Tattooing, body piercing and permanent makeup are increasing in popularity. Piercing involves making holes in the body with a needle so that rings or bars can be inserted. Piercing can be applied to many parts of the body, including ears, nose, lips, nipples and genitals. Piercing is not limited to the skin, and many include cartilage.
The use of unsterilised needles, needle bars and tubes, forceps, jewellery and contaminated pigments can result in bloodborne infections, such as hepatitis B , hepatitis C and HIV infection. These infections may be asymptomatic in the early phases and are therefore rarely noted.
As healing time may vary from one week (tattoo) to 9 months (navel piercing), there is a risk for infection after the initial application of a tattoo or piercing. The most common causal agents of these later infections are Staphylococcus aureus, group A streptococcus and Pseudomonas.
General rules for a well-equipped studio and preparation
The studio must have a treatment room, where one can concentrate and work hygienically, and a separate waiting room. Walls and floors of the treatment room must be of a smooth and easily cleanable material. The chair or table for treating clients must be upholstered with a non-absorbent fabric that can be thoroughly cleaned. The room must be equipped with a basin with a no-touch hot and cold water tap, a disposable paper towel holder, and a soap dispenser. A waste bin with a pedal operated lid must be present.
Information leaflets for studio clients must be available, with information concerning age restrictions for these procedures, possible complications, and instructions for aftercare. In the Netherlands, the age at which persons may decide for themselves to have a tattoo and piercing is 16 years. This age limit is suspended for earlobe piercing but pertains to all other areas, because children younger than 16 are still growing and thus at risk for displacements of tattoos and piercing.
Informed consent forms, with information concerning health (including allergies) must be available and must be signed by the client. Signed consent forms must be kept by the studio in a locked file for ten years.
Monitoring and law enforcement
The City of Amsterdam Health Regulations define the Municipal Health Services' duty to monitor compliance with its hygiene guidelines. These regulations have been in effect since November 1987. The authorised health official must at all times be allowed access to any tattoo and piercing studios for inspection of the premises, instruments and materials or for observation of a tattoo or piercing to gain insight into the method of operation. The tattoo and/or piercing studios are visited without any prior notification.