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Sunday, July 26, 2020

My Tattoo Rituals

I'm writing this so I don't forget my checklists for before, during, and after a new tattoo, but I reckon other people might reap the benefits of being prepared as well. What I've got here is a compilation of what I've found to be best practices for the process of getting and caring for a new tattoo.  None of these tidbits have much in the way of scientific backing, and it's pretty hard to find science to back anything having to do with tattoo culture. That said, there is some anecdotal evidence behind everything here. It's a set of rituals that I have come to believe in.

I absolutely go overboard in everything I do in getting a tattoo. It's a bit much, I admit. For me, the obsessive and likely excessive process is reassuring in the face of getting a mostly permanent mark on my body. But I can't be certain that any part of my process is necessary. With the advancement of tattoo equipment & ink, as well as the skill level of tattoo artists, it's possible that a good, lasting tattoo is pretty much guaranteed no matter what kind effort the client puts into preparation or aftercare. And I have no idea what impact individual physiology plays in tattoo outcomes. What I do know is that my process doesn't seem to hurt, and it's an accumulation of accepted and generally recommended practices.

Pre-Tattoo
Finding a tattoo artist is easy, finding the right one is not as easy. As tattoos have increased in popularity, the amount of tattoo artists have also increased. In general, the skill and talent level of the artist pool has risen over the years. But it's still worth taking time to do the leg work and research portfolios. On a related note, get an estimate from the artist before agreeing to a tattoo. Bargaining for a cheaper tattoo is a terrible idea.

I always make sure I've got post-tattoo supplies stocked at home before I actually go get a tattoo. These include:

1) Regular, orange, pump dial soap ("Dial Gold"). You want a pump soap because bacteria can live on bar soap, and you want the plain dial soap because you don't want anything crazy going into your tattoo, which, among other things, is an open wound.

2) Aquaphor Healing Ointment. A magic potion for helping tattoos heal fast, stay moist, and keep microbes out. It's super greasy and will stain almost anything it touches, so avoid brushing against anything you care about. Except for the new tattoo, that is. I like it best out of a tube, but it's easier to find in a jar.

3) Plastic Wrap or transparent film dressing (Tegaderm, Saniderm, Derm Shield, etc.). Needed for the first few days after getting a tattoo. More on this later.

4) Nonstick Gauze Pads. Try to get pads in a size that will cover your tattoo completely. The nonstick quality of the pad is very important, how well it absorbs fluids is not.

5) Medical Tape. To keep the plastic wrap on. Regular scotch tape works too, just not as well.

6) Aveeno Moisturizing Lotion. The daily moisturizing lotion works, as does the 24 hour lotion. I used to really like the intense hand cream, but I don't think it's sold anymore. Most fragrance-free lotions will work just as well, but I trust Aveeno to be readily available and less full of wildcard ingredients. I'm sure health food stores sell an even better, organic, limited ingredient, sensitive-skin-safe lotion than aveeno, I'm just not messing with what works for me. The key is avoiding additives to the lotion that may react negatively with your body or the ink.

7) Crappy Sheets, blankets, towels, and clothes. Tattoo ink, blood, and aquaphor are going to get all over the place.

8) Paper towels. Make sure they haven't been sitting in a spot where they've been exposed to dirt or nastiness.

Tattoo Anesthetic Options
How much pain is felt during a tattoo session depends on a variety of factors, some of which include: placement (see chart here), pain tolerance, attitude, sex, time of day, stress level, nutrition, hydration, length of session, body composition, and last night's sleep.

Remember this: people way wimpier than you have tattoos. You can do it. Honestly, the pain is tolerable and it is probably best not to mess around with anesthetic variables and just get through it with mental toughness. You can also ask for breaks when you need them.

However, there are options to take the edge off:

1) If you suffer from anxiety you may want to take your prescription medicine before your session.

2) Acetaminophen (Tylenol) may help reduce pain if taken prior to a session.

3) Numbing creams, gels, & sprays are widely available. The active ingredient is 3-5% lidocaine and sometimes a splash of epinephrine to reduce swelling/bleeding and prolong the effect of the lidocaine. Some things to remember if you're using a numbing agent:
  • Epinephrine will increase your heart rate. This can affect anxiety level and more depending on heart health.
  • A goodly number of artists are against the use of anesthetics. You may want to discuss with the artist. There are many claims that anesthetics can negatively affect tattoo outcomes.
  • Some claim that using the gels makes skin "mushy" and harder to work with. I imagine this effect is heightened when using them as directed- glopping it on and covering it with plastic wrap for 1 or more hours before the tattoo.
  • If the agent has absorbed into the skin fully before your appointment, it's probably best to remove all residue.
  • The spray forms usually only work once the skin is broken, so it's useless to apply them prior to sessions.
  • Anesthetics will blunt the pain, but rarely stop it.
  • Anesthetics will wear off during the session, ranging in effectiveness from 15 minutes to 4 hours.
  • The most effective way to use anesthetics would be to use the cream or gel before the session and "touch up" with the spray during the session.
4) DO NOT use Ibuprofen, Aspirin, or drink alcohol before a tattoo appointment. It thins the blood which might negatively impact your tattoo 

In preparation for the actual tattoo appointment, I like to:

1) Eat a solid, but not too filling or gross meal about 2-3 hours before the appointment
2) Drink some juice or eat some fruit. Raise my blood sugar level, get some vitamin c, and hydrate.
3) Be freshly showered
4) Have cash on hand to pay for the session and the tip* (a lot of places only take cash)
5) Have a copy of all reference art, even if I've already left a copy with the artist
6) Bring a gatorade or electrolyte drink to the appointment

* A note about tipping tattoo artists. General guidelines call for tipping the artist between 15-25%. Unless something goes horribly wrong, it's a good idea to tip. I always try to be generous, especially if I'm planning on going back for more ink in the future.

During the appointment-
1) Watch to make sure every implement the artist uses is opened in front of me, and that ink is squirted into little plastic dipping sauce cups. Most modern tattoo artists are laser focused on keeping things sterile, so this isn't as important as it used to be.
2) I generally go alone, and I think most artists prefer that
3) Some artists like to talk, some don't; I usually wait for them to initiate conversation.
4) I focus on my breath or the conversation and not the needle. I usually don't spend tons of time on my phone or listening to headphones because I consider it rude but I'm weird.
4) I ask for breaks if I need them, and sip gatorade when I get a chance.

Aftercare:

Leave the bandage or plastic wrap on for 2-5 hours after the appointment. Careful when moving the tattooed area- sometimes plasma, blood, and ink form in little puddles and drip out.

"Hot wash" the area with dial soap and a clean hand. Get in a hot shower, use lots of dial, and wash off any "slick spots" that you see. No scrubbing, but don't be afraid to rub that thing. This is probably the most important wash of the whole aftercare process- you don't want anything crusting or scabbing over, and you want to get excess ink off if there is any. There's that whole cleaning the wound so it doesn't get infected thing, as well.

The tattoo can be washed every 4-6 hours for the first day, maybe 3-4 times the second day, and then 1-2 times a day after that until healed. And of course it should be washed any time it gets dirty or exposed to something gross.

Let the tattooed area air dry, or pat it dry with a paper towel. This is how drying is going to work for the entire healing process. Air drying is preferred, and it's a good idea to let it get very dry. Occasionally, it's even good to go a little longer than just dry, and to give the skin a chance to breathe.

Apply a thin coat of Aquaphor to the tattoo. As much as possible over the next 1-2 (maybe even 3) weeks, that thin coat of Aquaphor should be in effect, using Aveeno lotion when Aquaphor isn't feasible. I apply a slightly thicker layer in the beginning so that I can see that it is covered without having to touch it and so that it acts as a barrier against outside contaminants. I find that the more I can use aquaphor during the healing process, the faster the tattoo heals. The issue of course is that aquaphor stains clothing, so if the area is going to touch my clothing I need to skip the aquaphor or cover it.

When and how long to cover a tattoo is debatable. For the first 1-3 days, it's a good idea to cover the freshly aquaphor'd tattoo and secure it with medical tape when going to bed. I think for the first 1-7 days you also want to cover it if you were going out somewhere gross. It also would probably be prudent to cover it if it still needs aquaphor and would come into contact with clothes. But if at all possible I leave the tattoo uncovered as much as possible with that layer of aquaphor on top.

How to cover a tattoo is also debatable. Plastic wrap is not breathable and not sterile. I only use plastic wrap for short periods (1-3 hours) if I need to keep aquaphor on the tattoo, because it is convenient. Many people swear by film dressings like tegaderm. Those dressings are sterile and breathable, and some even filter out UV light. However, they use an adhesive which can cause problems. First, when removing the dressing the adhesive can pull at the tattoo. Secondly, some people including myself have skin reactions to the adhesive. This can cause a bad heal.

What I do to cover a tattoo for longer periods is- apply aquaphor, cover the tattoo with a nonstick gauze pad, and secure it in place using either medical tape or transparent film dressing. I still get the skin reaction with the film, but not at the tattoo site. The benefit of the film dressing is that it seals off the tattoo from germs and will keep my leaking fluids inside. It also sticks better to my skin than tape.

When going to bed, make sure you're wearing crappy pj's, sleeping on crappy sheets, covering yourself with crappy blankets if you absolutely need them, and maybe using crappy towels to cover your crappy sheets. The tattoo will bleed during the first night (that's usually it for bleeding), ink will magically appear, and aquaphor will finish off any surface that wants a stain.

There are distinct phases of healing after a fresh tattoo:
1-3 days- The area stops bleeding, no more wet ink spills out, it's no longer a fresh wound
2-6 days- The area feels tender, and there might be some bruising
3 days-1 1/2 weeks- The tattoo starts shedding fruity or cocoa pebbles (depending on color or black ink), and gets very itchy
1 week-3 weeks- The tattoo stops shedding ink, stops itching, and looks fairly normal. It still is probably not fully healed at this point.
4-6 weeks- it's ok to start phasing out the lotion, and to go in the ocean or a pool.

During the fruity pebbles and itchy phase of healing, do not pick at the tattoo or scratch what itches. You can literally yank ink out of the tattoo and screw it up.

After the tattoo has popped out its pebbles and the area doesn't itch anymore, switch from Aquaphor to the Aveeno lotion. I almost always keep that up into at least the fourth week, which is overkill.

For the first month or more, keep that tattoo out of the sun! If you put a fresh tattoo into the sun, you'll know what it feels like to be a vampire.

After the Heal
There might be a spot where ink popped out. It's ok to ask the artist for a touch up, just make sure you're fully healed.

Other than that, maybe take a picture of the healed tattoo to send to your artist.

After all that hard work, enjoy the slow degradation of your tattoo and skin as you age. If you've followed the hot tips above, the freshness of the tattoo will outlast the looks of your paper thin, liver spotted mortal flesh.