Happily, no. “Someone with diabetes should be able to live just like everyone else,” says Joanne Rinker, RD, CDE, the director of practice and content development for the American Association of Diabetes Educators (AADE), who is based in Asheville, North Carolina. “Your lifestyle shouldn’t be impeded, but you may have to take an extra step or two to be safe about it,” she says. About 30 percent of Americans have at least one tattoo, according to a 2016 Harris Poll. And you can probably be one of them. Go ahead and get the tattoo or piercing of your dreams, but first, there are a few precautions to keep in mind.
Diabetes and Infections: Why Tattoos and Piercings May Affect Your Risk
While the American Diabetes Association (ADA) hasn’t issued a position on body art, diabetes experts pull from smart recommendations based on clinical knowledge of how someone with diabetes may heal and the complications they may face. “The skin is your body’s largest organ and protects you from the outside world. When there’s an opening in the skin, which is what happens during a tattoo or piercing, there’s always the opportunity for an infection,” explains Suzanne Ghiloni, RN, CDE, a nurse educator at Joslin Diabetes Center in Boston. The risk of infection is why you’re encouraged to perform good foot care and avoid, as best you can, getting cuts on your feet. And it’s not just a theoretical problem; a study published in October 2012 in JAMA reported on an outbreak of skin infections in four U.S. states arising from tattoos, linked to contaminated ink.
Who Can and Who Can’t Get a Tattoo or Piercing?
That’s why step No. 1 is to tell your doctor about your desire for a tattoo or piercing, and ask if she thinks you will be able to heal from it well and quickly. (If you need to find a certified diabetes educator — a diabetes specialist who can likely help answer this question for you — you can locate one on the AADE’s website.) “The first thing we consider is how controlled your diabetes is,” Ghiloni says. Your healthcare professional will most likely look at your A1C levels — the measure of your average blood sugar over the past three months). To be considered well controlled, your A1C should be less than 7. “That’s the goal that the Joslin Diabetes Center and the ADA agree is what we’re aiming for,” she adds. A higher A1C level suggests that you’re at a greater risk for slow wound healing. And the longer the skin takes to heal, the more likely you are to get a dangerous infection.
Why Diabetes Complications May Limit Where You Can Get Body Art
Unfortunately, that level of under 7 is not a hard-and-fast rule. “There isn’t a level at which we would say you should absolutely not get a tattoo. That’s why it’s a wise idea to talk to the doctor who knows you and your diabetes and how you handle it. He or she is better qualified to make an assessment of the safety risk of getting a tattoo or piercing,” Ghiloni says. For instance, your A1C may be a 7.6, but your physician may say that you’re completely fine to get inked. A1C isn’t always the be-all-end-all indicator of diabetes management, she adds. Also talk to your doctor about any limitations on where you should get a tattoo or piercing. For instance, if you have any neuropathy or circulation issues in your feet or lower legs, your doctor may suggest avoiding this area. “Neuropathy may mean you have a loss of sensation, so you’re less likely to feel an injury or problem as quickly as you should,” Ghiloni explains.
What to Do If Your Doctor Says You Can Get a Tattoo or Piercing
If your provider says that you’re doing a great job controlling your diabetes and can safely get a tattoo or piercing, the next important step is to do it as healthfully as possible by being proactive to prevent any issues from popping up. Follow these general guidelines: Do your homework. Find a reputable place to get a piercing or tattoo, a place that uses safe and sterile procedures. Ghiloni recommends asking friends for their recommendations, then checking with the Better Business Bureau or your local board of health to inquire about the facility. Tell the artist at the parlor that you have diabetes. No matter which parlor or where on your body you plan on getting your tattoo or piercing, it’s a good idea to give the tattoo artist or piercer a heads-up that you have type 2 diabetes. They won’t kick you out, but it’s important for them to take your condition into consideration while you’re in the chair. “Getting a tattoo is stressful on the body, and depending in the person, this could be a positive or negative stress,” Rinker says. Meaning, you may have a high tolerance for pain and be so excited about the image you’re about to get that it’s an entirely positive experience. Or maybe you really want one, but you’re nervous about it, and the stress may be more negative in nature. That stress can increase your blood sugar during the tattoo, she notes. Maybe you’ll need to check your blood sugar halfway through or you may need to take a break and catch your breath. “The person will be aware that this is the reason why you’re asking for that opportunity,” Rinker says. That said, you don’t have to reveal anything — it’s completely up to you. Before you go, ask about healing. Especially if this is your first tattoo or piercing, you may not have any idea what to expect as it heals. “Ask the tattoo parlor what your tattoo should look like,” Ghiloni says. Is crusting or scabbing normal? “As soon as it veers off normal, contact your doctor,” she adds. Clean it well. Your goal should be to try to prevent infection as your tattoo or piercing heals. Take the at-home follow-up cleaning guidelines the tattoo parlor gives you seriously. Maybe this also means you use that triple antibiotic ointment once or twice more per day, Rinker says. Ask your doctor what’s right for you.
One Last Thing: What About Medical Alert Tattoos?
Rather than wearing a medical ID bracelet revealing your diabetes status, some people are choosing to get medical alert tattoos on various parts of their bodies, where they can’t be lost. “This is certainly a personal preference. Some people say half the time they wear their bracelets, and half the time they don’t. So if they’re open to it and want a medical tattoo, I don’t mind. I think it’s a cool option,” Rinker says. She says that all the same advice applies in this case: Get clearance from your diabetes care provider and do your homework on the location of the tattoo and the tattoo artist — whether the artwork is for medical or personal reasons. She also adds that if you don’t like your bracelets but a tattoo isn’t for you, you can find other options, like a more attractive or less obtrusive bracelet or necklace.
