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Every tattoo artist across the globe has more than likely suffered through hand or foot tattoos that they didn’t want to do. Even more likely, every tattoo artist has had a moment in their career where they had no idea how to approach a tattoo design, a specific placement, or how to deal with an unruly client. The hand or foot tattoo is no different. It isn’t easy to ensure longevity, and placement is often not congruent with this part of the body.
Regarding this confusion, we are putting out this article with the intention of better educating tattoo artists and tattoo clients alike.
You expect to find information about how to approach hand and foot tattoos, assess skin composition to ensure proper placement of hand and foot tattoos, and how best to heal them in this in-depth article.
A Question Every Tattoo Artist Gets:
A commonly asked question from clients to us artists is, “Do you do hand and foot tattoos… and how long do they last?”.
I have personally worked in shops all over North America, and I have to tell you, the faces tattoo artists make as this question wafts across the shop floor sour. Their lips scrunch together; their eyes squint shut. It looks as if these well-trained individuals have just sucked on a lemon.
I still do not understand this knee-jerk reaction, but as I look back on my history in the industry, I believe the response is trained into the artist. It isn’t real.
All you tattoo artists out there or the clients who can feel the hate over the phone (or in-person), take heed! Those hand and foot tattoos can be done effectively, with grace and accommodation, as long as you know a few tricks. Let’s start this article with a quick overview of the skin and how it influences tattoos on the hands and feet.
How is the Skin on the Feet and Hands Different When Compared to Other Places on the Body?
The human body’s largest organ is its skin. What covers our bodies keeps us warm (thermal regulations), protects us from sickness, and houses beautiful artwork when we collect tattoos. While most of the skin covering our bodies is uniform, some areas have a much different composition.
Here is a shortlist of places to look for when comparing skin composition:
- The backs of your hands or the tops of your feet have very little fat (adipose tissue) and fewer connective tissues than less mobile areas of the body.
- The palms of your hands and soles of your feet have thicker skin (callouses) and more sensory nerves than other parts of the body.
- Places near mobile parts of your body (joints) have fewer or less dense connective tissues and feel thinner than other spots.
- The skin on your scalp has lots of hair follicles and feels thicker than other spots of the body.
- Armpits and the genital area have very thin feeling skin with hair follicles that produce thicker/longer hair than other body parts.
These differences make the process of tattooing more difficult for those who haven’t been trained in dealing with different types of skin. Focusing on just the hands and feet, how does their skin composition influence design?
For tattoo artists out there, you need to ask yourself, “How can I accurately assess the area for people who want their hands/feet tattooed?”.
To start the breakdown, we should look at the skin through our imaginary microscope and see how it is constructed. Pay attention to the average thickness of each layer and think about how that will influence hand speed, pressure, and stretching when giving/receiving a tattoo.
- Epidermis – about 0.1 mm in thickness.
- Waterproofing and barrier for the body. Made up of basal cells and keratinocytes.
- Keratinocytes – a bunch of different proteins, enzymes, lipids, and defense peptides that protect the body. They absorb water and don’t divide as normal cells do after being “selected” during a maturation stage. (more information found by following this link)
- Basal Cells – Keratinocytes found in the basal layer of the epidermis.
- Waterproofing and barrier for the body. Made up of basal cells and keratinocytes.
- Dermis – on average about 2 mm in thickness
- The living part of your skin supplies all the cells for the epidermis. It also contains vascular bodies, structural cells that give skin its physical properties, immune cells, and specific fat cells called adipocytes.
- Subcutaneous tissues – anywhere from 2 mm in thickness up to greater than 18 mm (> 18 mm)
- This is fat. The subcutaneous tissues give structure like your dermis but are made up of loose connective tissues to underlying structures. It’s like the dermis but is like…loose.
Here is a table that breaks down the layers in a more scientific way –
|Skin Layer||Structure||Role in Viscoelasticity|
|Stratum corneum—the outermost layer of epidermis structure||Structure of up to 25–30 rows of corneocytes; includes fibrous keratin; “brick and mortar” arrangement, in conjunction with other stratified layers in the epidermis, increases tensile strength (resistance to longitudinal stress), and resistance to damage (Micali, Lacarrubba, Bongu, & West, 2001)
Water content is 15–30% (Johnsen, Haugsnes, Martinsen, & Grimnes, 2010).
|Supports pliability (ease in a change of shape from baseline)
Promotes strength, elastic behavior, and resistance to loss of skin integrity with movement, stretching, and application of force basement
|Basement membrane zone (BMZ)||Collection of three cell layers between the epidermis and the dermis (lamina lucida, lamina densa, and lamina propria; Bruckner-Tuderman & Stanley, 2007; Chan, 1997); comprised of proteins (primarily laminins, proteoglycans, and types IV and VII collagens; Chan, 1997)
Desmosomes (cells responsible for adhesion) serve as binding cells between basal layer of skin and upper lamina lucida (Bruckner-Tuderman & Stanley, 2007; Chan, 1997)
Anchoring fibrils and a matrix of fibers at varying stages of maturity connect thicker lamina densa layer to the upper layer of dermis (Barland, Zettersten, Brown, Ye, Elias, & Ghadially, 2004; Chan, 1997)
BMZ semipermeable to water; limits water passage to maintain skin hydration and support viscoelasticity
|Lamina layers extremely flexible due to construction of multiple-microfibrillar subdensa and protein-based supra-lamina desmosomes (Bruckner-Tuderman & Stanley, 2007; Chan, 1997)
Supports epidermis and provides strong adhesion between the epidermal and dermal layers to protect against shearing forces (Chu, 2007); when force applied on parallel plane to skin, it has a viscoelastic response of expanding and then contracting fiber matrix and associated fluids
Serves as an anchor to surrounding layers; disruption of BMZ leads to amorphous structure within epidermis and dermis causing skin structure breakage and reduced viscoelastic response
|Dermis—layer between the epidermis and subcutaneous tissues||Within papillary region (uppermost layer of dermis), a networking of thin elastin protein fibers (oxytalan fibers and the elaunin fibers cross-linked via desmosomes) is in loose matrix with procollagen (a precursor to collagen that originates within ground substance) and ground substance (Chu, 2007; Haake et al., 2001; Schafer, Pandy, Ferguson, & Davis, 1985; Uitto, Chu, Gallo, & Eisen, 2007)
Reticular region (below papillary region and above hypodermis) is comprised of ground substance and a thicker mesh of collagen fibers wound among thicker elastic fibers assembled from elastin and microfibrils (Haake et al., 2001; Schafer et al., 1985; Uitto et al., 2007)
|With force, elastin molecules stretch in linear pattern, cross links maintain structure; quick elastic reaction provides immediate response to force, followed by slower viscous response and then full return to baseline
Elastic fibers are thinner in papillary region and used for quick response but break more easily; elastic fibers in reticular region thicker, more bundled with collagen, and provide slower, viscoelastic behavior and greater tensile strength (Uitto et al., 2007; Wysocki, 1999)
|Hypodermis—innermost and thickest layer of skin; connects dermis to bone or connective tissue||Adipose tissue is present in the hypodermis, but thickness of this layer may vary (Agache, 2006; Agache & Diridollou, 2006; Tortora & Grabowski, 1993)||Thickness of adipose deposits maintains shape of skin, protects it from underlying (bony) structures, and is positively correlated with skin strength and elasticity (Agache & Varchon, 2004; Smalls et al., 2006); positive and protective effects may negated in obesity (Yosipovitch, DeVore, and Dawn (2007)
Problems with obesity include impaired skin barrier repair, decreased lymphatic flow, decreased strength of collagen structures, impaired circulation, decreased wound healing, and skin disorders that change the structure and impair the function of the skin (Yosipovitch, DeVore, & Dawn, 2007)
Borrowed from source: Everett, J. S., & Sommers, M. S. (2013). Skin viscoelasticity: physiologic mechanisms, measurement issues, and application to nursing science. Biological research for nursing, 15(3), 338–346. doi:10.1177/1099800411434151
Let’s move on with a look at the subcutaneous tissues, how this layer of skin influences hand and foot tattoos, and why this layer of skin is so thin on your hands.
Subcutaneous Tissues of the Hand and Foot – How They Affect Hand and Foot Tattoos.
The back of your hands and the tops of the feet feel thin to the touch and have little connective tissue. This aspect of the body allows more movement of the underlying structures. It allows our hands and feet to take us through the world and interact with our environment.
The back of your hands looks like crêpe paper stretched over a turkey skeleton. There is little to no fat on the hands or feet of most people, and, as anyone who has had their hands tattooed, the shock and vibrations you get from a tattoo make the hands hurt a lot. Tattoos tend to blow out, heal hard, and take more of a beating through your typical day compared to other parts of the body.
All over your body, the fatty layer (also known as the hypodermis or subcutaneous layer) exists to absorb blows and gives easy-access pathways for blood vessels to connect through your body. It also stores/releases energy, insulates your body, and connects the tissue (skin) to the underlying fascia, which connects the skin to muscles, tendons and other stuff.
One additional part of this fantastic part of the skin is that it contains fibroblasts and macrophages, which migrate up from the lower layers of your skin. They are responsible for making the tattoo permanent.
More information on how tattoos heal and what are the most painful spot can be found in our article:
Fancy scientific mechanisms aside, the fatty tissues under the epidermis/dermis keep the skin supple. Those same tissues help absorb some of the force emitted by the tattoo machine. The subcutaneous tissues also help smooth out the dermis when you pull a stretch, making the layers under the epidermis and dermis more consistent thickness -wise.
Place a dish outside on a concrete slab and hit it with a hammer… what happens? It explodes!
Hand and foot tattoos for thick skin – Yes, everyone has thick skin
This may seem like a weird idea that we all have thick skin, but, in essence, we do. That thick skin is on the palms of our hands and soles of our feet. It’s there because we need additional protection from our environment with the feelers that we utilize to interact with our world.
Our hands and feet are what we use to interact with our environment. It gets us to work and allows us to do the jobs we choose to do. Our feet go through an immense amount of stress every day. Each step you take is an opera of stress distribution and pressure. With what speed you are going, your weight is absorbed by a complex network of bones, muscles, connective tissues, and a bunch of magic! (not really) Those stressors increase the pressures to a value that can be multiple factors higher than what your physical weight is.
Why are the fatty parts so important for tattooing?
The fat helps create a less volatile surface for you to tattoo. The needles that are being driven by a tattoo machine will have a little cushion when they strike the bottom of the machine stroke. This is supremely important as the cushion not only helps the client feel less pain (initially) but also enables the skin to settle evenly when stretched.
What’s that you say? Stretching is influenced by the amount of fatty tissue underlying the skin?!
It’s super important to get the stretch down right!
(Upcoming article on stretching will be linked HERE when it is completed)
Subcutaneous Layer – Skin on the hands and feet
The subcutaneous layer (SubQ or fatty layer, like stated before) that all but missing in the hands and feet make things difficult to tattoo but serve a function that is unique to these parts of the body.
Due to the lack of fatty tissue, there is less connection to the underlying structures in the hands and feet. This makes it easy for the fingers and feet to bend and move with less restriction, but it also has an effect when getting the hands and feet tattooed.
Yes, your magnificent biceps can take a tattoo and look amazing when oiled up! Could you imagine how it would feel if the skin on your hands were attached to the muscles the same way your arms or thighs? That would be weird and restrictive.
Walking or grasping something would become very difficult, in the beginning, but as your muscles developed those movements would be even further restricted. Larger muscles needed to move the restricted joints would cramp the area that they occupy. The idea of manual dexterity would be much different if we lost the ability to manipulate our appendages as easily as we do.
Next up on the block for tattooing hands and feet is the uppermost layer of your skin, the horny layer.
The Horny Layer – Not what you think
Another aspect that is unique to the hands and feet on a body is the excessively developed horny layer of skin. No, your hands don’t want to get down ya dirty, or maybe they do? The horney layer is another name for the uppermost layer of your epidermis, the stratum corneum.
The stratum corneum (which will be called the horney layer from here out because…I am a teenager at heart) is made up of all those dead skin cells that are slowly sloughing off when new ones are made. The skin all over your body is always dying but there is a greater sloughing that happens on your hands and feet because they are constantly in use.
One other aspect of these areas on your body is an additional layer of skin called the stratum lucidum.
Ahhhh, the circle of life!
The upper most layer of skin is comprised of mostly dead cells, they had to get there somehow. These dying or dead cells are migrated up through the skin by newly formed cells further down and once they reach the top, they fall off.
Working our way into the skin and looking at something that is totally unique to these body parts we end up at the stratum lucidum. It is located between your epidermis and dermis on the hands and feet. It’s a collection of specialized cells that give your hands and feet a waterproof, protective layer. Much like a rain slicker in inclement weather, this layer adds additional protection to these parts of your body and help to keep pathogens out of the parts of your body that interact with your world.
You may have noticed this specialized layer of skin if, like me, you have gone for a long walk and come home to some swollen, soaked socks. You can also see this layer in action when you take a nice hot bath and get all pruned!
The keratin cells in your hands absorb water and swell, but only the dead/dying layers on your hands above the stratum lucidum! neat eh! This specialized layer is great at protecting your most precious digits and, to be honest, aren’t we glad that our backs don’t wrinkle like that in the tub!
Next, onto the dermis!
The dermis is the target for permanence in tattooing.
Ok. This article has become more about the skin rather than focusing on tattooing. I understand if you need to go but, I promise, after this section we will move onto the real meat and potatoes you came for!
The dermis is what lies between the epidermis and the subcutaneous tissues of the skin. It is mostly made up of collagen and elastin. These two proteins are what gives your skin it’s resilience. Your nerves, blood vessels, lymph vessels and sweat glands are also crammed into this space!
We are not ignoring the blood and lymph vessels, which help with thermoregulation and supply oxygen and nutrients to surrounding cells. We are moving past them to talk about more specialized cells that have a hand in healing your tattoo.
The Immune Functions That Make Your Tattoo Permanent.
Another type of cell that makes up the dermis is a mast cell. These specialized cells are a part of the inflammatory response that helps the body deal with intruders (infectious materials like viruses or other things that shouldn’t be there). I’ll leave you a link that explains it all in a much better fashion than I can.
Why is the dermis important?
The dermis is where the pigment stays and becomes “permanent”. Your epidermis is constantly sloughing off and is composed of dead/dying cells (mostly keratinocytes). These cells that are being pushed out are not capable of “holding” pigment. The pigment holding cells are the macrophages that are summoned up from the lower layers of the dermis.
These specialized cells deal with infections and foreign particles (like ink). The macrophages consume/engulf the pigment particles that have been injected into the skin and hold it in place. These cells, like all others in our bodies, slowly die off and dump their contents (tattoo pigment) back into the skin before being transferred up to be sloughed off.
What happens to the pigment when that occurs, you ask?
The body sends more macrophages in response the released foreign particle. The newly formed macrophages come forth, engulf the pigment and lay in wait until they meet their inevitable end.
This process continues during your livable existence and ensure that your tattoo is going to last a lifetime.
Things to Focus on When Doing Hand and Foot Tattoos
- With a layer of subcutaneous tissue that is less evident, the body can experience greater trauma when being tattooed. Higher degree of trauma = lower chance of healing cleanly. Utilizing good hand motions, proper stretching, and proper machine speed is recommended when tattooing hands or feet.
- Lower levels of subcutaneous tissue create a more difficult stretch. This in turn creates a more uneven dermal layer for your tattoo needles to insert pigment into. Being uneven makes it nearly impossible to place the pigment consistently in the skin. It shows an even tone and doesn’t “blow out”.
(A blow out is where the pigment is placed in a way that causes it to spread in an unpredictable way under the skin. The pigment placed into the body can roll along the capillary pathways, along soft spots of less dense skin or be carried into less dense areas by the inflammatory/immune response that occurs during a tattoo.)
- Higher levels of stress from normal daily use increase the amount of shedding that needs to occur as more cells are destroyed from use. This means that the tissues you have to pierce through are going to be more likely to repel water-based pigments – think of the stratum lucidum – and other foreign particles. You need to trick the immune system into being ready to accept the particles by prepping the skin appropriately before tattooing starts, and before every needle stick is done.
- Being nearly in use constantly, the environmental stresses are greater than other parts of the body. An increase in healing time is going to occur just due to that increased use. This can be exacerbated by the fact that the hands and feet are the furthest point from the center of your circulatory system (heart) but is mitigated due the construction of the skin making semi-selected immune cells readily available in the hands and feet.
- The thicker horny layer creates a longer pathway for ink and needles to travel. this travel will dislodge pigment at different depths that can create an illusion of a well-done tattoo. When the tattoo heals, and the misplaced pigment is shed (not absorbed) the finished product could be much lighter than anticipated.
How can we tell who would be a best candidate for a hand or foot tattoo?
This one is simple. You do a consult and touch their hands/feet after washing your hands and putting on a set of gloves. Look at the skin, ask questions, and get to understand what the skin you will be working with is like.
Is it thin looking? If so, you will need to adjust your machine speed to ensure quality injection of pigment. Does the person have hairy feet like a hobbit? They will probably feel tons more pain than the average-hairy person.
Give the skin a little push and pull. Does it feel tight or strongly attached to the underlying structure? If it does, there is a better chance that the subcutaneous layer is thicker than average and should be easier to tattoo. If the skin is very loose, there is a better chance that the tattoo will fall out or blow out if your needle depth is not set shallow and run on a slower machine setting.
This really comes down to thinking critically, jumping at the opportunity to explain why you are doing what you are doing, and creating a hypothesis about how to best tattoo the client you are working with.
This is advanced tech and theory for tattooing and most tattoo artists out there don’t need to understand this to do a good tattoo. I can attest to the understanding helping decrease trauma levels in hand tattoos and increase the ability to retain, over longer timespans, a cleaner looking tattoo if an artist does grasp some aspect of this.
Thanks for reading.