Tattooing involves placing ink into the dermis layer of the skin with a needle. If a tattoo artist does not follow appropriate safety guidelines, there is the possibility of transmitting bloodborne viruses, such as hepatitis C. It is essential to seek professional and licensed artists who maintain a safe, sterilized environment while tattooing.

Hepatitis C is a liver disease that occurs due to an infection with the hepatitis C virus (HCV). It is the most common bloodborne viral infection in the United States. This means that the virus lives in a person’s blood, and people may acquire the infection after exposure to blood that contains the virus.

Although it is more common for people to acquire HCV from the transfusion of unscreened blood or from intravenous drug use, the virus can also spread when getting tattoos in unlicensed facilities or when the artists uses
unsterile instruments.

In this article, we will discuss the potential risk of hepatitis C from a tattoo and whether people with hepatitis C can get a tattoo.

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Hepatitis is a term that refers to inflammation of the liver. Several viruses can cause hepatitis, with the most common types being A, B, and C. These viruses invade liver cells, causing swelling and dysfunction that can result in organ damage.

HCV is a bloodborne virus that causes hepatitis C. It is estimated that roughly 2.4 million people in the U.S. have hepatitis C. However, many people do not know they have it, so the true number could be as high as 4.7 million.

HCV infections can be either acute (short term) or chronic (long lasting). When a person has acute hepatitis, symptoms can last for 6 months. An acute infection can become chronic if the body is unable to clear the virus. This is common and accounts for roughly half of cases.

Most new cases of hepatitis C occur from contact with needles or other equipment used to prepare or inject drugs. This is often from sharing needles or accidental contact in healthcare settings. This can also include the use of unsterilized equipment in unlicensed tattoo studios.

There is no current vaccine against hepatitis C, but antiviral medications can now treat more than 95% of people with chronic hepatitis C.

Hepatitis C spreads through blood-to-blood contact. Exposure to the virus may occur through blood infusions and intravenous drug use.

If a person shares drug equipment, such as needles and syringes, they may risk exposure to infected blood. Injection drug use is the cause of 60% of new cases of hepatitis C every year.

Blood supplies undergo screening for conditions that can transmit via blood, such as HCV. However, before 1992, healthcare professionals did not screen for HCV. A person who has received a blood transfusion or organ transplant before this time may have been at higher risk of exposure to HCV.

Although less common, other ways hepatitis C may spread include:

  • Birth: There is a small chance that a person with hepatitis C will pass on the infection to their infant, estimated at roughly a 6% chance.
  • Healthcare: Since exposure to a person’s blood is a possibility in the medical profession, there is the chance of hepatitis C transmission if healthcare professionals do not follow proper procedures, although this is rare.
  • Sex with a person infected with hepatitis C: Although uncommon, people can spread HCV through sexual contact. Risk factors can include having a sexually transmitted infection (STI), having sex with multiple partners, and having anal sex.
  • Sharing personal items: Items such as blood glucose monitors, razors, and toothbrushes all may have a person’s blood on them and if shared may lead to transmission of the virus.
  • HIV: HIV suppresses the immune system and can also spread through a similar way to HCV. Therefore, if a person has HIV, they may be at a higher risk of also having hepatitis C. It is estimated that 15–30% of people with HIV have a coinfection of HCV.
  • Unsterilized tattoo needles and reused tattoo ink: Tattooing involves a small needle injecting ink into the dermis layer of the skin. If the needle, or the ink the artist is using, has any trace amount of an infected person’s blood, the virus may spread.

Similar to hepatitis C, other bloodborne viruses such as hepatitis B and HIV may also be transmitted if tattooing equipment is not sterilized.

A further health risk of tattoos is the potential for an allergic reaction to the tattoo ink. A person may develop an allergic reaction immediately, a few weeks after the tattoo, or, in some cases, decades afterward. Symptoms of an allergic reaction may include:

  • redness and swelling
  • itchiness
  • blisters
  • deep lumps
  • fluid leaking from the affected area

A tattoo creates an open wound in the skin that has the potential to become infected, particularly if sterilized equipment is not used or if the appropriate tattoo aftercare is not followed. An infected tattoo may cause:

  • redness
  • pain that continues or worsens after the tattoo
  • rash
  • pus and open sores

If the infection becomes more severe, a person may develop a fever and experience:

  • chills
  • shaking
  • sweating

Treatment for such infections may involve a variety of antibiotics and, in some cases, surgery.

The risk of hepatitis C exposure during the tattooing process comes from the reuse of unsterilized needles that may still have a previous client’s blood on them. If a tattoo artist does not use new pots of ink, blood may also get into the tattoo ink.

Even if the blood is not visible on the equipment, hepatitis C can still spread. HCV can live outside the body and on surfaces for a long time, with some evidence from 2013 suggesting it can remain infectious for up to 6 weeks outside the body.

To reduce the risk of HCV transmission, a person should only go to a licensed tattoo parlor. The laws around tattoos vary from state to state. To ensure a safe and hygienic environment, a tattoo artist will:

  • wear gloves throughout the process
  • use new needles from a separate, sterilized packet
  • use new ink and containers
  • wrap everything they may touch during the procedure in plastic wrap

It is not advisable to receive a tattoo if the artist does not follow these hygienic procedures, as it increases the risk of health complications. To further reduce the risk of any infection during the healing process, a person should also follow the aftercare advice given by the tattoo artist.

During the acute phase of the infection, most people do not experience symptoms. If they do, it usually occurs 2–12 weeks after exposure, although it can be up to 6 months after. Symptoms tend to be mild and flu-like in the acute stage. They may include:

  • tiredness
  • joint pain
  • fever
  • loss of appetite
  • nausea and vomiting
  • stomach pain
  • dark urine
  • light-colored stool
  • jaundice

More than half of people with acute hepatitis C do not clear the virus and go on to develop chronic hepatitis C. It is common for people to not have symptoms in the chronic stage or experience general symptoms such as chronic fatigue and depression.

If left untreated, chronic hepatitis C may lead to chronic liver disease and liver cancer. Chronic liver disease in people with hepatitis C tends to develop slowly over years without many symptoms.

Approximately 5–25% of people infected with HCV develop cirrhosis within 10–20 years. Cirrhosis is a late stage liver disease that permanently scars and damages the liver and may lead to liver failure.

A person with hepatitis C may still get a tattoo, but they should tell their tattoo artist. Some artists may not be comfortable tattooing in this case, or may advise them to wait until their treatment is complete.

A person with hepatitis C wishing to get a tattoo should seek out an artist who is qualified and experienced in tattooing people with hepatitis C. The artist may take further measures during the tattoo, such as wearing a mask or adding extra plastic coverings on surfaces.

If a person has been in an environment where there is a risk of exposure to HCV, such as during a tattoo, and is experiencing any HCV symptoms, they should contact a doctor. The earlier a doctor can diagnose HCV, the earlier treatment may begin to clear the infection and prevent any long-term damage.

Although rare, people can get hepatitis C during a tattoo. This can occur if a tattoo artist does not sterilize their equipment and follow appropriate, hygienic measures. Any person wishing to get a tattoo should seek out a professional artist with a license who follows the correct guidelines to ensure a clean and safe environment while tattooing.

If a person has an HCV infection, it is possible for them to receive a tattoo. However, they should seek out an artist with experience tattooing people with HCV. Informing the artist of the infection allows them to follow extra safeguarding procedures to ensure no complications occur.