MRSA

Tattoos and Skin Infections

Skin infections from tattoos are not common. Most tats heal without any problem. However, getting a tattoo does involve injury to the skin. And any time there is a break in the skin, infection is a possibility.

Most skin infections are caused by one of two types of bacteria: Streptococcus and Staphylococcus (often called "staph"). There are many different species of staph, but the most common one in skin infections is called Staphylococcus aureus. Methicillin-Resistant Staphylococcus aureus (MRSA) is one specific strain.

Severe Infections

Usually, staph infections can be treated with a brief course of antibiotic pills. More serious infections require a hospital stay for IV antibiotics.

Any skin infection can be dangerous if it isn't treated. Most will eventually heal, as the body's immune system does its job. If the body can't fight the infection, it can spread to surrounding skin and, eventually, to the bones, blood and internal organs. Antibiotics are essential in these cases. Left untreated, deep infections can cause severe skin damage and scarring. Bone infections can require amputation. Blood infections can be fatal.

Why MRSA Is Dangerous

Methicillin-Resistant Staphylococcus aureus got its name because it is resistant to methicillin, a type of penicillin. In fact, it's resistant to many antibiotics, including many of the ones commonly prescribed by doctors and used in hospitals.

In the past, this type of staph almost always appeared in patients who were already hospitalized. When antibiotics are used frequently, bacteria evolve to find ways to fight them. Hospitals, where many different antibiotics are used daily, are excellent breeding grounds for resistant bacteria. So it's not surprising that MRSA would appear in hospitalized patients.

In recent years, however, a strain of MRSA has begun appearing among the general public. It has been passed among athletes, who often have skin-to-skin contact on the playing field; prison inmates; military recruits; IV drug users, who may use dirty needles and have weakened immune systems; and people who received illegal tattoos.

Doctors may try to treat this resistant bacteria like an ordinary staph infection. But ordinary antibiotics will not always work. There have been cases of healthy young people developing serious, even fatal infections after initial treatment failed. The bacteria has also been known to cause a deep, damaging infection called necrotizing fasciitis. Luckily, with the right antibiotics, MRSA infection is almost always curable.

MRSA and Tattoos

According to a report from the U.S. Centers for Disease Control (CDC) in June, 2006, there were at least 44 cases of MRSA infections linked to tattoos in 2004 and 2005. Since not all cases are reported to the CDC, it's possible that there have been more.

The reported cases were traced back to 13 tattooists in Ohio, Kentucky, and Vermont. None of the artists were licensed, and none of them used proper sterile technique. Almost all of the patients were healthy, without any particular risk factors. Many of the infections were mild or moderate, but at least 16 people needed surgical treatment. Four patients developed blood infections and needed special IV antibiotics.

Not all doctors are aware of the connection between this infection and tattoos. Telling the doctor about a recent tattoo and asking about MRSA can alert him or her to the possibility of a resistant infection.

Recognizing the Infection

MRSA infections tend to look like ordinary staph infections. These include:

• Cellulitits, a painful, red, swollen area of skin.
• Boils, painful blisters containing pus.
• Folliculitis, small red bumps that appear around hair follicules.

The infection may improve with ordinary antibiotics, but not go away completely. In some cases, the infection spreads rapidly, involving large areas of skin and/or leading to a blood infection or pneumonia. It's important to get medical help right away if the infection is spreading or is accompanied by fever, trouble breathing, or other whole-body symptoms.

Necrotizing fasciitis (NF) is not common, but when it does occur, it's dangerous. NF is an infection of the deep layer between skin and muscle. It can spread quickly and be painful. Treatment may involve surgical removal of large areas of infected skin. Severe cases can be fatal.

Prevention

Getting a tattoo always involves some risk of infection, however small. The best way to minimize the risk is to choose a licensed artist who practices careful sterile technique. The artist should:

• Wear surgical-style gloves, change them often, and always change gloves between customers.
• Use new, sterile needles and inks for each customer.
• Sterilize non-disposable equipment before each use.
• Keep the tattooing area clean and organized.

After the tattoo is finished, proper aftercare is important. This includes removing the bandage after the first few hours, keeping the tattoo clean, and seeking medical care if any signs of infection appear.