Some people with diabetes, allergies and other conditions are forgoing medical alert bracelets for tattoos. Is that a good idea?
From health risks to future job opportunities, here's what you should consider before getting inked.
By Anna Medaris MillerAug. 20, 2015 | 1:43 p.m. EDT+ More
Chris Miller was never a tattoo guy. He describes himself as quiet and introverted, someone who tries to please others. But two years ago at age 42, the newspaper reporter in Edmonton, Canada got inked for the first time. "It's my one and only," says Miller, who's currently on medical leave.
Miller's tattoo isn't intended to make a political statement, inspire him, express an artistic side or, honor someone or something. Rather, it's meant to notify medical professionals that he has Type 1 diabetes in the case of an emergency.
"I've always worn medical alert bracelets and, over the years, they break from time to time," says Miller, who was diagnosed at age 3. "I just thought a tattoo made sense because it's permanent." Plus, he adds, the process wasn't so foreign. "I'm sort of used to needles," he says.
“I wanted to be clear that it’s not just a design,” says Chris Miller, whose friend found the pattern online.
His tattoo, which covers a few inches of his right wrist, says "T1 DIABETES," with the "T" doubling as a syringe. It's enclosed in a blue circle, the universal symbol for diabetes.
It's unknown how many people have medical alert tattoos like Miller's, since no organization tracks them, says Dr. Saleh Aldasouqi, chief of endocrinology in Michigan State University's College of Human Medicine who brought attention to the issue in 2011, when he published a case study about a patient with diabetes who had a tattoo in lieu of medical alert jewelry. Even patients can hesitate to tell doctors they've gotten such tattoos or are thinking about it, due to varying social and religious views on tattooing, Aldasouqi says.
But for some people, including Miller, the tattoos are one less thing to think about when living with a chronic condition.
"If it's a medical condition that won't be going away, like my diabetes won't be, then [a medical tattoo] is worth pursuing because it's something that could help you," Miller says. It can also help reduce the stigma around some conditions, he says. "People see the tattoo, and it opens up the door to speak about diabetes."
Think Before You Ink
Tattoos as substitutes for medical jewelry are still far from mainstream, says Dr. Mark Reiter, president of the American Academy of Emergency Medicine, who doesn't recall seeing one in his 10-plus years of emergency medicine practice. That's not a bad thing, he says, since emergency responders aren't trained to look for them. What's more, the tattoos aren't standardized in terms of location, appearance or size. And as tattoos for nonmedical purposes are on the rise (a 2014 poll of 1,000 Americans found that 40 percent have a tatted housemate – nearly double the number in 1999), a caduceus could get lost among the roses.
"If I saw somebody who came in and had a tattoo that said 'diabetes,' I'd think that this guy probably has diabetes, but who knows?" Reiter says. "Maybe it was that his mom had diabetes, and he was trying to make a statement."
People who need to communicate something to first responders – say medications they're allergic to or that they have a history of seizures – are "a lot better off with a more adopted form of communication such as a clearly legible, well-organized list in their wallet," Reiter says. "Or, if they're more concerned, a medical alert bracelet."
The very reason medical alert tattoos can be appealing – they are "awfully permanent," says Matt Petersen, the American Diabetes Association' managing director of medical informatio – is also a reason to think twice before getting one. "You want your medical ID to change over time" to reflect changes in your condition or how you treat it, Petersen says.
While the ADA won't advise someone not to get a tattoo – "tattoos are a personal decision," Petersen says – it supports IDs that are universally recognized, such as a bracelet or wallet card. "We’re not going to expect all people with diabetes to get get a tattoo, so that’s not going to become the standard," Petersen says.
Young people should be particularly cautious before getting a medical alert tattoo, since the art might affect future job prospects, warns Michelle Yager-Frenc, owner of Carmel Tattoo INK in Carmel, Indiana who has tattooed several teens under 18 for medical purposes with their parent's consent. "Having a tattoo on their wrists, it's still going to affect where they can and can't work," she says. One of Yager-French's clients, a 15-year-old boy with diabetes, couldn't wear a bracelet because he is allergic to metals. Another, a 13-year-old girl, was sent to Yager-French by her doctor because "she literally almost died that week" due to her severe nut allergy, Yager-French says. The girl's tattoo is a big red cross on her wrist with the words "nut allergies."
For other people with severe allergies, tattoos in place of medical bracelets or wallet cards can pose risks, ays Dr. James Sublet, an allergist-immunologist in ouisville, Kentucky, and president of the American College of Allergy, Asthma and Immunology. For one, some people are allergic to tattoo ink. "It's probably not advisable for people who already have allergy problems to introduce something like that into their system," he says. Then there's the risks of tattoos themselves, including infections from contaminated needles that the U.S. Food and Drug Administration warns could lead to hepatitis or HIV.
Like Petersen, Sublett recommends sticking with an alert system that emergency responders are sure to recogniz. "The medical community is pretty well tuned in to looking for bracelets or alert cards in wallets," he says. "I'm not sure that medical tattooing – especially with the prevalence of tattoos we see nowadays – could be easily [picked up]." The American Public Health Association, for one, eclined to comment on this story in part because it does "not fully support tattoos in general," says Kimberly Shor, a spokeswoman for the organization. The American Medical Association didn't have anyone to speak on the topic, either.
But Aldasouqi of Michigan State University encourages associations to take a more proactive approach to the issue, since it won't be going away, he says. "The reaction I'm seeing is dismissing it as if it's not our business," he says. "It is our business. It's our patients, it could be relatives or loved ones of ours."
Tattoo Safety 101
Still want a medical alert tattoo? Take these precautions before pulling up to the parlo:
- Talk to your doctor. In 2008, a patient reluctantly told Aldasouqi he had a medical alert tattoo. "He as wanting to hide it from me because of the stigma," Aldosouqi says. But bringing it up with your doctor is critical. For example, people who might have bleeding problems or reactions to the ink should be ruled out. "You need to understand this is not just a tattoo for the sake of a tattoo – this is a medical application of tattoos," Aldasouqi says.
- Do your research. Every state regulates tattoo shops differently, so "it's always been a buyer beware situation," says Sailor Bill Johnso, a tattoo artist at Tattoo Time in Maitland, Florida, and vice president of the National Tattoo Association who tattoo about one or two medical alert designs each year. If possible, check with local authorities to rule ou places that have health code iolations, Yager-French recommends. And, while it can be helpful to view photos of a tattooist's ast work, a better way to ensure a good experience is to get a personal recommendation. "You need to know someone who's gotten tattooed by that person – 00 percent," Yager-French says. Once you've found a prospective shop? Don't be shy, Johnson says. "Don't be afraid to ask questions" of the tattoo artists, he says. "If someone blows you off or says they don't have time for that, walk right out the door."
- Have a backup plan. To cover your bases, keep a medical ID card in your wallet and continue managing your condition responsibly. For example, keep necessary medical tools (like an EpiPen for allergies or an insulin pump for diabetes) with you at all times, and be sure that family, friends, co-workers and others close to you know about your condition, how to recognize an emergency and what to do if one strikes, Sublett says.
- Wear it loud and proud. Don't lose sight of the tattoo's purpose: to potentially save your life in an emergency. "In an emergency situation, someone's not going to sit there and look at everyone's tattoos to see what they look like," Johnson says. He suggests designing one that looks like a medically-recognized symbol and inking it prominently on the wrist or arm. "It should stand out and be large enough so [emergency professionals] can see the actual medical emblem," ohnson says.
For Miller, the visibility of his Type 1 diabetes tattoo has only elicited one negative reaction: from his cat's veterinarian. "Interesting that you should choose to label yourself that way," Miller remembers him saying. But he doesn't mind the label. "[The tattoo] is something that could potentially save my life someday," Miller says. "It's not like my diabetes is something that I'm ashamed of."