Explosion in tattooing, piercing tests state regulators

State legislators and health officials across the country are trying to keep up with the growing popularity and evolving trends of body art.

Eamon Queeney—North State Journal
An outdoor view of Mad Ethel's Tattoo in downtown Raleigh

RALEIGH — Anyone who goes into a tattoo parlor in N.C. can be assured that it has a permit from the state health department and that inspectors have checked the premises for safe and sanitary conditions.But go for a body piercing in the Tarheel State and there’s no such protection. A state law, approved in the 1990s, regulates tattoos but doesn’t apply to other forms of body art.”Most people think it’s all regulated,” said state Rep. Kevin Corbin (R-Cherokee). “But we found out there’s no law on the books.”N.C. is not alone. State legislators and health officials across the country are trying to keep up with the growing popularity and evolving trends of body art.Health officials worry that unregulated body art studios may not follow safe practices, which can lead to scarring, nerve damage and infections, including hepatitis C, the leading cause of liver cancer in the U.S.”The body art industry is much more nimble than the government,” said Doug Farquhar, who tracks body art legislation in the states as the director of environmental health for the National Conference of State Legislatures.Nearly four in 10 people born after 1980 have a tattoo and one in four have a piercing some place other than an earlobe, the Pew Research Center has reported.Besides tattoos and pierced navels, today’s self-expression through body art may include branding, scarification (scratching, etching or cutting to produce a design in the skin), or subdermal implants (placing objects under the skin for ornamentation).Nearly every state has some type of body art law, but laws vary widely. Most states do agree on one thing: age limits. At least 45 states prohibit minors from getting tattoos, and 38 states prohibit body piercing and tattooing minors without parental permission, according to NCSL.In the last four years, states have considered 167 bills on body art and tattooing, and 33 have become law, Farquhar said.Oregon, for example, extensively rewrote its tattooing regulations in 2012, updated them last year, and in January clarified that “microblading,” in which a practitioner uses fine needles and pigment to create eyebrow hairs, is tattooing and not an esthetic, or cosmetic, practice.Oregon requires practitioners to have hundreds of hours of training and pass written exams before being licensed for specific types of body art. Georgia is among states that do not regulate or certify the body art industry, but most Georgia counties have adopted ordinances.Maryland does not license body artists, though it requires them to use sterile instruments, wash their hands, wear disposable gloves during procedures, and cleanse customers’ skin. They also must maintain three years of customer records and make them available to health officers if requested.But some Maryland localities, such as Baltimore, do require licenses. In Nevada, which has no state body art regulations, local ordinances, such as in Las Vegas’ Clark County, prevail.North Carolina is one of at least six states considering body art legislation this year. Corbin co-sponsored a bill updating the tattoo law to include other types of body art. It passed the state House in April and is under consideration in the Senate.The sharp increase in hepatitis C cases in the last few years has intensified states’ concern about sterile and sanitized needles and equipment and associated health and safety training.The number of new hepatitis C infections in the United States tripled between 2010 and 2015, to more than 2,400, the Centers for Disease Control and Prevention reported last month. The CDC blames the increase on the rise of injection drug use associated with the opioid epidemic and says major research studies have not shown hepatitis C to be spread through licensed, commercial tattooing facilities.”However,” the CDC said, “transmission of hepatitis C (and other infectious diseases) is possible when poor infection-control practices are used during tattooing or piercing.”Corbin was a Macon County commissioner last year and a candidate for the North Carolina state legislature when he heard from his county health officers about the rising rate of hepatitis C and the gap in state law regulating body art.Macon County environmental health specialist Jonathan Fouts explained his frustration inspecting a tattoo shop: “Usually beside the tattoo room is the piercing room. I felt like I was only doing half of what I should be doing, since I couldn’t say anything about the piercings and needles.”Corbin took the problem to the North Carolina Association of County Commissioners, which made a body art bill a legislative priority. Then the freshman representative took the issue to Raleigh.”I don’t personally have any piercings and I don’t plan to have any, but if someone wants to have them, more power to them,” Corbin said. “We want them to be safe.”The bill is currently in the Senate Rules Committee.