Hot Tubs and Tattoos: When is it Safe to Get In?

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Pools and tubs come in many varieties. Some contain natural salts. Others contain chlorine. As a client recently receiving a tattoo, you are told you shouldn’t enter the water, but why is that a recommendation?

Tattoo Artists Claim Tattoos Disappear from Chlorine but Is That True?

Honestly, tattoo artists don’t know what will happen with tattoo pigment when it comes in contact with chlorinated water. There are assumptions and wild guesses. I have heard from tattoo artists over the years many crazy beliefs about what will happen. Anything from getting in a pool right after getting a tattoo will alter the pigment in a tattoo, to blacks can turn orange or green when exposed to chlorine. I have even heard that dogs licking your tattoo is suitable for aftercare.

The most common missing information in the tattoo artist’s tool chest is the increased chance of allergic reaction to certain pigments. Claims that reds can inflame and cause skin eruptions, or that blues/greens will turn darker and almost look black are nearly pervasive in the industry. Yet many people don’t understand the “why” or how it happens.

Tack onto that scholarly articles describing how tattoo pigment and chlorinated/saltwater pools interact are absent.

It is a mess.

Until there is sufficient science to explain this concern, clients will be forced to assume the worst when faced with fake horror stories. But we have a little information for you. We can give you the facts we know and leave the decision up to you.

 

Even If There Is a Lack of Knowledge, the Tattoo Artist Mean Well.

I cannot prove that the claims are accurate, but I can understand why these claims are made – pool chlorine is like household bleach, and bleach changes clothing colors. Perhaps there is an association between skin and clothing? While some of these assumptions can be taken as anecdotal (at best), what we do know is that there is an increased chance of obtaining a nasty infection if you choose to settle into a body of water after getting your tattoo. Whether the body of water is a hot tub, a pool, or the ocean, there is a greater chance that you will get an infection if you soak after getting that new tattoo. It kind of makes sense, right? These places aren’t ever immaculate, and you have a wound on your body. That wound is an opening that allows pathogens to enter, take hold, and make you sick.

The Goal of This Article

What we hope to answer in this article is what the recommended minimum safe time of healing a tattoo before getting in the water is, what possible infections can occur if you get into a body of water before the tattoo has reached the minimum safe healing time, and what to expect in healing a tattoo if a person decides to deviate from the recommended safe healing time.

For Those of You Who Hate to Read – Here is the Short Answer.

You are safe to soak in bodies of water after the tattoo has finished peeling, stops looking glossy, and appears to be healed. If it is not red, raised, bleeding, or oozing, has no scabs left on the skin surface, and feels like your average, natural skin, you are free to get back in the water. For those of you who want more knowledge, keep reading.

Chlorine, Hot Tubs, and Healing a Tattoo

Making a mark and introducing things into your skin starts a cascade effect on your body’s immune system. Specialized cells do their part by locking onto the foreign particles, identifying them as something disrupting their homeostatic state, and working to repair the damage and possible infectious load that is introduced. Adding to the stress experienced by a client’s naturally occurring healing process, the effects of chlorine as an irritant become more evident. Its role as a killer of unwanted pathogens is well documented, but chlorine’s role as an irritant is more critical. 

People use chlorinated products to clean and maintain hot tubs and pools but at a cost: The use of such products increases the occurrence of dermatitis and other inflammatory issues of the skin. These occurrences are widespread, if not ubiquitous, and maybe more exacerbated when going swimming after getting a new tattoo.

The role of your Skins Microbiome

Living on your skin are colonies of bacteria. They are a world of their own and in constant flux. Some are good for you (by keeping the bad ones in check). Others are bad for your health if they end up getting past your body’s defensive layer (your skin). Learn more about your skin and healing a tattoo by reading our article “Understanding Tattoo Pain and How Tattoos Heal”

A disrupted microbiome occurs when receiving a tattoo. The breaks in the skin give opportunistic pathogens a chance to infect a person. The breaks in the skin make it possible for these pathogens to take hold where they would otherwise not be able to.  This disruption to the layer of skin, the main organ that protects against outside infection, occurs when a tattoo artist implants pigment into the dermis of a client’s skin. The body must work to restore homeostasis and heal the break in the skin that occurs after being tattooed.

“Homeostasis is when everything is a state of equilibrium between the stuff in/on your body.”

The healing process is not atypical and follows a well-described path unless a person suffers from some underlying medical condition. We aren’t going to get too in-depth about the biological processes your body goes through to heal a tattoo in this article but, perhaps we will soon.

What is the Minimum Safe Healing Time for Your Tattoo?

There is no clear-cut answer for this, as every person heals at different speeds because every person’s body is different. The most direct answer to this question is, “When you are fully healed,” but no one wants to take that passive-aggressive tone when dealing with a reasonable question!

The first question in diagnosing a healed tattoo is: are there any visible scabs left on the tattoo?

Answer: If there are any visible scabs on the tattoo, it is not fully healed. 

So, rule #1– Once all of the scabs have fallen off; you are safe to go into a hot tub or go swimming. Take this at face value, though, because if you have been picking your scabs, creating newly opened areas of the skin that are prone to infection, getting in the water is a bad idea. This is usually why most aftercare regimes have the addendum of *don’t pick or scratch your tattoo*.

Coming up with a second question becomes more difficult. If the tattoo has no scabs and has been healed effectively by the client (by following prescribed aftercare instructions), there should not be any question that regular daily routines are safe to start again. What can be worrisome is if there is no scabbing on the tattooed area, yet redness and swelling have persisted for the heal duration.

So, a second question to ask is: If your tattoo is glossy, itchy, red, and swollen, can you get into a hot tub?

If your tattoo looks like the above image, you should not get in a hot tub.  When skin looks red, irritated, swollen, or is itchy, bruised, or sensitive to the touch, there may be other issues with the tattoo or underlying tissues. To be safe, talking to a physician for advice or waiting until everything feels normal (beyond looking normal) is the safest course to take.

Things to be Aware of When Healing Your Tattoo.

There is no one-size-fits-all healing program for tattoos. Regardless of what the artist or shop offers regarding safe healing times, all recipients of tattoos must listen to their bodies, have patience with the healing process, and be available to talk to licensed medical professionals when questions pop up. If there is any apprehension about the healing process, any clients should be willing to listen to second opinions. Clients should not be pressured into not going to the doctor for a second opinion. It is the job of the artists to ensure a quality, healthy experience for the client. If this includes a trip to the doc, then all parties involved should be aware and present for a (hopefully) positive outcome. Now that a few questions have been asked, the role of pathogens in hot tubs should be defined to understand better what is at risk when jumping the gun on hot tubs and healing.

Common Infectious Agents of Pools and Hot Tubs

Bacteria, Protozoa, Fungi, Viruses, and Hot Tubs

Regardless of how uncomfortable the water can be in a hot tub for a person, warm water is a perfect breeding ground for pathogens. The water temp of a hot tub can accelerate the growth of some pathogens! Some of the organisms found in the hot tub water are not a big worry to most humans with a new tattoo, but others can be hazardous. Here is a breakdown of what we could find lurking in hot tubs, including E. coli, shigella (which causes dysentery), campylobacter, and salmonella. 

• Bacteria are generally killed quickly by chlorine disinfectant inadequately maintained swimming pools at a concentration of 1 part per million. Still, in most cases, the evaporation or neutralization of chlorine starts as soon as supporting levels are achieved (this is why pool maintenance is an ongoing process, regardless of use). E. coli, for instance, will be inactivated in less than one minute if exposed to typical disinfectant concentrations but will take longer (if it is at all possible) at lower concentrations.
• Protozoa, such as cryptosporidium {Cryptosporidium is a microscopic parasite that causes the diarrheal disease cryptosporidiosis) is complicated to get rid of in pools, even with proper maintenance. Both the parasite and the disease are commonly known as “Crypto,” and many varieties of Crypto infect animals, some of which also infect humans. The parasite is protected by an outer shell that allows it to survive outside the body for long periods and makes it very tolerant to chlorine disinfection.
• Giardia is a protozoan that causes diarrhea. This germ is found in the fecal matter of a person or animal who has been infected. It has a tough outer shell that allows it to survive for up to 45 minutes, even in properly chlorinated pools.

Some of these pathogens are highly resistant to chlorine and can survive in typical chlorine concentrations for days. This is why people are told NEVER to ingest pool water! Some viruses thrive in warm water.

• hepatitis A transmitted via the fecal-oral route. If some poop gets in the water, someone can contract the virus. Hepatitis A virus is moderately resistant to chlorine and can take as long as 16 minutes to kill live viruses in pool/tub water.
• Norovirus gives you gastroenteritis (stomach flu). It can be transmitted with a low viral load and is resistant in hot tubs and pools treated with up to 10 ppm chlorine.

What does all of this mean to a person who wants to have a soak before their skin is fully healed? That the risk cannot outweigh the benefit of a relaxing soak.

What to Expect if you Jump the Gun and Get in a Hot Tub?

The risks are variable, and I cannot claim that you will or will not get sick. I can say that soaking your fresh tattoo will increase the healing time. You can get into the water faster and enjoy that therapeutic heat if you just wait! Well, now you must be asking what else can go wrong if I jump into the tub before my tattoo is healed. Here is a list for you:

The Heat from a Hot Tub Can Burn Your Wounded Skin.

Yes, that is right! Your skin is the organ that protects you from pathogens and regulates your body’s temperature. When the uppermost layer is damaged due to a tattoo, the underlying tissues become more susceptible to heat and cold. This opens the skin up to contact temperatures that may cause severe burns if left in contact with the hot water for too long.

Hot Tubs Can Transmit Pathogens

Like the article stated above, you can get an infection from the water of a hot tub. This potential of disease is increased when damaged skin comes into contact with contaminated water

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If you Get Lightheaded and Trip, You Can Damage Your Tattoo or Hurt Yourself.

A good trip and fall on any day are painful, but you will hate life even more if you scrape that new tattoo. Sitting in a hot tub widens the vascularization in your skin, increasing your heart rate and dropping your blood pressure. When this happens, some people can get lightheaded. If it is severe enough, passing out may occur, resulting in injury (or even death in extreme cases). That’s it for this article. Hopefully, it answered a few questions that were not fully explained. Until next time: Think before you ink… and soak!

The Extra Stuff.

We also have a YouTube channel that breaks down commonly asked tattoo questions. You can find it by following this link:

Better Tattooing YouTube Channel

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References

https://en.wikipedia.org/wiki/Vibrio#:~:text=Vibrio%20is%20a%20genus%20of,and%20do%20not%20form%20spores. https://www.cdc.gov/parasites/giardia/index.html#:~:text=Giardia%20is%20a%20microscopic%20parasite,from%20infected%20humans%20or%20animals. https://www.cdc.gov/parasites/crypto/index.html https://www.cdc.gov/healthywater/pdf/swimming/resources/giardia-factsheet.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352248/ https://www.karger.com/Article/Pdf/484899 ISAACS, T; NGWANYA, R M  and  LEHLOENYA, R J. Tattoos: A summary knowledge for the practicing clinician. SAMJ, S. Afr. med. j. [online]. 2018, vol.108, n.9 [cited  2020-07-30], pp.714-720. Available from: <http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742018001000013&lng=en&nrm=iso>. ISSN 2078-5135.  http://dx.doi.org/10.7196/samj.2018.v108i9.13231.