Tag Archives: Saleh Aldasouqi

Do Medical Tattoos Need Guidelines?

Should medical tattoos be standardized? Should there be guidelines pertaining to their design, and where on the body they’re located? Should physicians prescribe tattoos to patients with hidden medical conditions? And if the answer to any of those questions is yes, should medical personnel be the ones doing the tattooing?

Photo by Miriam E. Tucker / Used with permission

Those were among the questions raised by Dr. Saleh Aldasouqi in a poster presentation and at a press briefing at the annual meeting of the American Association of Clinical Endocrinologists.

Some patients with diabetes and other hidden medical conditions are choosing to be permanently tattooed rather than wear a necklace or bracelet to alert emergency personnel of their conditions. This is particularly common among patients with type 1 diabetes, for whom low blood sugar can result in unconsciousness or odd behavior that can easily be mistaken for drunkenness.

“There are a lot of patients with diabetes who are getting tattoos. Just Google ‘medical tattoos’ or ‘diabetic tattoos’ and you’ll find a large number from around the world.  The problem is they’re not consulting their physicians. They could have high sugar, which can affect wound healing. …There are so many issues now being talked about with regard to medical tattooing,” noted Dr. Aldasouqi, an endocrinologist at Michigan State University, Lansing.

He believes these issues should be addressed by professional medical organizations, possibly including those pertaining to diabetes, dermatology, and emergency medicine.

As for tattoo location on the body,  the wrist would be the most logical place since first responders will always check there, he said.

So who should do the tattooing?  Tattoo parlors that are licensed under state or local laws are typically clean and use sterile equipment, and require customers to read and sign consent forms that address medical conditions and risks.  Of course, tattoo artists would need to be educated about any new standard.

But dermatologists or plastic surgeons could do it as well. “We’re not competing with tattoo artists, but at least we can collaborate with them by standardizing at their level, or make it a minor surgical procedure. In fact, this is being done to mark the skin for radiation therapy in cancer patients, and in reconstructive surgery after breast cancer. Some medical tattooing is already being done  by medical specialists. So, it’s open for discussion.”

-Miriam E. Tucker (@MiriamETucker on Twitter)

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Filed under Allergy and Immunology, Dermatology, Emergency Medicine, Endocrinology, Diabetes, and Metabolism, Family Medicine, Health Policy, Hospital and Critical Care Medicine, IMNG, Infectious Diseases, Internal Medicine, Plastic Surgery, Primary care, Uncategorized

All Over the Internet, But Not in Your Journal

Photo courtesy of Dr. Saleh Aldasouqi

Photo courtesy of Dr. Saleh Aldasouqi

 At the annual meeting of the American Association of Clinical Endocrinologists, Dr. Saleh A. Aldasouqi presented the case of patient with type 1 diabetes who had decided to get a permanent tattoo on his wrist that identified him as a diabetic. The patient, who had lived with diabetes for 35 of his 36 years, had frequent bouts of hypoglycemia but didn’t want to wear medical identification jewelry. According to the patient, the tattoo had been carved at a professional tattoo parlor under sterile conditions.

Dr. Aldasouqi, who practices endocrinology in Cape Girardeau, Mo., had not encountered this practice before, so he and his colleagues first searched the medical literature and found just one similar case report. There were no published guidelines or consensus on the practice.  Then they tried Google.  Bingo—The topic of “medical tattoos” is all over the Internet, with diabetes patients blogging and chatting about tattoos in general, and “medical tattoos” in particular. Indeed, the concept has been around for a while. Here’s a 2005 entry from one of the more popular diabetes blogs:  http://www.diabetesmine.com/2005/08/tattoos_for_lif.html

Tattoos pose potential health risks for people with diabetes, since uncontrolled blood sugars increase the risk for infection.  While no official, evidence-based guidelines exist, an “unofficial” consensus from healthcare providers and patients on the Internet appears to be that the practice is okay as long as blood sugars are well-controlled.  Some also suggest avoiding tattoos on the feet, ankles, and lower limbs, since those areas are most often affected by poor circulation and neuropathy. 

Dr. Aldasouqi told me that he had submitted this case report to an endocrinology journal and a family practice journal and it was rejected by both.  So here’s an idea: Medical journals could launch a column called “All Over the Internet,” devoted to informing physicians about unorthodox and potentially harmful practices such as this one (“diabulemia” is another example), unproven uses of medications or supplements, unsubstantiated beliefs (i.e., the anti-vaccine stance), as well as positive and potentially helpful things that patients are sharing in blogs, chats, Twitter, and other social media but that are currently absent from the medical literature because they lack hard data. Front-line clinicians would be encouraged to contribute.

In a press briefing, Dr. Aldasouqi stressed that he is not advocating the use of medical tattoos, but merely calling attention to a phenomenon that patients are already doing. “Because this is happening, I thought we needed to talk about it,” he said. ###

–Miriam E. Tucker

(@MiriamETucker on Twitter)

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Filed under Endocrinology, Diabetes, and Metabolism, Family Medicine, Infectious Diseases, Internal Medicine, Primary care