatment for a condition of the pelvis, very probably chronic pelvic peritonitis.”

Today, medical tattoos are widely used in radiotherapy to ensure proper placements of instruments for repeated application. These are also common in breast reconstruction procedures. Additionally, medical tattoos are also used to even skin tone in cases of skin discoloration conditions such as vitiligo. 

Quick Guide: Getting Inked for the first time?

Before getting inked, here are things that you need to know. 

Most tattoo artists and those who wear tattoos have always pointed out two points before getting a tattoo. First, remind yourself that this is a choice that you have to think carefully through because tattoos are permanent. Even with the advent of laser technology which now allows complete removal of tattoos, it’s not an excuse to make hasty decisions about it. Though it’s entirely subject to preference, they encourage people to meaningfully ink themselves. There are instances of peer pressure that have led to decisions that would soon be regretted. 

It’s your body, it’s your choice. 

Second, take the necessary tests before getting one. In an article published by Bustle, Caitlin Hoff, a Health & Safety Investigator at ConsumerSafety.org says, “Tattoos have become an almost integral part of the millennial culture, but many people don’t do all their homework before sitting under that needle.” She also adds, “Studies are currently still looking into more long-term health effects of tattoos and the inks themselves.”

It’s important to ensure that you have had all your immunizations prior especially hepatitis B and tetanus. If you have existing medical issues like heart disease, diabetes, weak immune system, or bleeding problem, it’s highly encouraged to get your doctor’s approval before getting a tattoo. That is also the case if you’re suffering from skin problems like eczema or psoriasis, keloids, or any history of allergic reactions. 

Tattoos are decorative body arts and sometimes, the experience of getting one pushes away the practical thoughts of infections and allergic reactions into the back of the mind which compromises one’s health safety. 

Also part of the safety measures is to research about the tattoo shop you would want to get inked in. Make sure that it’s licensed – that means they are following proper health and safety guidelines and all employed tattoo artists are licensed practitioners. Check for reviews about the shop or if you have acquaintances that have tried the shop, ask about their experience. 

Professional tattoo studios use single-use needles and sterilize all equipment through an autoclave. Ink cartridges should also be disposed of after every customer. Universal precautions should also be in place to prevent spread of HIV, hepatitis B, and other serious blood infections.

If you are unsure about the place, walk away. 

What tattoo design and where should I get inked?

First, you have to note the tattoo design and its size that you want to get permanently done on your body and the area where you want it to be inked. 

For the tattoo design, some are called “flash” which are copyrighted tattoo designs that have been mass produced usually for industrial designs. Tattoo studios also have an arsenal of tattoo designs that you could choose from instead if by chance you only walked in a studio for a spontaneous ink. (Though we do not generally recommend doing walk-ins unless you’ve already tried getting inked more than once and you are familiar with the area.) But the best is to have a customized design. Tattoo artists usually do design services as well so don’t worry if you’re not creative enough to make a drawing of your tattoo. 

You should also consider the size of the tattoo. 

In general, small sized tattoos typically 2”x2” in dimension range from a minimum of $30 to $100. Larger sizes are more expensive. Tattoos with 3”x3” dimensions can cost around $100-$200 while 4”x4” tattoos start from $250 upwards. These are just base rates and depend on the area or tattoo studio. Tattoo prices also depend on the complexity of the tattoo (especially if it’s custom), amount of ink to be used, and how long it would take to finish. Aside from that, there’s also the artist’s hourly rate depending on his/her skill, experience, and waiting list. An experienced artist usually charges $150-$250 while those who are famous can charge as high as $500 per hour. Nevertheless the base price for beginner artists is already at $80/hr. This is one practical thing that you should note before deciding on your tattoo design. If you’re not ready to spend, it’s better to put off getting one. Also note that tattoo shops require down payment for its services. 

And to put it out as well, it’s also good to know the price for removing tattoos. Tattoo removal starts around $250 depending on the size of the tattoo and can go as high as $1000. Laser removal sessions cost $1000 – $2000 for a medium sized tattoo. 

For the placement especially for beginners, it’s best to try out less painful ones – though placement of tattoos also considers whether it can be easily hidden or a meaningful place in your body. 

In general (gathered through consensus), the least painful areas are those with the most fat, fewest nerve endings, and thickest skin while bony areas (least fat, many nerve endings, thinnest skin) usually hurt a lot. 

Here is a short guide of the least painful to the most painful areas. 

Least painful areas

Upper outer thigh, forearm, outer shoulders, outer bicep, calves, upper and lower back.

You will experience low to medium levels of pain in these parts since these are generally fatty areas. 

Most painful areas: 


This is one of the most painful places to get your tattoo and pain levels could get severe which is why most tattoo artists advise against getting inked in this part of the body.

Rib cage

According to consensus, this is the second most painful place next to the armpits since skin here is very thin and in the process of tattooing, breathing can make the pain more severe. 

Ankles and shins

These areas are very close (just layers close) to the bone which makes it painful to tattoo over here. Some noted that the pain is more or less the same when getting tattooed over the rib cage. 

Nipples and breasts, groins

These areas are very sensitive and filled with a lot of nerve endings that can be irritated with tattoo needles. Usually, women who have undergone mastectomy opt for this kind of cosmetic tattoo. 

Elbows and kneecaps

Like your ankles and shins, these areas lie close to the bones and vibrations caused by the tattooing process can cause high to severe levels of pain.

Behind the knees

Though these are quite fatty areas, the skin here is loose and stretchy with many nerve endings. 


If you have less fat on your hips to cushion the hip bones, you will experience severe pain. 

Neck and Spine

Alongside armpits, these two areas are among the most painful tattoo places since they are very sensitive. 


Anywhere on the head and face have thin skin making it very prone to severe pain when pricked by a tattoo needle. Specifically for the lips which have generally loose skin and scattered nerve endings, a tattoo besides being severely painful can also lead to bleeding, swelling, and bruising. 

Hands, fingers, feet, toes

These are the most common places to get a tattoo and are also painful areas. Moreover, the nerve endings in the hands and feet may undergo spasm during the tattooing process. 


This body part is usually in the transition area of less painful to most painful to get a tattoo. Pain here largely depends on what kind of shape you’re in. 

Inner bicep

The muscles here are usually soft and loose making it a very painful area to get your tattoos. 

These areas also take more time to heal. 

Slipping it in, most frequently asked question is whether you can tattoo over a scar. The answer is yes but you have to wait for the scar to completely heal – that is, the scar exhibits a white color (not red or pink) – before you can have it tattooed.

How does it feel getting a tattoo?

Pain can be subjective as individuals have varying degrees of personal pain tolerance. Aside from that, it’s also affected by different factors such as: 

  • Sex – researches conducted have shown that women experience more pain than men although they are also more accepting or tolerating of the pain 
  • Age and weight – older people have generally thinner skin while heavier people though have more fats also have looser skin 
  • Experience – if you’ve had any subsequent tattoos, you will be able tolerate the pain more 
  • Size and type of tattoo which provides the coverage of the tattoo (especially for colored ones, an area may be tattooed in layers to provide rich color)
  • Skin sensitivity apart from your pain threshold
  • Artist skill and technique – Experienced artists can adapt to your pain level and is more familiar when to take breaks 
  • Stress and anxiety – stress can lower down your ability to modulate pain and can affect the overall experience

Here are some common pains experienced during the tattooing process but are not generalization of experience for all. 

  • Burning Pain – This feeling is close to getting your skin pressed against something hot over a certain period of time. The burning pain is usually felt as a combination of the skin’s progressive sensitivity with longer periods of time subjected to needles and the “trauma” felt by the skin due to repeated pricks. Although it’s not as painful, it’s very bothersome and irritating. 
  • Dull or Background Pain – This is the most common pain which happens during the first interaction between your skin and the needle as your body releases stress hormones like adrenaline
  • Scratching Pain – According to many tattoo artists, this is the most common sensation experienced while getting a tattoo. This feels like a cat is dragging its claws across your skin. This is intensified when an artist shades the tattoo which involves multiple needles. 
  • Sharp, Stinging Pain – This like tiny bee stings which happens when a needle is poked deeply into the skin. Thin skins usually experience a more intense stinging pain than other parts of the body cushioned with fat. If you experience too much stinging pain, it might be because the needle is pushed in too deeply into the skin which is not good since it could lead to tattoo blowout (dispersing ink across the top layer of the skin) which could be painful and result in low quality tattoo.
  • Vibrating Pain – This kind of pain is experienced in the bony sections of the body interacting with the needle. 

Tattoo pain will definitely feel intense during the first few minutes as your body is adjusting to the pain but will wear down eventually to a comfortable level. If the tattoo is large, you may feel pain backing up again as the pain and dulling stress hormones such as endorphins eventually fade. 

What is the process of getting a tattoo?

Getting a tattoo is a very fulfilling experience and some even note to be very memorable. To get the best experience, it’s highly encouraged to get an experienced artist. Generally, the procedure is as follows:

  1. The tattoo artist will follow health and safety measures by washing his or her hands thoroughly and wearing gloves and face mask.
  2. The area where you will get inked will be cleaned with rubbing alcohol and any hair present will also be shaved.
  3. The tattoo artist will then transfer the stencil or outline of your tattoo onto your skin with water or moisture stick for placement approval. 
  4. The area is then cleaned again with antiseptic and a thin layer of ointment like petroleum jelly will be applied.
  5. Using a tattoo machine or manually, the tattoo artist will start working on the outline of the tattoo and you will start feeling sting sensations. 
  6. Depending on the design, once line work is done, the tattoo artist will proceed to shade and color the tattoo. 
  7. Any blood or fluid will be wiped with a clean cloth or sterile disposable gauze.
  8. The final tattoo will then again be cleaned and applied with a layer of ointment before bandaging. 

The length of the tattooing process depends on the size and complexity of the tattoo. A small design like a small star will only take as fast as 5 minutes but larger designs especially sleeve designs (covering arms) take multiple sessions to finish. 

After getting a tattoo, you might feel some itching or burning sensation which indicates that the skin is healing. It can also look red and swollen which is perfectly normal. If you feel increasing pain after getting a tattoo, reach out to your doctor. 

How do I take care of my tattoo?

Getting a finished tattoo is not the end of the journey. A tattoo is like a wound that needs to be tended to properly to avoid unnecessary infections. It will usually take about two weeks for your tattoo to heal. During that time, here’s what you can do.

  1. First, keep the bandage on the area for 24 hours and then afterwards remove it and keep the tattoo open to air. 
  2. Avoid touching the tattooed area and as much as possible keep it free from any clothing contact. It might get a little itchy but never scratch it or pick any scab. As much as it’s a health concern, it can also lower the quality of your tattoo as the ink is still not fully settled. 
  3. For tattoo aftercare, leave it clean and dry for the first few days then wash it twice daily with a gentle cleanser and then pat it dry. You can apply antibiotic ointment, thick skin cream, or vitamin E oil (excellent in repairing damaged tissue) to the tattoo around 2-3 times a day for a week. Do not apply petroleum jelly over your tattoo. It’s also good to apply light thin layers of lotion to address the itch issue and to also keep the skin moisturized. 
  4. Don’t let the tattoo soak in water or expose it directly to the sun. Steer clear of baths and swimming but light showers are okay until the tattoo is completely healed. 
  5. Avoid doing heavy workouts that would cause you to sweat and soak the tattooed skin with water. 
  6. Even when the tattoo is fully healed, apply sunscreen with a minimum sun protection factor (SPF) of 30 to protect your tattooed skin and to keep it from fading. 

Finally ready to get inked!

Remember that tattoos are permanent and it’s best to take your time before getting one so you’re sure that by the time you decide to go for it, you are completely committed to it. Make important pit stops on your journey by getting a design that suits you and your meaning best and where to place it. Be ready to spend. Tattoos are investments as well and it’s always better to spend in quality. It’s your body after all. Research the tattoo studio and get to know your artist as you’re both in with the experience. Be prepared with the pain and make sure to listen to your tattoo artist on how to best take care of your tattoo.