Hispanic Tattoo Artists Could Provide Skin Cancer Prevention via Aftercare Instructions and Social Media

December 2019 | Volume 18 | Issue 12 | Original Article | 1237 | Copyright © December 2019


Cristian D. Gonzalez MD,a Adrian Pona MD,a Barbara J. Walkosz PhD,b
Robert P. Dellavalle MD PhD MSPHa,c

aDepartment of Dermatology, University of Colorado School of Medicine, Aurora, CO
bKlein Buendel, Inc, Golden, CO
cUS Department of Veterans Affairs Rocky Mountain Regional VA Medical Center Dermatology Service, Aurora, CO

instructions including proper wound healing instructions and sunscreen information (how often to reapply, best sunscreen brand, recommended SPF). No tattoo artist referred their client to a healthcare provider in regard to an abnormal mole; however, four tattoo artists reported referring a client to a healthcare provider due to acne (10%), skin infection (10%), allergic reaction (10%), warts (10%), and tattoo-related complication (10%). Only one artist (10%) knew of a doctor that he could consult for general inquiries. Two tattoo artists were interested in knowing a local tattoo laser removal technician or physician to refer their clients that wanted either complete tattoo removal or lightening of their tattoo for cover ups. If a mole was located where the tattoo would be placed, the tattoo artists would either tattoo over the mole (10%), around the mole (20%), or would stay away from the mole (70%). All tattoo artists felt comfortable tattooing over freckles.

Aftercare Instructions
All Hispanic tattoo artists recommended some form of sun protection in their aftercare instructions (Table 2). However, six tattoo artists provided verbal aftercare instructions only whereas four tattoo artists provided both written and verbal aftercare instructions. All tattoo artist specified that their recommended sun protection advice was for the actual tattoo and not the rest of the skin. Most tattoo artists (70%) recommended long-term sun protection advice to the tattooed skin, mainly to preserve the ink density and vibrant colors. Recommended sun protection behaviors implemented into the tattoo artist’s aftercare instructions included sun avoidance (100%), sunscreen use (80%), and protective clothing (50%). Of the eight tattoo artists that recommend sunscreen use in their aftercare instructions, none recommended a specific SPF and five tattoo artists mentioned “the higher the SPF, the better.” No tattoo artist recommended reapplying sunscreen every 2 hours or the use of hats to protect tattoos on the head and neck in their aftercare instructions.

Need for Culturally Sensitive Approach to Aftercare Instructions
Only one Hispanic tattoo artist provided written aftercare instructions in Spanish upon client request. Six tattoo artists provide verbal aftercare instruction in Spanish to their Spanish speaking only clients. However, all tattoo artists agreed that providing Spanish aftercare instructions was a great idea. Despite all tattoo artists having a large portion of Hispanic clientele, all tattoo studio websites and social media pages were in English only. Although home remedies are a common type of alternative medicine used by Hispanics, no tattoo artist inquired if their client would use a home remedy for wound care. In addition, only three artists inquired about their client’s occupation prior to tattooing. Eight tattoo artists reported having clients that were Latino men that worked in construction, roofing, and other outdoor blue-collar occupations. Tattoo artists often do not recommend sunscreen to these clients since many of them consider creams, lotions, and sunscreen feminine. Instead of