Sign on the line: Five reasons to limit ink to your medical certificate

I soon make the biannual pilgrimage to my AME, expecting to leave with the good doctor’s ink on my certificate.  Prior to visiting, I compile a list of the past two year’s medical interactions, complete  FAA’s  MedXpress form online and apply a silly temporary tattoo to amuse my doc.   

Tattoo is derived from the Polynesian word tatau - literally “workmanlike”- and means to puncture and permanently mark the skin. Tattoos are common in south sea island culture such as moko inkings among the New Zealand Maori, a mark of status and identity, as well as a place to store their spirit. Captain James Cook is credited for bringing “tattaws” to the northern hemisphere. Examination of Egyptian mummies revealed that the practice was common there and today, as a British soccer fan, I am intrigued at how many players are “inked” from head to toe, a trend reaching epidemic proportions.  Body designs have a tawdry history; Roman soldiers, gladiators and slaves were marked, the latter with “stop me I’m a runaway,” graduating to the despicable numbering of humans in Nazi concentration camps. 

Medical tattoos guide radiotherapy, cover up vitiligo (pale skin) or help create new nipples after mastectomy.  Cosmetic tattoos enhance eyeliner, lipstick or moles and this practice is growing in popularity. The Second Council of Nicaea banned all tattoos, labeling them “pagan” in the year AD787, but that edict seems to have been lost in the mists of time.

The stick-on tats I use for my AME are not only impermanent but do not carry various risks associated with their permanent cousins. Of course, being sober makes it easier to self-apply a sticker in the desired location, whereas being inebriated makes it easier to end up with something embarrassing emblazoned across your body. So, what are the risks?

(1.)             One is injecting ink into the skin and, like any injury, this can cause scarring and deformity. Sometimes the ink is perceived as a “foreign body” by your body and a granuloma forms. This is a fancy name for a lump, probably not what you planned punctuating “I love mum.” 

(2.)             I never enjoyed heavy metal music and I certainly don’t want heavy metals in my body. In Lewis Carroll’s “Alice’s Adventures in Wonderland” we meet the Mad Hatter, probably inspired by hatter’s disease; mercury used in processing hat felt damaged nerves causing nasty symptoms such as shakes, memory loss, digits falling off and the like. Nasty. Well guess what? Red inks contain mercury and even if it does not damage mental function, it can cause rashes, scarring and allergic reactions to mercury dental fillings or eating mercury-tainted fish. Other heavy metals like arsenic (yes Arsenic!) lead, cobalt and beryllium are also used in various inks. As I said, I don’t like heavy metal. Consider just choosing black, or metal-free inks.  

(3.)             Everyone has heard of MRI machines, right? MRI stands for Magnetic Resonance Imaging. If you need to have this test at any time the technician will have you disrobe and leave your wallet and any metal items in a locker far away. Why? The Magnet in MRI is the clue; it is a strong magnet and will wipe your credit cards and eat your watch and plane keys. Check out #2 above……yes, tats contain metal and when they turn the machine on, your permanent eyeliner or image of a warbird with guns blazing will heat up and maybe swell. If you are already inked, make sure you tell your doctor prior to an MRI, they may have to consider an alternative imaging technique. 

(4.)             I have written about Hepatitis C in this magazine (AOPA Pilot Magazine, “Stealing Fire” October 2011) and in online newsletters – it causes chronic liver disease, and even death. And it can be transmitted by contaminated tattoo needles, as can HIV and other infectious diseases.  So, you might want to ask about practices before having that image of your favorite plane indelibly imprinted on your left seat.  Also, check the Department of Health and online for complains. 

(5.)             So, you have decided to absolutely, positively, get a tattoo. You would obviously ensure the spelling of any words is correct, right? Unfortunately not; this is not uncommon and my favorite is “Stay strong no matter wath happens.” Ouch. Or some folks like to choose Oriental characters, selecting those that are supposed to say “Strength & Courage,“ but you end up with “Little animal, big mistake.” 


Before a large and angry tattoo artist offers to change the color of my face to black and blue, let me clarify; this is a matter of personal taste and I am sure there are hygienic and professional inkers out there. Just make sure you are well informed before taking the leap. And not pickled!

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Jonathan Sackier
Dr. Jonathan Sackier is an expert in aviation medical concerns and helps members with their needs through AOPA Pilot Protection Services.

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