Skin Protection and Tattoos: Advice from a Burn Specialist

According to the Pew Research Center, nearly one third of adults in the U.S. have a tattoo, and 22% have more than one. What happens to our skin when we get a tattoo and what makes them permanent? Alan Pang, M.D., Texas Tech Physicians surgeon specializing in burn would, trauma and critical care, is our guest expert for this episode. Dr. Pang answers our question about protecting our skin when we get tattoos or remove them, and offers alternatives to covering up or erasing scars. 

Transcript

Melissa Whitfield
00:09
Melissa, hello and welcome back to Texas Tech Health Check from Texas Tech University Health Sciences Center. I'm your host. Melissa Whitfield. We want you to get healthy and stay healthy with help from evidence based advice from our physicians, health care providers and researchers. According to a Pew Research Center poll from 2023 almost 1/3 of American adults have permanent tattoos. Stigma around tattoos has decreased in the past few years. So what exactly happens to your skin when you get a tattoo and what makes them permanent? What if you want to remove one, or perhaps you want to cover up a scar? Dr Alan Pang, Texas Tech Physicians surgeon who specializes in burn wound, trauma and critical care, answers our questions about what happens to our skin and what we can do to protect our skin before and after someone gets a tattoo. Dr Pang, welcome to our podcast.

Alan Pang, M.D.
01:11
Thank you for having me.

Melissa Whitfield
01:12
We're happy to have you. Can you tell our listeners a little bit about yourself, your expertise and what you do here at the Health Sciences Center?

Alan Pang, M.D.
01:19
Of course, my name is Alan Pang. I'm one of the burn surgeons here at Texas Tech University Health Sciences Center. My expertise is burn surgery. I'm trained on burn surgery, trauma surgery and general surgery. Largely my practice is burn surgery, and I treat the burn patients that come through Lubbock.

Melissa Whitfield 
01:37
Well thank you again for coming on our podcast and also for indulging us for this little Halloween themed episode, because nothing scares me more than pain, and I associate tattoos and pain together. So my question is, what happens to our skin when we get a tattoo? And can we get tattoos over scars or stretch marks?

Alan Pang, M.D.
01:59
Absolutely, I think pain is scary. It's actually very interesting what happens to our skin. So we know it's painful because these pens that the tattoo artists are using inject ink into our skin. And there are several layers to our skin, the epidermis, the dermis and the hypodermis. And the skin has a very interesting cell in it that basically does a lot of things, but is mainly an immune type of cell that protects us from foreign bacteria and things of that sort. So when ink enters our skin, when we get a tattoo, these cells like to gobble it up, and they hold on to that ink for the duration of their life, and you can see it through the skin, and that's why we have tattoos that you can see from the outside world. The interesting thing is that when these cells die, one of their partners comes up and gobbles up that piece of ink again. And that's why tattoos are so permanent, because that ink is just sitting inside of our cells for all time.

Melissa Whitfield
03:04
So can we get tattoos over scars or stretch marks?

Alan Pang, M.D.
03:08
Yeah, that's also very interesting, because our scars actually have more of these immune cells in them. So tattoos are actually very effective in scar tissue.

Melissa Whitfield
03:18
How can people avoid scarring or complications when they get tattoos. And what do you recommend people do before and after the tattoos to protect their skin

Alan Pang, M.D.
03:27
I think moisture is probably the most important. Dry skin is never good for us. It can crack and cause wounds and cause scars when you're causing wounds. In general, you want to keep a relatively moist environment. Our body likes a moist environment to heal wounds. So, you know, moisturizing before and after your tattoo, protecting it in that kind of peri tattoo time, so that dirt and things of that sort don't get in and you don't get infections. Those are, those are the most important things.

Melissa Whitfield
04:01
So can you tell us what is the process to have tattoos removed?

Alan Pang, M.D.
04:05
Yeah. So the important thing about removing tattoos is making sure that ink gets removed from our skin. So in the past, you would have to basically cut that skin off and either do a skin graft or close that area of skin. Luckily for us, in modern day, we have lasers. The laser that I largely use is called a fractional carbon dioxide laser. And what that laser can do is there's a variety of settings on it that allow us to target different layers of the skin. And when you're removing a tattoo, you basically have to use different wavelengths on the laser to let this ink release from your body.

Melissa Whitfield
04:44
Interesting. Is there an alternative to tattoos when it comes to covering up or erasing scars?

Alan Pang, M.D.
04:50
Absolutely. I know scars can be very disfiguring and restricting in your motion. It can cause pain and itching. So the alternatives to the disfigurement that scars can cause other than tattoos is laser therapy in general. What we've discovered is that if you can induce your body into thinking that some of these scars are sustaining another wound, your body will start to rearrange that scar tissue into softer, more pliable scar. It can help with discoloration. That discoloration that you see are, you know, a lot of blood vessels that grew back into that scar when you healed. And so when we do laser therapy, which is part of my practice, it helps to rearrange the scar tissue without having to necessarily cut it out of you. And it's it's a long process. It takes a couple weeks for that scar tissue to rearrange, and oftentimes it takes a couple sessions. But largely, we see that a lot of people are happy with the outcomes of that.

Melissa Whitfield
05:50
Now this may seem like a really silly question, but is this just for scarring on the outside, on our skin, or is it for internal also?

Alan Pang, M.D.
06:00
Unfortunately, we don't have lasers for emotional scarring yet, but I assure you that we are working on that. But in all seriousness, it's actually a very astute point. All scars can be treated for the most part, with laser therapy. So whether this is a burn scar or an infection scar or a surgical scar, or, you know, you just fell off your bike when you were a kid, all these scars can be treated with laser therapy.

Melissa Whitfield 
06:27
Well, great. Thank you so much for coming on our podcast and talking to us about tattoos. Do you have any tattoos?

Alan Pang, M.D.
06:33
I do not.

Melissa Whitfield 
06:34
Okay, maybe one day, me too, maybe once I get over the pain. All right. Thank you very much. Thank you. Thank you for listening to Texas Tech Health Check. Make sure to subscribe or follow wherever you listen to podcasts. This information is not intended to be a substitute for professional medical advice. Always seek immediate medical advice from your physician or your health care provider for questions regarding your health or medical condition. Texas Tech Health Check is brought to you by Texas Tech University Health Sciences Center and produced by T.R. Castillo, Suzanna Cisneros, Mark Hendricks, Kay Williams, Hope Caperton and me, Melissa Whitfield.