By its very nature, the process of getting a tattoo involves repeatedly piercing the skin with tiny pricking motions to insert ink. This raises the issue of whether there is a risk of getting a MRSA staph infection when getting ink done.

What is MRSA? MRSA stands for methicillin-resistant Staphylococcus aureus. Scary already, huh? In English, this phrase refers to a bacteria that is resistant to treatment by antibiotics that are commonly prescribed to treat bacterial infections. This is a more resistant strain of the basic staph infection referred to in most medical discussions.

Why is MRSA a big scare these days? Well, 19,000 people a year die from the infection. That being said, is has been getting more attention recently because of outbreaks in the NFL. Professional football players with the St. Louis Rams and Cleveland Browns have been infected with MRSA at an alarming rate. Some players have missed entire seasons while others have simply been hospitalized in the middle of the season.

MRSA generally becomes a problem when it penetrates the skin and gets into the internal blood transfer system. That being said, it is easy to kill when it is on the exterior of the skin, a place it is often found. The use of products like Hand Sanz and rubbing alcohol can usually wipe out the bacteria within 15 seconds.

So, are you at an increased risk for a MRSA staph infection if you get a tattoo? Yes, but the question is how much so? Well, let me ask you a question. If there were MRSA outbreaks in tattoo parlors, do you think we would hear about them in the news? You and I both know it would be the lead story and followed by some politician looking to shut the tat businesses down!

While there is a risk with just about anything, tattoo studios are actually very clean environments. Bet you didn’t see that one coming. It has to do with the fact that laws were passed that require the studios to focus on sterility. This includes everything from wearing sterile medical gloves to using sterile needles to cleaning the area of the body in question by sterilizing it prior to applying the tat. Basically, it is sterility from beginning to end, so the opportunity for MRSA to cause problems is pretty low. Again, it should be stated that is a legal requirement and tattoo studios are hypersensitive to keeping things clean because they know their business realizes upon it.

Is there some risk of a MRSA infection when getting a tattoo? Yes. Is it a big risk? Statistically, it is not.

First, there are two distinctly different types of white tattoos being done currently. One is done with white ink only, will be slightly visible under natural daylight and is permanent. The other is done with white UV black light ink and may not be visible at all once healed fully and may or may not last a long time.

The first type is done with only white, normal tattoo ink. There are many brands of white ink on the market today and new brands are showing up all the time. Brands like Starbright, Millenium “Moms’, Kuro Sumi, Fantasia, Eternal, Iron Butterfly, and others basically use titanium white powered pigment in a carrier fluid. This carrier fluid is usually made of glycerin, witch hazel, alcohol, and/or water. The FDA has not at this time approved any inks for injection under human skin. But, we in the market, are expecting that to change in the near future. Some inks are sold as opaque white, while others are intended to be used as a mixing agent with other colors to brighten or lighten the base color, much as is done when tinting paint colors. As a professional tattoo artist of many years, my experience has been that these inks are great when used in small areas, such as edging out a rose, as accents to edges of elements and as reflection points on elements meant to be representational of reflections. But, experience also has taught me that these whites when used in larger areas tend to not hold up well and tend to fade out completely in a year or less depending upon how much that area of the skin is exposed to sun light.

Historically, tattoo artists didn’t even have access to white ink until about 30 years ago. It simply didn’t exist before that time. So, areas that were white in a drawing were usually left naked skin when tattooing was done. Some things like skull teeth, white roses, bones, etc. are usually shaded out with a variety of grays then highlighted with white to give the visual impression of being something white. Many designers of tattoo flash (artwork) today who are not tattoo artists, fail to take into account that white does not hold up well in skin in large areas, over a long period, and design pieces of artwork that require large areas of white ink application in the design. Many tattoo artists will try to advise their clients that perhaps a pale blue, pale yellow, pale purple can be used instead of straight white since with just a slight amount of another pigment added to the white in the area tends to last longer and hold up better.

One particular type of ink that offers a very opaque white ink that does seem to hold up well over time is the brand produced by Intenze. Intenze inks are made with the usual pigments and carrier fluids, but have an added difference. According to the MSDS sheets that tell what the ingredients of inks are, Intenze inks also include a finely ground acrylic polymer. Acrylic polymers are used in car paints, house paints, and other applications. There has been some discussion in online forums between artists that there is a fear that the acrylic polymers may melt and solidify in the skin and make a patch of tougher skin than the surrounding areas. I have been using Intenze inks for over 5 years now and have never had one single complaint from any customer about this problem. I have used this ink on myself with beautiful results. Intenze white is the only white ink that I can use on darker skin and actually get it to show up well. Granted, it sometimes takes a double coat (two applications; apply once, let heal, apply again) to get the intensity the client wants, but it is without a doubt one of the most opaque white inks I have used. My clients love the way it looks and when I explain the pros and cons of the ink types, invariably they choose the Intenze white ink.

The second type of white tattoos being done now are UV blacklight reactive. There are also several brands of white UV inks on the market. One of the oldest is a microencapsulated type of ink where every molecule of tattoo ink is encapsulated in very tiny clear, flexible containers like a gel cap pill. These inks are only produced by one manufacturer at the moment and they have been rigorously tested in animals for many years. Because of their micro encapsulation, the ink never actually comes in contact with the skin in any way and the only way the ink can be broken out of the micro-container is by freezing. But, hey, if you’re frozen, you’re probably dead anyway, so where’s the contamination issue? I have also been using this ink successfully for over 4 years and have never had one complaint from a client. As usual, I tested it on myself before letting customers request it. The think about this ink, is that is thin, and the manufacturer suggests that it is not to be mixed during the tattoo process with normal inks, as they will cancel out the UV properties. Basically this means that if you want a highly visible tattoo, get a normal tattoo first, let it heal completely, then go back to the tattoo artist and have them apply the UV inks over the existing tattoo. If you want a tattoo less noticeable, then use just the UV micro encapsulated inks.

If you have a tattoo done with strictly white micro encapsulated white ink, the tattoo will appear pink (skin irritation from the tattoo process) or purple (stain from the tattoo stencil that fades away completely in a day or two). Once the tattoo is fully healed (perhaps 1 - 2 months) the pinkness goes away and the tattoo is invisible except under UV black lights. I have done a number of these in the past recent years on people like doctors, law enforcement officials, financial and real estate people and others who want tattoos but also respect the constraints of their career fields and need their tattoos to be invisible. The results have been exactly what the client wants. A tattoo artist needs to be very skilled before attempting to use these inks, though, because they are not easy to get good results unless you have the patience to practice a lot on pig ears before you try them on human skin. There is definitely a special technique required to get good results when using UV Black light inks.

Recently, a new tattoo ink manufacturer has come out with a line of nonencapsulated UV black light inks. I have tried the Tokyo Pink and find this ink to be thin, not as bright in the skin as in the bottle, and a couple of clients have come back after 3 - 4 months saying that their pink areas are not glowing under a black light anymore. So, these inks may be good, but their ‘glow power’ endurance seems to be in question. My advice would be to work with an artist who has used a particular type of ink for over 1 year and can give you qualified, expert advice about which brands will do what you want from them.

As for white tattoos? My attitude is, if you’re going to get a tattoo, get a tattoo!! Be proud, be bold, show it off and never apologize for being yourself. But, yes I realize there are some that feel the need to compromise. If white tattoos are what you want, shop around, find an experienced tattoo artist who can show you pictures of their work and give you client referrals so you can make an informed decision, and get what you want.