Cora Breuner, MD, MPH, FAAP
Adolescent Medicine, Seattle Children’s Hospital
Body modification (tattooing and piercing) has become increasingly popular among people of all ages, especially among adolescents. We see this in our clinics, when we are out and about, and on social media. Pediatric providers should be familiar with different types of body modification practices, regulations, prevalence, motivations, risk of complications, and removal practices to provide informed and supportive care.
Recent data show the rate of one or more tattoos in adolescents ages 12-22 to be anywhere from 4-13% in industrialized countries. Evidence also shows that obtaining a tattoo prior to the age of 18 was associated with higher risk of nondisclosure to parents, higher chance of obtaining the tattoo in a non-authorized facility, and higher use of recreational drugs, although more recent data shows a decrease in these associations.
Piercing prevalence in teens is higher. The rate of non-earlobe piercing in ages 12-22 is anywhere from 27%-42%. Other studies of students with current piercings show a breakdown as follows: 53% high ear cartilage, 38% navel, 13% tongue, and 9% genital.
Understanding and appreciating your patient’s motivation to pursue body modification is essential as well as knowledge about regulations for consent which vary depending on where your patient lives or where they are travelling. Pediatric providers can offer anticipatory guidance by reviewing motivations, discussing the benefit of certified facilities, maintaining sterile technique, after care instructions, and potential complications. Here are links to AAP and NASPAG review articles, and resources for aftercare and/ or complications.
- AAP Clinical Report: Adolescent and Young Adult Tattooing, Piercing, and Scarification
- Journal of Pediatric Adolescent Gynecology Review: Tattoos and Piercings in Female Adolescents and Young Adults
- AAP Video
If you have questions, feel free to reach out to us at the Seattle Children’s Hospital Adolescent Medicine Clinic.