A tattoo is a permanent marking made by inserting ink into the layers of skin to change the pigment for decorative or other reasons. Tattoos on humans are a type of decorative body modification, while tattoos on animals are most commonly used for identification or branding.
Tattooing has been practiced worldwide. The Ainu, the indigenous people of Japan, traditionally wore facial tattoos. Today one can find Berbers of Tamazgha (North Africa) and Maori of New Zealand with facial tattoos. Tattooing was widespread among Polynesian peoples and among certain tribal groups in the Philippines, Borneo, Mentawai Islands, Africa, North America, South America, Mesoamerica, Europe, Japan, Cambodia, New Zealand and Micronesia. Despite some taboos surrounding tattooing, the art continues to be popular in many parts of the world.
Etymology
The origin of the word tattoo is from the Samoan word tatau, meaning "open wound".[1] The OED gives the etymology of tattoo as "In 18th c. tattaow, tattow. From Polynesian (Tahitian, Samoan, Tongan, etc.) tatau. In Tahitian, tatu." The word tatau was loaned into English, the pronunciation being changed to conform to English phonology as "tattoo".[1] Sailors on the voyage later introduced both the word and reintroduced the concept of tattooing to Europe.[2]
Tattoo enthusiasts may refer to tattoos as "Ink", "Tats", "Art", or "Work", and to tattooists as "Artists". The latter usage is gaining greater support, with mainstream art galleries holding exhibitions of both traditional and custom tattoo designs. Copyrighted tattoo designs that are mass-produced to tattoo artists are known as flash, a notable instance of industrial design. Flash sheets are prominently displayed in many tattoo parlors for the purpose of providing both inspiration and ready-made tattoo images to customers.
The Japanese word irezumi means "insertion of ink" and can mean tattoos using tebori, the traditional Japanese hand method, a Western style machine, or for that matter, any method of tattooing using insertion of ink. The most common word used for traditional Japanese tattoo designs is Horimono. Japanese may use the word "tattoo" to mean non-Japanese styles of tattooing.
History
Tattooing has been a Eurasian practice at least since around Neolithic times. Ötzi the Iceman, dating from the fourth to fifth millennium BCE, was found in the Ötz valley in the Alps and had approximately 57 carbon tattoos consisting of simple dots and lines on his lower spine, behind his left knee, and on his right ankle. [19] Other mummies bearing tattoos and dating from the end of the second millennium BC have been discovered, such as the Mummy of Amunet from Ancient Egypt and the mummies at Pazyryk on the Ukok Plateau.[3]
Pre-Christian Germanic, Celtic and other central and northern European tribes were often heavily tattooed, according to surviving accounts. The Picts were famously tattooed (or scarified) with elaborate dark blue woad (or possibly copper for the blue tone) designs. Julius Caesar described these tattoos in Book V of his Gallic Wars (54 BCE).
Tattooing in Japan is thought to go back to the Paleolithic era, some ten thousand years ago.[citation needed] Various other cultures have had their own tattoo traditions, ranging from rubbing cuts and other wounds with ashes, to hand-pricking the skin to insert dyes.[citation needed]
Tattooing in the Western world today has its origins in Polynesia, and in the discovery of tatau by eighteenth century explorers. The Polynesian practice became popular among European sailors, before spreading to Western societies generally.[4]
Purposes
Decorative and spiritual uses
Tattoos have served as rites of passage, marks of status and rank, symbols of religious and spiritual devotion, decorations for bravery, sexual lures and marks of fertility, pledges of love, punishment, amulets and talismans, protection, and as the marks of outcasts, slaves and convicts. The symbolism and impact of tattoos varies in different places and cultures. Tattoos may show how a person feels about a relative (commonly mother/father or daughter/son) or about an unrelated person.
Today, people choose to be tattooed for cosmetic, sentimental/memorial, religious, and magical reasons, and to symbolize their belonging to or identification with particular groups, including criminal gangs (see criminal tattoos) but also a particular ethnic group or law-abiding subculture. Some Māori still choose to wear intricate moko on their faces. In Laos, Cambodia, and Thailand, the yantra tattoo is used for protection against evil and to increase luck. In the Philippines certain tribal groups believe that tattoos have magical qualities, and also to their bearers. Most traditional tattooing in the Philippines is related to the bearers Accomplishments in life or rank in the tribe.
Identification
People have also been forcibly tattooed for various reasons. The well known example is the identification system for inmates/Jews in concentration camps during the Holocaust. However, tattoos can be linked with identification in more positive ways. For example, in the period of early contact between the Māori and Europeans, Māori chiefs sometimes drew their moko (facial tattoo) on documents in place of a signature. Tattoos are sometimes used by forensic pathologists to help them identify burned, putrefied, or mutilated bodies. Tattoo pigment is buried deep enough in the skin that even severe burns will often not destroy a tattoo. Because of this, many members of today's military will have their identification tags tattooed onto their chests or ribs (these are sometimes known as "meat tags" in the American armed forces).[dubious ] For many centuries seafarers have undergone tattooing for the purpose of enabling identification after drowning. In this way recovered bodies of such drowned persons could be connected with their family members or friends before burial. Therefore tattooists often worked in ports where potential customers were numerous. The traditional custom continues today in the Royal Navy (Great Britain) and in many others.[1]
Tattoos are also placed on animals, though very rarely for decorative reasons. Pets, show animals, thoroughbred horses and livestock are sometimes tattooed with identification and other marks. Pet dogs and cats are often tattooed with a serial number (usually in the ear, or on the inner thigh) via which their owners can be identified. Also, animals are occasionally tattooed to prevent sunburn (on the nose, for example). Such tattoos are often performed by a veterinarian and in most cases the animals are anesthetized during the process. Branding is used for similar reasons and is often performed without anesthesia, but is different from tattooing as no ink or dye is inserted during the process.
[edit] Cosmetic
When used as a form of cosmetics, tattooing includes permanent makeup and hiding or neutralizing skin discolorations. Permanent makeup is the use of tattoos to enhance eyebrows, lips (liner and/or lipstick), eyes (liner), and even moles, usually with natural colors as the designs are intended to resemble makeup.
Medical
Medical tattoos are used to ensure instruments are properly located for repeated application of radiotherapy and for the areola in some forms of breast reconstruction. Tattooing has also been used to convey medical information about the wearer (e.g. blood group).
PrevalenceTattoos have experienced a resurgence in popularity in many parts of the world, particularly in North and South America, Japan, and Europe. The growth in tattoo culture has seen an influx of new artists into the industry, many of whom have technical and fine arts training. Coupled with advancements in tattoo pigments and the ongoing refinement of the equipment used for tattooing, this has led to an improvement in the quality of tattoos being produced.[citation needed]
During the first decade of the 21st century, the presence of tattoos became evident within pop culture, inspiring television shows such as A&E's Inked and TLC's Miami Ink and LA Ink. The decoration of blues singer Janis Joplin with a wristlet and a small heart on her left breast, by the San Francisco tattoo artist Lyle Tuttle, has been called a seminal moment in the popular acceptance of tattoos as art.[5] Tattoos are generally considered an important part of the culture of the Russian mafia.
In many traditional cultures tattooing has also enjoyed a resurgence, partially in deference to cultural heritage. Historically, a decline in traditional tribal tattooing in Europe occurred with the spread of Christianity. However, some Christian groups, such as the Knights of St. John of Malta, sported tattoos to show their allegiance. A decline often occurred in other cultures following European efforts to convert aboriginal and indigenous people to Western religious and cultural practices that held tattooing to be a "pagan" or "heathen" activity. Within some traditional indigenous cultures, tattooing takes place within the context of a rite of passage between adolescence and adulthood.
Many studies have been done of the tattooed population and society's view of tattoos. In June 2006 the Journal of the American Academy of Dermatology published the results of a telephone survey which took place in 2004. It found that 36% of Americans ages 18–29, 24% of those 30-40 and 15% of those 41-51 had a tattoo.[6] In September 2006, the Pew Research Center conducted a telephone survey which found that 36% of Americans ages 18–25, 40% of those 26-40 and 10% of those 41-64 had a tattoo.[7] In January 2008, a survey conducted online by Harris Interactive estimated that 14% of all adults in the United States have a tattoo, just slightly down from 2003, when 16% had a tattoo. The highest incidence of tattoos was found among the gay, lesbian and bisexual population (25%) and people living in the West (20%). Among age groups, 9% of those ages 18–24, 32% of those 25-29, 25% of those 30-39 and 12% of those 40-49 have tattoos, as do 8% of those 50-64. Men are just slightly more likely to have a tattoo than women (15% versus 13%)[8]
Negative associations
In Japan, tattoos are strongly associated with the yakuza, particularly full body tattoos done the traditional Japanese way (Tebori). Certain public Japanese bathhouses (sentō) and gymnasiums often openly ban those bearing large or graphic tattoos in an attempt to prevent Yakuza from entering.
In the United States many prisoners and criminal gangs use distinctive tattoos to indicate facts about their criminal behavior, prison sentences, and organizational affiliation.[9] A tear tattoo, for example, can be symbolic of murder, with each tear representing the death of a friend. At the same time, members of the U.S. military have an equally well established and longstanding history of tattooing to indicate military units, battles, kills, etc., an association which remains widespread among older Americans. Tattooing is also common in the British Armed Forces.
Insofar as this cultural or subcultural use of tattoos predates the widespread popularity of tattoos in the general population, tattoos are still associated with criminality. Although the general acceptance of tattoos is on the rise in Western society, they still carry a heavy stigma among certain social groups.
The prevalence of women in the tattoo industry, along with larger numbers of women bearing tattoos, is changing negative perceptions. A study of "at-risk" (as defined by school absenteeism and truancy) adolescent girls showed a positive correlation between body-modification and negative feelings towards the body and self-esteem; however, also illustrating a strong motive for body-modification as the search for "self and attempts to attain mastery and control over the body in an age of increasing alienation."[10]
Religious perspectives
Judaism
Tattoos are considered forbidden in Judaism[11] based on the Torah (Leviticus 19:28): "Do not make gashes in your skin for the dead. Do not make any tattoo marks on your skin. I am God." The prohibition is explained by contemporary rabbis as part of a general prohibition on body modification that does not serve a medical purpose (such as to correct a deformity). This is motivated by the view that the human body belongs to God, and therefore modification, such as tattooing, would be a defacement of God's property.[citation needed]
Procedure
Tattooing involves the placement of pigment into the skin's dermis, the layer of connective tissue underlying the epidermis. After initial injection, pigment is dispersed throughout a homogenized damaged layer down through the epidermis and upper dermis, in both of which the presence of foreign material activates the immune system's phagocytes to engulf the pigment particles. As healing proceeds, the damaged epidermis flakes away (eliminating surface pigment) while deeper in the skin granulation tissue forms, which is later converted to connective tissue by collagen growth. This mends the upper dermis, where pigment remains trapped within fibroblasts, ultimately concentrating in a layer just below the dermis/epidermis boundary. Its presence there is stable, but in the long term (decades) the pigment tends to migrate deeper into the dermis, accounting for the degraded detail of old tattoos.[12]
Some tribal cultures traditionally created tattoos by cutting designs into the skin and rubbing the resulting wound with ink, ashes or other agents; some cultures continue this practice, which may be an adjunct to scarification. Some cultures create tattooed marks by hand-tapping the ink into the skin using sharpened sticks or animal bones (made like needles) with clay formed disks or, in modern times, needles. Traditional Japanese tattoos (Horimono) are still "hand-poked," that is, the ink is inserted beneath the skin using non-electrical, hand-made and hand held tools with needles of sharpened bamboo or steel. This method is known as tebori.
The most common method of tattooing in modern times is the electric tattoo machine, which inserts ink into the skin via a group of needles that are soldered onto a bar, which is attached to an oscillating unit. The unit rapidly and repeatedly drives the needles in and out of the skin, usually 80 to 150 times a second. This modern procedure is ordinarily sanitary. The needles are single-use needles that come packaged individually. The tattoo artist must wash not only his or her hands, but they must also wash the area that will be tattooed. Gloves must be worn at all times and the wound must be wiped frequently with a wet disposable towel of some kind.
Prices for this service vary widely globally and locally, depending on the complexity of the tattoo, the skill and expertise of the artist, the attitude of the customer, the costs of running a business, the economics of supply and demand, etc. The time it takes to get a tattoo is in proportion with its size and complexity. A small one of simple design might take fifteen minutes, whereas an elaborate sleeve tattoo or back piece requires multiple sessions of several hours each.
The modern electric tattoo machine is far removed from the machine invented by Samuel O'Reilly in 1891. O'Reilly's machine was based on the rotary technology of the electric engraving device invented by Thomas Edison. Modern tattoo machines use electromagnetic coils. The first coil machine was patented by Thomas Riley in London, 1891 using a single coil. The first twin coil machine, the predecessor of the modern configuration, was invented by another Englishman, Alfred Charles South of London, in 1899.
"Stick and poke"
A technique often used for home-made tattoos is "stick and poke" Normally performed by inexperienced artists called "scratchers". The tip of a sewing needle is wrapped in ink-soaked thread, leaving only the point protruding. Keeping this simple instrument saturated with ink, the skin is pricked over and over, creating a design. The purpose of the thread is to keep the point of the needle coated in ink, increasing the quantity of ink that penetrates the skin. Inks can be improvised from a number of sources such as coal, ashes or shoe polish, but Higgins "Black Magic" waterproof ink is the brand most commonly cited by collectors of so-called "India ink" or "stick and poke" tattoos in the United States.[citation needed] Sometimes called "prison tattoos", these tattoos are popular with gutter punks and others associated with the modern hobo subculture, who frequently tattoo visible parts of their bodies, including their hands and faces.[citation needed]
Dyes and pigments
Early tattoo inks were obtained directly from nature and were extremely limited in pigment variety. Today, an almost unlimited number of colors and shades of tattoo ink are mass-produced and sold to parlors worldwide. Tattoo artists commonly mix these inks to create their own, unique pigments.
A wide range of dyes and pigments can be used in tattoos, from inorganic materials like titanium dioxide and iron oxides to carbon black, azo dyes, and acridine, quinoline, phthalocyanine and naphthol derivates, dyes made from ash, and other mixtures. The current trend for tattoo pigment favors Acrylonitrile butadiene styrene (ABS plastic) as seen by the widespread popularity of Intenze, Millennium and other ABS pigmented brands.[citation needed]
Iron oxide pigments are used in greater extent in cosmetic tattooing. Many pigments were found to be used in a survey of professional tattooists.[citation needed] Recently, a blacklight-reactive tattoo ink using PMMA microcapsules has surfaced. The technical name is BIOMETRIX System-1000, and is marketed under the name "Chameleon Tattoo Ink". This same ink can also be found as "The Original Blacklight Inks by NEWWEST Technologies".[citation needed]
Modern tattooing inks are carbon based pigments that have uses outside of commercial tattoo applications. Since 2004, the United States Food and Drug Administration has performed studies to determine if the contents pose hazards, and have followed up with legal action in case of non-safe materials, including traces of heavy metals (such as iron oxide) or other carcinogenic materials.[citation needed] In 2005 at Northern Arizona University a study characterized to makeup of tattoo inks (Finley-Jones and Wagner). The FDA expects local authorities to legislate and test tattoo pigments and inks made for the use of permanent cosmetics. In California, the state prohibits certain ingredients and pursues companies who fail to notify the consumer of the contents of tattoo pigments. Recently, the state of California sued nine pigment and ink manufacturers, requiring them to more adequately label their products.[citation needed]
Acrylonitrile butadiene styrene (ABS plastic) ground down to an average diameter of slightly less than 1 micrometer is used as the colorant in the brighter tattoo pigments that are less likely to fade or blur than the traditional pigments. Many popular brands of tattoo pigment contain ABS as a colorant.[citation needed]
There has been concern expressed about the interaction between magnetic resonance imaging (MRI) procedures and tattoo pigments, some of which contain trace metals. Allegedly, the magnetic fields produced by MRI machines could interact with these metal particles, potentially causing burns or distortions in the image. The television show MythBusters tested the hypothesis, and found no interaction between tattoo inks and MRI.[citation needed]
Professional tattooists rely primarily on the same pigment base found in cosmetics. Amateurs will often use drawing inks such as low grade India ink, but these inks often contain impurities and toxins which can lead to illness or infection. Although "greywork" is often done with a better quality pelikan #17 or Talens drawing ink mixed with a darker lining ink to obtain a softer grey.[citation needed]
Studio hygiene
The properly equipped tattoo studio will use biohazard containers for objects that have come into contact with blood or bodily fluids, sharps containers for old needles, and an autoclave for sterilizing tools.[13] Certain jurisdictions also require studios by law to have a sink in the work area supplied with both hot and cold water.
Proper hygiene requires a body modification artist to wash his or her hands before starting to prepare a client for the stencil, between clients, and at any other time where cross contamination can occur. The use of single use disposable gloves is also mandatory. In some states and countries it is illegal to tattoo a minor even with parental consent, and it is usually not allowed to tattoo impaired persons, people with contraindicated skin conditions, those who are pregnant or nursing, those incapable of consent due to mental incapacity or those under the influence of alcohol or drugs.
Before the tattooing begins the client is asked to approve the final position of the applied stencil. After approval is given the artist will open new, sterile needle packages in front of the client, and always use new, sterile or sterile disposable instruments and supplies, and fresh ink for each session (loaded into disposable ink caps which are discarded after each client). Also, all areas which may be touched with contaminated gloves will be wrapped in clear plastic to prevent cross-contamination. Equipment that cannot be autoclaved (such as counter tops, machines, and furniture) will be wiped with an approved disinfectant.[14]
Membership in professional organizations, or certificates of appreciation/achievement, generally helps artists to be aware of the latest trends. However, many of the most notable tattooists do not belong to any association. While specific requirements to become a tattooist vary between jurisdictions, many mandate only formal training in bloodborne pathogens, and cross contamination. The local department of health regulates tattoo studios in many jurisdictions.
For example, according to the health department in Oregon and Hawaii, tattoo artists in these states are required to take and pass a test ascertaining their knowledge of health and safety precautions, as well as the current state regulations. Performing a tattoo in Oregon state without a proper and current license or in an unlicensed facility is considered a felony offense.[15] Tattooing was legalized in New York City, Massachusetts, and Oklahoma between 2002 and 2006.
Aftercare
Tattoo artists, and people with tattoos, vary widely in their preferred methods of caring for new tattoos. Some artists recommend keeping a new tattoo wrapped for the first twenty-four hours, while others suggest removing temporary bandaging after two hours or less. Many tattooists advise against allowing too much contact with hot tub or pool water, or soaking in a tub for the first two weeks. This is to prevent the tattoo ink from washing out or fading due to over-hydration and avoid infection from exposure to bacteria and chlorine. In contrast, other artists suggest that a new tattoo be bathed in very hot water early and often.
General consensus for care advises against removing the scab that forms on a new tattoo, and avoiding exposing one's tattoo to the sun for extended periods; both of these can contribute to fading of the image. Furthermore, it is agreed that a new tattoo needs to be kept clean. Various products may be recommended for application to the skin, ranging from those intended for the treatment of cuts, burns and scrapes, to cocoa butter, salves, lanolin, A&D or Aquaphor. Oil based ointments are almost always recommended to be used in very thin layers due to their inability to evaporate and therefore over-hydrate the already perforated skin. In recent years, specific commercial products have been developed for tattoo aftercare. Although opinions about these products vary, there is near total agreement that either alone or in addition to some other product, soap and warm water work well to keep a tattoo clean and free from infection.[16] Ultimately, the amount of ink that remains in the skin throughout the healing process determines, in large part, how robust the final tattoo will look. If a tattoo becomes infected (uncommon but possible if one neglects to properly clean their tattoo) or if the scab falls off too soon (e.g., if it absorbs too much water and sloughs off early or is picked or scraped off), then the ink will not be properly fixed in the skin and the final image will be negatively affected.
In the UK, most tattoo artists recommend Bepanthen as the main aftercare product for new tattoos.
Health risks
Because it requires breaking the skin barrier, tattooing may carry health risks, including infection and allergic reactions. In the United States, for example, the Red Cross prohibits a person who has received a tattoo from donating blood for 12 months (FDA 2000), unless the procedure was done in a state-regulated and licensed studio, using sterile technique.[17]. Not all states have a licensing program, meaning that people who receive tattoos in those states are subject to the 12-month deferral regardless of the hygienic standards of the studio. Similarly, the UK does not provide certification for tattooists, and so there is a six month waiting period without exception.[18]
Modern western tattooers reduce such risks by following universal precautions, working with single-use items, and sterilizing their equipment after each use. Many jurisdictions require that tattooists have bloodborne pathogen training, such as is provided through the Red Cross and OSHA.
Infection
Since tattoo instruments come in contact with blood and bodily fluids, diseases may be transmitted if the instruments are used on more than one person without being sterilized. However, infection from tattooing in clean and modern tattoo studios employing single-use needles is rare. In amateur tattoos, such as those applied in prisons, however, there is an elevated risk of infection. To address this problem, a program was introduced in Canada as of the summer of 2005 that provides legal tattooing in prisons, both to reduce health risks and to provide inmates with a marketable skill. Inmates were to be trained to staff and operate the tattoo parlors once six of them opened successfully.[19]
Infections that can theoretically be transmitted by the use of unsterilized tattoo equipment or contaminated ink include surface infections of the skin, herpes simplex virus, tetanus, staph, fungal infections, some forms of hepatitis, tuberculosis, and HIV.[20] People with tattoos are nine times more likely to be infected with hepatitis C, according to a study by Robert Haley, MD, chief of epidemiology at the University of Texas Southwestern Medical Center in Dallas.[citation needed]
No person in the United States is reported to have contracted HIV via a commercially-applied tattooing process.[21] Washington state's OSHA studies have suggested that since the needles used in tattooing are not hollow, in the case of a needle stick injury the amount of fluids transmitted may be small enough that HIV would be difficult to transmit. Tetanus risk is reduced by having an up-to-date tetanus booster prior to being tattooed. According to the Centers for Disease Control and Prevention no data indicates an association between tattooing in the United States and increased risk for HCV infection.[citation needed] In 2006, the CDC reported 3 clusters with 44 cases of methicillin-resistant staph infection traced to unlicensed tattooists[22]
Allergic reactions
Perhaps due to the mechanism whereby the skin's immune system encapsulates pigment particles in fibrous tissue, tattoo inks have been described as "remarkably nonreactive histologically".[12] Allergies to latex are more common; many artists will use non-latex gloves when required.
Allergic reactions to tattoo pigments are uncommon except for certain brands of red and green. People who are sensitive or allergic to certain metals may react to pigments in the skin with swelling and/or itching, and/or oozing of clear fluid called serum. Such reactions are quite rare, however, and some artists will recommend performing a test patch. Due to the fact that laser removal of tattoo ink causes a release of ink into the bloodstream the risk of anaphylactic shock is also present during removal.[23]
Tattoo removal
While tattoos are considered permanent, it is sometimes possible to remove them with laser treatments, fully or partially. Typically, black and darker colored inks can be removed more completely. The expense and pain of removing tattoos will typically be greater than the expense and pain of applying them. Some jurisdictions will pay for the voluntary removal of gang tattoos. Pre-laser tattoo removal methods include dermabrasion, salabrasion (scrubbing the skin with salt), cryosurgery, and excision which is sometimes still used along with skin grafts for larger tattoos.
Different inks can be more or less difficult to remove; one ink, InfinitInk, is designed to be easily removed, in a single laser treatment.
Temporary tattoos
Temporary tattoos are popular with models and children as they involve no permanent alteration of the skin but produce a similar appearance that can last anywhere from a few days to several weeks. The most common style is a type of body sticker similar to a decal, which is typically transferred to the skin using water. Although the design is waterproof, it can be removed easily with oil-based creams. Originally inserted as a prize in bubble gum packages, they consisted of a poor quality ink transfer that would easily come off with water or rubbing. Today's vegetable dye temporaries can look extremely realistic and adhere up to 3 weeks due to a layer of glue similar to that found on an adhesive bandage.
Henna tattoos (Mehndi) and silver nitrate stains that appear when exposed to ultraviolet light can take up to two weeks to fade from the skin. Temporary airbrush tattoos (TATs) are applied by covering the skin with a stencil and spraying the skin with ink. In the past, this form of tattoo only lasted about a week. With the newest inks, tattoos can reasonably last for up to two weeks.
Types of tattoos
The American Academy of Dermatology distinguishes 5 types of tattoos:[24] Traumatic tattoos, also called "natural tattoos", that result from injuries, especially asphalt from road injuries or pencil lead; Amateur tattoos; Professional tattoos, both via traditional methods and modern tattoo gun; Medical tattoos; Cosmetic tattoos, also known as "permanent makeup".
Traumatic tattoos
According to George Orwell, coal miners could develop characteristic tattoos owing to coal dust getting into wounds.[citation needed] This can also occur with substances like gunpowder. Similarly, a traumatic tattoo occurs when a substance such as asphalt is rubbed into a wound as the result of some kind of accident or trauma. These are particularly difficult to remove as they tend to be spread across several different layers of skin, and scarring or permanent discoloration is almost unavoidable depending on the location. In addition, tattooing of the gingiva from implantation of amalgam particles during dental filling placement and removal is possible and not uncommon. A common example of such accidental tattoos is the result of a deliberate or accidental stabbing with a pencil or pen, leaving graphite or ink beneath the skin.
