Tattooing and Health: What People Need to Know Before Making a Permanent Choice. An Interview With Roman Zao

Tattooing has become a mainstream form of self-expression, yet questions about its impact on health remain common. What materials are safe? How does tattooing affect the body long-term? And what role does the artist play in minimizing health risks?
To explore these questions, Dr. Brooks spoke with Roman Zao, an internationally recognized tattoo artist, experienced judge at major tattoo conventions, and researcher whose work bridges practice, anatomy, and visual culture.

— Dr. Brooks: Roman, one of the most common questions people ask is simple: how harmful is tattooing to health?

— Tattooing itself is not inherently harmful when done correctly. The risks arise when standards are ignored — unsafe pigments, poor hygiene, lack of understanding of skin and anatomy. Tattooing is a controlled injury to the skin, so it requires knowledge, discipline, and responsibility from the artist.

— Many people don’t realize that tattooing is a physiological process. What actually happens to the body during a tattoo?

— The skin reacts immediately. There’s an immune response, mild inflammation, and a healing process that can take weeks. Long-term, the body encapsulates pigment particles within the dermis. When this process is respected and supported — through proper technique, materials, and aftercare — the body adapts without negative consequences.

— Let’s talk about materials. How important is pigment quality from a health perspective?

— It’s critical. Pigments should be produced according to international safety standards and be free from toxic heavy metals and harmful additives. Not all pigments are equal. A responsible artist knows exactly what materials they are using, where they come from, and how they behave in the skin over time.

— Does color matter in terms of health impact?

— Yes, but not in the way people often think. The issue isn’t brightness or darkness, but composition. Some pigments are more stable than others. A knowledgeable artist understands how different pigments interact with various skin tones and how they age. This reduces the risk of irritation, allergic reactions, and long-term complications.

— What should people look for when choosing a tattoo artist from a health standpoint?

— First, hygiene standards. The studio should follow medical-level sterilization protocols. Second, transparency. An artist should be able to explain what materials they use and why. Third, experience. Someone who has worked with healed tattoos understands long-term skin behavior, not just immediate results.

— You often emphasize healed work. Why is that relevant to health?

— Healed work shows how the body has accepted the tattoo. It reflects proper technique, correct depth, and respectful treatment of the skin. From a health perspective, healed tattoos are evidence that the artist understands skin recovery and long-term outcomes.

— How does tattooing affect people psychologically? Is there a health aspect there as well?

— Absolutely. Tattooing can significantly impact self-perception, confidence, and emotional well-being. For many people, a tattoo marks a personal transition or decision. When the process is handled thoughtfully, it can be psychologically positive. When rushed or poorly executed, it can have the opposite effect.

— Are there people who should avoid tattooing altogether?

— Certain medical conditions require extra caution — autoimmune disorders, severe skin conditions, or compromised immune systems. In such cases, consultation with a healthcare professional is essential. A responsible artist will always advise postponing or declining a tattoo if there’s a health risk.

— As someone who judges professional tattoo competitions, how often do you see health standards being overlooked?

— Less often than in the past, but it still happens. The industry has matured significantly. Today, health awareness is becoming part of professional credibility. Artists who ignore safety simply don’t earn long-term respect within the community.

— In your view, what is the artist’s responsibility when it comes to health?

— The artist is responsible for more than the image. They are responsible for the body they work with. Tattooing leaves a permanent mark, so the decision-making process must include health, anatomy, and long-term impact — not just aesthetics.

— Finally, what advice would you give to someone considering their first tattoo?

— Don’t rush. Research the artist, ask questions, understand the materials, and listen to your body. A tattoo should be a thoughtful choice, not an impulsive one. When done responsibly, it can be both safe and meaningful.

Tattooing sits at the intersection of art and physiology. As Roman Zao’s perspective makes clear, health-conscious tattooing depends not on trends, but on knowledge, experience, and professional responsibility.

Roman Zao website: https://tinyurl.com/3cyrv89y