Getting a tattoo is largely safe, though experts advise using a reputable shop By Bonnie Berkowitz Washington Post Staff Writer Monday, February 7, 2011; 6:01 PM Dermatologists' organizations, tattoo artists and the Food and Drug Administration agree that tattooing is largely safe, but any time you stick a needle into skin there are risks. Consumers need to do their homework. Perhaps it would help to think of your potential tattoo not as a sweet ink job but by its sober-sounding medical name, micro-pigment implantation. Do not assume that a shop's existence means it has the government's stamp of approval. Most states including Virginia license tattoo shops and artists in some way, but oversight varies greatly. Some Maryland counties regulate while others do not; D.C. does not regulate. Because oversight is loose, national tattoo organizations set their own standards. "Reputable shops and tattoo parlors govern themselves and follow strict safety procedures to protect their clients - and their body artists," the Centers for Disease Control says on its Web site. A tattooist who follows the guidelines will be happy to prove it. The American Academy of Dermatology, the FDA and tattoo artists' organizations agree on these tips for potential consumers: 1) Don't make a snap decision. A 2008 Harris poll found that 16 percent of tattooed adults regretted it. Large intricate tattoos take time and money to put on and to take off. 2) Carefully choose an artist by looking at his or her work and getting recommendations. If you want custom work, bring samples of what you like and dislike. A good artist can boil down your random ideas into a coherent piece. 3) Don't shop by the lowest price alone. Great work will be expensive, up to hundreds of dollars per hour. 4) Visit the shop beforehand and make sure you are comfortable. Different shops cater to different types of clients. 5) Ask to see the shop's log books. They record when the autoclaves - where the instruments are sterilized - were last spore-tested. This test, usually done monthly, shows how effective an autoclave is at killing a certain heat-resistant bacteria. Reputable artists expect these questions. 6) Make sure anything that will touch your skin - gloves, needles, ink cups - is single-use only, unwrapped in front of you. 7) Get a list of inks used with the manufacturer's lot numbers just in case you need to try to track down an ingredient. Allergic reactions are rare but they can occur, according to the FDA, which does not regulate ink or its ingredients. The tattoo may become itchy and inflamed or blistered, and extreme cases may require a visit to a dermatologist. Other common adverse reactions are excessive scarring or raised nodules called granulomas forming around the pigment. Occasionally a tattoo will interfere with an MRI, but that is rare as well. 8) Alert the tattooist to any relevant medical conditions If you take blood thinners or other types of medication that affect bleeding, be sure to check with your doctor first. 9) Follow the aftercare instructions, which will tell you how to clean and care for the tattoo while it heals. These are often printed on the tattooist's business cards. Staff researcher Magda Jean-Louis contributed to this report.