Anyone who visits a salon regularly knows no hairstyle or manicure lasts forever - unlike a tattoo, which is usually indelibly permanent. Stylists and nail technicians are expected to complete hundreds of hours in cosmetology school and serve out an apprenticeship under a licensed mentor in order to legally work in Maryland. But, when it comes to puncturing a client's skin over and over with ink-laden needles, no license is required in most areas of the state.
"You have to jump through hoops to cut someone's hair but anyone can give anyone a tattoo in Maryland," said Jason Lynn, a tattoo artist at House of Madness & Ill Humors Tattoo Emporium & Odditorium in Hampstead.
Lynn said so-called scratchers - amateur tattoo artists who don't hold themselves to any standards of practice - give his entire profession a bad name.
"We are working with bodily fluids and have to constantly guard against contamination," Lynn said.
At least once a week, said Lynn, people come into his shop with infected tattoos they received at a tattoo party or from someone working out of their home. He said these clients usually want him to fix the mess a scratcher made of their tattoo, but he has to advise them on how to clear up the infection before he can do the work.
At least one infection was so bad, the client had to go to the hospital and have an abscess on the tattoo lanced, he said.
Lynn did point out that even if people use a tattoo professional who does everything right, they can still get an infection if they don't follow the instructions for taking care of the tattoo afterward. But, he said, scratchers are more likely to be at fault.
Without any kind of licensing requirements, some scratchers are able to set up shop and advertise, he said, which causes even more problems for experienced professionals in the industry as more people are injured or put at risk for the transmission of disease.
Lynn is currently working with Millicent Campbell, of Columbia, to fix a tattoo she received at a tattoo party in January. Campbell said she had to wait until March before her skin healed enough for Lynn to begin fixing the tattoo on her chest.
"I hear about tattoo parties all the time," said Campbell, who already had five other tattoos. "This was my first time attending one, but never again."
Campbell said she arrived at the party with half a dozen other people who wanted cheap tattoos. She received her first clue something was wrong when she felt intense pain during the procedure.
"Normally, I fall asleep while getting a tattoo," she said "But, this guy pretty much dug into my chest. It was too deep."
She stopped the tattoo after about an hour, she said, even though she had already put down a $100 deposit on the work that would have cost $300 complete.
"It was supposed to be an owl for my daughter," said Campbell. "It looked nothing like an owl."
Campbell said she went to Lynn because her mother recommended him. She said two sessions are required to fix the tattoo. She went in for the first session in March and will go back in April for the finishing touches. The total cost to fix her tattoo is $500, she said.
"If anyone tells me of another tattoo party, I'm going to warn them - don't do it," she said. "You are better off going to a tattoo parlor."
She said it's important to do research before getting any tattoo. Researching a tattoo that will be part of someone for the rest of their life is important, Campbell said. But, it's also important to research the person doing the tattoo, she said.
"When it comes down to it, you get what you pay for," Lynn said. "How often do you get to buy something you take to the grave with you?"
Tattoo laws in Maryland
The Code of Maryland Regulations does list several requirements for infection control for any person conducting skin-penetrating body adornment procedures in COMAR 10.06.01.06. The regulation states tattoo artists must practice in a sterile environment, use sterile equipment, keep records and provide information on risks and aftercare to clients. However, there are no specified penalties associated with the regulation for people who don't abide by it. It does authorize the Carroll County Health Department to investigate any complaints. The regulation does not require any licensing or inspection of tattoo practitioners.
The county health department hasn't received any complaints specifically related to tattoos for at least five years, said Ed Singer, director of environmental health for the department. But, he said, a lack of complaints doesn't mean there haven't been problems with tattoos that have gone unreported.
"This is an industry where people are inserting needles into other peoples' bodies," he said. "Our nursing chief feels very strongly there is a possibility of disease being transmitted. It's hard to say why this industry isn't licensed or inspected."
At least one county in Maryland has established its own licensing requirements for tattoo artists. In Calvert County, tattoo parlors must be licensed by the county and submit to routine and random inspections by the health department.
It's difficult to know how many problems have been caused by infected tattoos, because they are not generally reportable as a cause for infection, said Dr. Larry Polsky, Calvert County health officer. However, there have been studies in other parts of the country that showed a third of college students have had skin infections or permanent skin damage from tattoos and body piercings, he said.
Polsky said it was a group of tattoo artists who were unhappy about tattoo parties and the problems they caused for patrons that first pushed for regulation. The group eventually helped draft the regulations in 2010.
"Our goal was not to stop tattooing; it was to try to make sure services provided met reasonable sanitary conditions and the people doing tattooing had a certain amount of knowledge," Polsky said.
To receive a license in Calvert, tattoo artists are required to complete an online class about blood borne pathogens and to learn basic first aid and CPR in addition to following an approved plan for contamination and infection control.
Nick Herrick, of Battle Scars and Beauty Marx in Prince Frederick, said his shop was one of the first to get licensed in Calvert. Since the new regulations have been enacted, he said he has seen fewer people walk in the door with problems caused by scratchers. Since the push for regulation, he has seen more awareness about the importance of professionalism among typical tattoo parlor patrons.
Multiple attempts have been made in the Legislature to attach penalties to the state regulation prohibiting the tattooing of minors in recent years, but none have been signed into law. The last time a bill was introduced to require licensing of tattoo parlors in Maryland was in 1997.
Laws in other states
Most states prohibit the tattooing of minors without parental consent and some ban underage tattoos altogether. But, the penalties and the ways in which this prohibition is enforced vary widely.
Likewise, the requirements for state or local licensing and, if applicable, the requirements to receive a license, are anything but standard. Inspections may or may not be conducted depending on location. Some tattoo artists may be required to take formal or online classes. Some can only work with a medical professional present.
In Pennsylvania, a bill, HB 1249, is under consideration that would regulate tattoo, body piercing and permanent cosmetic artists; limit tongue splitting; provide for powers and duties of the Department of Health; establish a Body Art Regulation Fund and impose penalties.
Virginia allows any locality to regulate the sanitary condition of the personnel, equipment and premises of tattoo parlors and body piercing salons and specify procedures for enforcement.
Alabama requires licensing and inspection by the Department of Health, as does California.
In Connecticut, tattooing is prohibited except under the direction of a licensed doctor, physician assistant or registered nurse.
Reach staff writer Priscilla Loebenberg at 410-857-7862 or