By Indiana law, a tattoo is: 1. Any indelible design, letter, scroll, figure, symbol, or other mark placed with the aid of needles or other instruments; or 2. Any design, letter, scroll, figure, symbol done by scarring on or under the skin.

By Indiana law, body piercing is: The perforation of any human body part, other than ear lobe, for the purpose of inserting jewelry or other decoration or for some other nonmedical purpose.

A needle, connected to a small machine with tubes containing dye, repeatedly pricks into the skin. Each needle puncture inserts tiny droplets of ink. The process, which may last several hours for a large tattoo, causes a small amount of bleeding.

In 1997, Indiana Code (IC) 16-19-3-4.1 required the Indiana State Department of Health (ISDH) to adopt rules to regulate the sanitary operation of tattoo parlors. The rule, 410 IAC 1-5, became law on June 12, 1998, and was readopted July 21, 2004 and July 15, 2010. IC 25-1-19 prohibits scleral tattooing as 7/1/2018. The following are some requirements of the tattoo rule:

• Gloves or other appropriate personal protection must be worn when performing tattooing and piercing procedures and when handling blood

• All needles must be sterile and designed for single use

• Reusable equipment must be sterilized

• Infectious waste must be handled properly according to Indiana law.

The rule does NOT:

• Require a tattoo or piercing artists or shop owners to register with the ISDH

• Require the ISDH to perform routine inspections of tattoo and piercing parlors

• Require tattoo or piercing artists to receive training or certification on the tattooing or piercing process

IMPORTANT NOTE: Tattoo and body piercing artists and shop owners should contact their local, county health department for local laws that might pertain to the registration or licensing of tattoo and body piercing facilities. Investigations may occur as the result of a complaint filed with the local health department. Some local health departments perform routine inspections based on county ordinances. Call your local health department for more information about inspections and requirements.

• The tattooist and parlor should be neat and clean in appearance

• PATRON RIGHTS AND UNIVERSAL PRECAUTIONS posters must be displayed

• There should be handwashing facilities with running water available for the tattooist to use

• The staff should be willing and able to answer your questions

• Tattooists should not work when sick

• Tattooists must wear gloves when tattooing

• All equipment should be single use. Each needle and tube set should be individually packaged, dated, sealed, sterilized, and opened immediately prior to your tattoo

• A new ink supply should be poured into a disposable container

• Any razors, needles, ink, plastic trays or containers, gloves, or ointments used in your tattoo application should be discarded after use

• Appropriate disinfectants should be used to clean the work area after tattoo application

While a tattoo or piercing may only take a few minutes to acquire, it is permanent. You should understand the risks and research the process and the facility before getting a tattoo or piercing. Tattooing and piercing involves breaking the skin, one of your body’s main protective barriers. This means you can be more susceptible to skin and blood infections. Specific risks include:

• Blood-borne diseases such as HIV, hepatitis B, and hepatitis C could be contracted if equipment used for your tattoo or piercing is contaminated with the blood of an infected person (please refer to ISDH HIV, hepatitis B, and hepatitis C Quick Facts at http://www.in.gov/isdh/20209.htm#i)

• Unsterile tattooing and piercing equipment, or re-used tattoo ink can cause symptoms of minor skin infections from redness, swelling, or pus-like drainage, to potentially serious antibiotic resistant skin infections (please refer to ISDH MRSA Quick Facts, http://www.in.gov/isdh/20209.htm#i).

• Granulomas, or bumps, may form around the site of the tattoo as a reaction to the ink

• Tattooing can cause keloids, or raised areas of excessive scarring

• Tattoo ink may cause allergic reactions, such as an itchy rash, at the tattoo site even if you have had the tattoo for years

• Magnetic resonance imaging (MRI) exams may cause swelling or burning of tattooed areas

Your tattoo or piercing artist should tell you what to expect after getting a tattoo or piercing. Some swelling around the tattoo is normal. You should contact your health care provider if you have any of any of the following signs of infection:

• Thick yellow or green drainage from the site

• Continuous oozing or bleeding

• Red streaks or a hot sensation surrounding and moving away from the tattooed or pierced area

• Worsening pain

• Any unusual swelling

• Removal Issues: only laser treatment removal is approved in Indiana and requires physician management since it is a medical procedure. The process is painstaking and involves several treatments. Complete removal without scarring may be impossible.

The tattoo artist should provide you with detailed instructions on care for your tattoo, to include:

• Cleaning with soap and water

• Applying moisturizer

• Avoiding sun exposure

• Not picking at scabs