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Although body modifications have become a mainstream trend, they still may be associated with medical complications and, among adolescents, may also co-occur with high-risk behaviors.

This first clinical report from the American Academy of Pediatrics on tattooing, piercing, and scarification discusses the history of these methods of body modification, educates the reader on methods used, reports on trends in associated adolescent and young adult risk behaviors, differentiates between nonsuicidal self-injury (NSSI) and body modifications, and educates the reader about how to anticipate and prevent potential medical complications.

A survey conducted among college freshmen from Italy found that many students undergoing tattooing and/or piercing were unaware of the associated health risks.

It can include cutting, scratching, burning, and hitting oneself.Although interest in body modification has increased recently, history teaches us that body modifications are not new.Archeologists have found evidence of tattoos, piercings, and scarification as far back as 2000 BC, when they were largely used as a form of art or to identify group membership, such as a religious group or tribe.From another survey regarding technological and social changes, 40% of respondents said that more people getting tattoos has been a change for the worse, 45% of respondents said that it has made no difference, and only 7% said this has been a change for the better.As might be expected, older Americans are far more likely to negatively view this trend; 64% of those 65 years and older and 51% of those 50 to 64 years of age said more people getting tattoos has been a change for the worse.When available, information also is presented on societal perceptions of body modification.Tattoos, piercings, and scarification, also known as “body modifications,” are commonly obtained by adolescents and young adults.Although mostly used to describe loyalty, interests, and lifestyle choices, body modification had also been used to label criminals, slaves, and convicts.Although in the late 20th century, most tattoos were on men, ranging from the stereotypical tattooed sailors and motorcycle bikers (eg, The Hells Angels in the 1960s) to 1980s gang members, now, tattoos are collections of colorful ornamentations for both women and men.One early study among high school students from 8 states found that 10% had tattoos, and 55% expressed interest in tattooing.Of students with current piercings, high-ear cartilage (53%) was the most common visible piercing, followed by navel (38%), tongue (13%), and nipple and genital (9%) piercings.

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