Inked for Life? Tattoos as a Medical Alert Mechanism

As primary care providers, we constantly seek new ways to prevent disease. Tattoos have long been discouraged by physicians due to the risks of various diseases transmittable through poorly sanitized tattoo methods and dyes. However, is there a role for a tattoo being a permanent means of alerting health professionals to potentially life-threatening diseases?

For many people, medical alert bracelets are inappropriate—for example, those who use heavy machinery at work. What’s more, gender biases discourage some men from wearing health alert necklaces or bracelets.

A recent case presents certain arguments for a medical alert tattoo. The patient is a 56-year-old man with a history of hemophilia and familial colon polyps requiring frequent colonoscopies. He operates heavy machinery and is unable to wear jewelry or loose clothing while on the job. His hemophilia puts him at risk for exsanguination in the event of an injury on the job. The tattoo has proven its value already: When the man experienced rectal bleeding following a recent colonoscopy, his primary care provider noted the tattoo and used it as a means of getting him the correct coagulation factor VIII replacement therapy.

Various studies have highlighted the risks of tattooing in transmitting hepatitis and other bloodborne pathogens. Some research describes tattoos on adolescents as a sign of potentially risky behaviors.¹ Anecdotally, a PubMed search results in numerous articles discussing new skin infections associated with permanent tattoos, one of which even highlights the high rate of recipients’ intoxication when tattoos are applied.² No articles describe any benefits of tattoos. Still, the use of medical alert tattoos may become more widespread, and health care providers will be asked to consider individual risks and benefits of this type of medical alert identification.³

In this singular patient’s case, only time will tell whether further harm will be prevented through this unusual and unconventional use of a tattoo, but it certainly caused me to think twice about options for patients who need a nontraditional means of medical alert identification. n

Abigail Urish, MD, is a physician at Rangely District Hospital in Rangely, Colorado.

References:

1. Carroll ST, Riffenburgh RH, Roberts TA, Myhre EB. Tattooing and body piercings as indicators of adolescent risk-taking behaviors. Pediatrics. 2002;109(6):1021-1027.
2. Liszewski W, Kream E, Helland S, Cavigli A, Lavin BC, Murina A. The demographics and rates of tattoo complications, regret, and unsafe tattooing practices: a cross-sectional study. Dermatol Surg. 2015;41(11):1283-1289.
3. Chason R. Unregulated rise of medical alert tattoos stirs debate. USAToday. July 24, 2014. http://www.usatoday.com/story/news/nation/2014/07/24/medical-alert-tattoos-debate/12788747/. Accessed April 14, 2016.