Tattoos are popular. From sheik designs that mirror the most talented artist, to more dark and rugged symbols of skulls and daggers.

It is estimated that 45 million Americans have tattoos. More men seek out tattoos, but not by much, over women, 15 to 13 percent.

The American Academy of Dermatology recognizes five types of tattoos: traumatic (natural), which are caused by injuries (asphalt, lead pencil); amateur, professional; cosmetic (i.e., eye liner);and medical (.i.e., positioning for radiation treatment).

If you are contemplating getting a non-medical tattoo, are there real risks? Is it safe? If you later regret your decision, can a tattoo easily be erased?

Tattoos are permanent ink inserted into the top layer of the skin. As a result of piercing the skin, real risks include: infection, bleeding, contracting blood diseases (tetanus, hepatitis B and C) and an allergic reaction.

In addition, skin problems also may arise: excessive scaring, development of keloids (large raised scars) and granulomas (small lumps that develop at the site of the tattoo).

A tattoo can interfere with diagnostic imaging, such as an MRI scan. Local burning, swelling and inflammation can occur at the site of the tattoo. In addition, the ink in the skin can distort the image quality of the MRI.

If you are seriously considering getting a tattoo, think twice about the implications. Select the location carefully. Do you want others to see it? Should it be in a private location?

As you age, so too will the tattoo. The skin naturally thins and loses its elasticity, wrinkling, stretching, and sagging. Undoubtedly a tattoo will succumb to the same fate, as well as fade in color. That tattoo may not look so sharp and nice hanging from your abdomen, underarm or thigh.

Choose a tattoo studio carefully. Reputation, customer service and satisfaction are important. Select a studio that is clean. The tattoo artist should change gloves after each person. Be sure non-disposable equipment is properly sterilized, and have sealed packages (ink, needles) opened up in front of you.

Aftercare is equally important. Keep the tattooed area covered for 24 hours. Thereafter, wash with soap and water daily and pat dry. Apply antibiotic ointment and a moisturizer daily until healed (about two weeks). Keep the area out of the direct sun for at least two weeks.

If at some point you feel “tattoo regret,” wishing removal, the process is difficult and often with less than ideal results. It is virtually impossible to erase the entire tattoo without significant discomfort and residual scar. Removal procedures and techniques include: dermabraision, laser treatments, and surgical removal. The fading creams available over the Internet are not very effective.

Think twice before getting a tattoo, as it is meant to be permanent body art. Ask yourself ahead of time the following questions: Will I regret this decision in the near future? Will it always fit my image? Could I have an allergic reaction? Could scarring be worse than the tattoo? As I age, how will the tattoo look?

Dr. Linda Petter of Auburn is a weekly feature on KOMO TV/News Radio (1000 AM and 97.7 FM) every Saturday and Sunday 7:45 a.m. and 9:45 a.m., and on a weekday during the morning and evening commute. She trained at the Mayo Clinic and the University of Illinois, Carle Hospital. Dr. Petter is chief of the Department of Family Practice at St. Francis Hospital. She is a consumer healthcare advocate, and her books, “Healthcare On a Budget” and “Common Medical Sense”, are available on Amazon.com.  Visit her website, www.DocForAll.com, or call her office at 253-568-0841.