Tattooing and ear/body piercing are increasingly popular among Canadians. These procedures, however, may increase the risk of contracting a number of serious blood-borne diseases.


Tattoos and ear/body piercings are very popular, especially among those aged 18 to 22. Between 73 and 83 percent of women in the U.S. have had their ears pierced. An American university survey in 2001 found that 51 percent of students had piercings and 23 percent had tattoos. U.S. studies show that the number of women with tattoos quadrupled between 1960 and 1980. The number of tattooing and piercing shops in Canada has increased dramatically in the last few years.

Health Risks of Tattooing and Ear/Body Piercing

Skin and mucous membranes in the mouth and nose protect you from many infections. Both tattooing and ear/body piercing procedures involve piercing the skin or mucous membrane with a needle or other sharp instrument.

Unless the needles are new, sterilized for each treatment and properly handled by the practitioner, instruments can be contaminated with the infected blood or bodily fluids of another person.

You may also have bacteria or viruses present on your skin that can enter your body and cause infection when your skin is pierced. Practitioners who do the tattooing and piercing are also at risk of becoming infected through accidental cuts and punctures.

It is possible to transmit viral infections such as hepatitis B, hepatitis C, Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) and herpes through tattooing and piercing, as well as bacterial skin infections such as Streptococcus and Staphylococcus.

Minimizing your Risk

The best protection against disease and infection is to carefully choose where you obtain your tattoo or piercing. Here is a list of conditions on which to base your decision:

-- The work area is clean and brightly lit.

-- The shop uses instruments that are easily cleaned and sterilized, such as stainless steel.

-- Tattooing is done with sterile needles in a tattoo machine that has been wiped with alcohol after each use and covered with new disposable plastic.

-- Ear piercing is done with a sterile needle or a gun that has a disposable sterile cartridge to holds the studs.

-- Tattoo and piercing needles are new and sterile for each treatment. They should never be reused.

-- Those performing the procedure have clean working habits, including washing their hands before and after procedures, after handling contaminated items, before opening and handling sterile supplies, and before putting on and after removing their gloves.

-- Practitioners wear medical gloves during the procedures.

-- The shop has a "clean zone" and a "dirty zone." The procedure should be done in the clean zone where only sterilized packages and clean equipment are kept and used. The dirty zone is the contaminated area where there is a washing sink and holding basin for disinfecting implements.

-- Work surfaces are made of smooth and non-porous materials.

-- All surfaces are cleaned with a solution of bleach and water.

-- The shop has a sterilizing machine, preferably a steam sterilizer, and test strips are used to indicate whether the machine is operating correctly.

-- Waste is disposed of properly, with blood-contaminated waste placed in plastic bags and tied before being added to the regular waste.

-- Sharp implements used to pierce the skin are put into puncture-resistant containers.

-- Oral and written instructions are given to clients for personal care after the procedure.

You can minimize your own risk of infection by taking these precautions:

-- Choose a good professional practitioner who has been trained.

-- Ask the practitioner if she or he follows the Infection Control Guidelines for tattooing and ear/body piercing.

-- Never tattoo or pierce skin that has a cut or break, pimples, warts, or other abnormalities.

-- Make sure the practitioner disinfects the skin area using a skin antiseptic before the procedure.

-- Wash your hands thoroughly before you apply lotions or ointments to the tattooed or pierced area after the procedure or when rotating the jewelry, as directed by the practitioner. If you are concerned that the tattoo or piercing is infected, contact your doctor or local health unit.

-- Hepatitis B vaccine will help protect you from hepatitis B, but there is no vaccine for hepatitis C or HIV.

Health Canada's Role

Working in partnership with the provincial and territorial governments, Health Canada has created Infection Control Guidelines for tattooing and ear/body piercing. These guidelines were developed for practitioners of tattooing and ear/body piercing by representatives from industry, health services, and Health Canada's Centre for Infectious Disease Prevention and Control.