Whether it is an implanted piece of plastic beneath the skin or cutting flesh to create a permanent scar, body art is becoming more and more extreme, says Myrna Armstrong, Ed.D, professor of nursing at Texas Tech Medical Center.

Branding, implants and scarification are emerging forms of body art that have gone beyond more traditional tattoos and piercings, she said.

"I think there are three camps of people who are doing branding," Armstrong said. "One fraternity brands members with a horseshoe, and a limited amount is being done in studios, but most brandings are done by amateurs."

Amateur brandings involve taking a red-hot hanger or paper clip, creating a design and branding the skin. Reputable artists, on the other hand, mold strips of stainless steel into designs and are very cautious of gaining between a second- and third-degree burn when branding.

"They might strike the skin up to 10 times to get the desired effect," Armstrong said. "In fact, one artist I have read about strikes the skin between 10 and 30 times. That's how they perfect the brand."

Armstrong says branding and scarification, or cutting patterns in the skin deeply enough to create a permanent scar, are very dangerous forms of body art. "When it comes to the branding and especially the cutting, it borders on self-mutilation," she said.

Implanting, which involves inserting items such as jewelry-like metal or pieces of hard plastic under the skin, also is much more dangerous than traditional forms of body art, Armstrong cautions.

"Officially, implanting is considered surgery and should not be done at all," she said. "How do they open the skin? What are they putting in? How do they close the skin? The procedure is outlawed, but we're seeing it."

Armstrong says tattoos and piercings continue to grow in popularity, as well, although about half of piercings lead to infection.

"Body piercing in particular is becoming very extreme. We are seeing more genital piercings, more chest piercings and chains, generally more kinkiness," she said. "We also see piercings of the cheek and piercings on the lateral side of the neck, which is dangerously close to the carotid artery."

She encourages parents and adults to be proactive in talking about body art with their adolescents. "Kids know about body art," Armstrong said. "They can tell you about it, they can tell you where every studio is, and they've probably been into them.

"We also have to help our young people to be more informed," she continued, "so if they choose to go into a studio, they know the correct questions to ask. It's important that they have a product they like, because they are going to have it for a long time."

Armstrong, who has researched body art extensively over the past 10 years, adds that with spring break right around the corner, the incidence of young adults getting pierced or tattooed is likely to increase.

"Body art, particularly tattooing, is about self-identity," she said. "It increases people's self-esteem and makes them feel unique. It's symbolic and means something to them. They believe it's art."

Contact: Julie Toland, Texas Tech University Health Science Center, News and Publications Office, 806-743-2160, [email protected]

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