Did you know about one out of
every three people have a tattoo? That number can go over 40 percent if you just
take into consideration the younger generations! I think it's important that we use real
human skin to go over the anatomy of tattoos, or in other words how tattoos work, what
layer does the ink specifically go into, and why doesn't our body
try to get rid of the ink? It's technically a foreign substance... Also what (do) we mean [that]
tattoos are permanent, because certain things can cause
tattoos to fade with time. Obviously we have some questions to answer. So, let's do this! If we're going to talk about
how tattoos work we definitely need to have a basic understanding of the skin. The skin belongs to a system called the
Integumentary System, or just the Integument. It's comprised of three main layers. From top to botto — or superficial to
deep — starting with the Epidermis, then the Dermis, and then the Hypodermis,
also known as the Subcutaneous Layer. We are definitely going to take a look at
all three of these layers on real human skin but, I have to mention something important about these layers as it pertains to
tattooing and ink deposition. Each one of these layers, the
Epidermis, Dermis, and Hypodermis is made out of a completely different
tissue when you compare it to the other. In other words the Epidermis is made out of
a totally different tissue than the Dermis, and the Dermis is made out of a totally
different tissue than the Hypodermis.
Why is that important? Because, the nature of the tissue will definitely
influence how ink is deposited in that layer, how permanent the ink is in that layer,
and even just how the tattoo works. In other words, it influences how the ink
is going to behave in each individual layer. Let's start with that Epidermis. Here we've got two skin grafts. Let's start with this one. This outer layer here is the actual Epidermis. I always find it interesting when
we bring the Esthetic students in here — they always notice the
freckles and the sun damage here.
But, this Epidermis, if I show you the cut
edge is just that top paper-thin layer there. The majority of the tissue you see
here is actually the dermal tissue. Just that top paper thin edge is the Epidermis, which is pretty remarkable because
it can be up to 50 cell layers thick. The Epidermis is your protective layer, and it's
made out of a tissue called Epithelial tissue. Epithelial tissue is a highly cellular tissue. What I mean by that is that the cells are just
packed together and stacked on top of each other. Like I mentioned earlier, it can be up to 50
cell layers thick and sometimes more, but to the naked eye that's only about .1 millimeters,
so, relatively thin from our perspective. But these cells that are at the
bottom of the Epidermis or this Epithelial tissue that makes up
the Epidermis, copy themselves. So, when one cell copies itself,
one of the copies goes on top. Guess what happens next? It makes another copy, and the cell
that was right here gets pushed up and the new copy comes underneath it. That continues to happen, and cells move upward. As the cells move upward closer to the surface
they start to flatten out and die because they get pushed further from the blood supply.
We don't care about that because those dead flat cells give us a nice protective
barrier from friction and abrasion. That's what I'm doing here
— not itching my skin here, but, it protects us from
that friction and abrasion. That process just continues on every single day. Now as the cells move up, eventually
they're going to get to the very top and flake off you can shed
over a million cells per day. You can think that's disgusting, but
it's anatomy, so it technically is under the classification of being "awesome."
Now think about how that influences
tattoo and ink deposition. This wouldn't be a great layer to tattoo or put
ink into, but the reality is some of the ink as it is being injected into the skin does get deposited
into this layer, and therefore some of the cells. Because those cells are moving upward, eventually
any ink that's in there is going to flake off. It takes around four weeks or so from a cell
for a cell to get from the bottom to the top. So, any of the ink that
does get deposited in there you can see it pretty much scattered
throughout your house to have to dust. So the next layer down is extremely
important to tattooing and ink deposition. As we mentioned earlier
this was called the Dermis. Let's take a look again at the cadaver dissection. Remember the majority of this
cut edge here was the Dermis, or the Dermal tissue where that
paper thin top was the Epidermis. The Epidermis is again made of Epithelial
tissue, but the Dermis or this Dermal tissue is made out of a totally different tissue
called Dense Irregular Connective Tissue. It's the nature of this Dense Irregular Connective
Tissue that allows ink to be deposited and, for it to last many, many years or
what we would think of as permanent. For us to more fully appreciate how the ink
can be permanent or relatively permanent in this layer, we're going to zoom in
to this cut edge of the Dermis here like on a little "Magic School Bus"
ride by zooming in to the model. So this would be that same cut
edge here and to orient you. This would be the Epidermal
layer here, or the Epidermis. From my thumb to my pointer
down here would be the Dermis. Now (these are) very different tissues
— the Epidermis and the Dermis. Remember this had tons of cells packed together. (In) the Dermis we wouldn't see that. We see only a few cells scattered throughout
the spaces between all these other structures and those cells are important because they
are called Fibrocytes and they produce a protein fiber called Collagen, one of the
most abundant proteins in the human body.
Now the model is actually trying
to show you, if we zoom into it the fiber orientation of the Collagen
you can see some lines going this way, some other lines in between the other
spaces going in other directions. That is why the tissue or the
Dermis is referred to as a Dense Irregular Connective Tissue because the
Collagen fibers are going in all directions which we'll talk about the
interaction with ink here soon. But, because the Collagen is going
in all directions it gives skin its strength to be tugged on in every which
way, or in other words — all directions. Now the skin is not just made up
of — or I should say specifically the Dermis — is not just made
up of Fibrocytes and Collagen. As you can see from the skin model, there are
a whole bunch of other structures in here. We've got sweat glands, blood
vessels coming through here, nerve endings, and even hair follicles
that have pushed down from the Epidermis. So again, how does this anatomical knowledge help
us understand how tattoos work in this layer? Ink is being deposited into the Dermal layer, and a lot of that ink is going to get
suspended in that collagen matrix, and some of it will be even taken up by those
Fibrocytes or those cells I mentioned earlier. That's not the only thing that's going on here. You see during tattooing, a needle is puncturing
the skin at anywhere from fifty to three thousand times per minute that's creating trauma as well
as injecting a foreign substance into the skin. Now usually when our body deals with trauma,
or a foreign substance gets introduced, our immune system has something to say about that
and the inflammatory process gets activated.
Now we could do a whole video just
on the process of inflammation. One of the main take-home points for us is
that inflammation is getting white blood cells to the site of injury, infection,
or to deal with foreign substances. That's what happens during the tattoo process. White blood cells get called to the
area, they'll leave these blood vessels, and then go roam through the tissue which
is a really interesting thing because, these cells — specifically these white blood cells
called Macrophages — are these little engulfers. In other words they engulf or take up
foreign substances that could be viruses, that could be bacteria, dead tissue, and debris. But in this case, they start
trying to engulf the ink. Now that engulfment process is a
technical term called Phagocytosis. Typically once a white blood cell Phagocytozes, or, engulfs something it starts
to break it down and digest it.
However, it's used to breaking down
and digesting biological substances. Ink can include dye, plastics, and even
solids that our immune system or our white blood cells are not really equipped
to break down very well or digest. So what's the solution? We think with some of the research that's leading
to this, is instead of being able to break it down because they can't, it's more like, "let's
isolate it and contain it and not let this ink go to other areas of the body."
That's pretty crazy to think about! Those white blood cells getting
some of that ink from the collagen. They'll even engulf some of the dead
Fibrocytes, and that ink stays in them. You can see that through the surface of the skin. The idea is that those white blood
cells just kind of stay put there. If you're like me you're
kind of thinking, "you know, white blood cells don't last a person's
lifetime... so how is that staying there for the majority of this tattoo, or
for the length of a person's life?" Tattoos are relatively permanent. What they have started to find, is that
when the Macrophages that engulf the ink, when they die they release the
ink, and then guess what happens? A new macrophage comes in and engulfs that ink. It's almost like this engulf,
release, engulf, release... is a kind of cyclic process, that happens
to maintain the tattoo in that area. But remember I mentioned the whole idea — at
least the going theory — is we're going to just contain the ink here and it does
obviously a pretty good job because those of you who have tattoos or have seen people
with tattoos, you notice the tattoo doesn't move. But you do notice that it
sometimes fades with time. So there's a couple of going
theories with this one. It’s that as a Macrophage dies and releases
that ink the new incoming macrophage engulfs most of the ink and some
of the smaller broken down ink particles will get taken
away into the lymphatic vessels. We know that some of the ink
gets into the lymphatic system, because they've done biopsies on distant
lymph nodes and found tattoo ink in there. That is likely contributing to the
fading of tattooing over time.
Granted other things like UV light can
fade tattoos and break the ink down, but, that's one of the ideas of how these are
relatively permanent with some changes over time. Now one other thing I need to address —
some of you may be thinking "Jonathan sure has used the phrase foreign substance
multiple times throughout the video... Should I be worried about getting a tattoo or even
worried about the tattoo that I already have?"
No, not so much. We've used foreign objects or substances in
things like surgeries, knee replacements or metal rods, for preparation of major
fractures, or for support of those bones, even mesh for things like hernia repairs. Now that doesn't mean people haven't
had reactions to those substances or even reactions to tattoo ink but
the majority of people do just fine. The most important parts of getting a
tattoo are one, going to a reputable tattoo artist that uses precautions to help
mitigate risk of infection and reactions. As well as this other important concept when it
comes to getting a tattoo and that is aftercare. That's why I really love the sponsor
of this video called Saniderm Medical. They truly understand the importance of aftercare and even skin care prior to and
during the tattooing process. Like I said, I want to say
thank you to the sponsor of this video Saniderm for supporting this project. Saniderm brings you the best of the
best of skin and wound care products from sterile clear breathable wound bandages,
to dermal supplements, to replenishing lotions and balms and even invigorating
soaps — which I'm pretty excited about. Now while Saniderm is world renowned as a
dermal authority in the tattoo industry, they're bringing that expertise
well beyond the world of ink. They are now bringing the medical grade, uncompromised ingredients to the
masses for everyday skin care. Saniderm focuses on healing and
protecting the skin from the inside out and through all stages of life, and why not? We have to carry around this Integument, or the skin, through the entirety of our
life and frankly we're kind of mean to it. Sometimes we get sunburns, dirt, and
grime, abrasions, so we might as well protect it and help it heal with amazing
skin care products that Saniderm provides. If you go to saniderm.com and
type in the code "iohaskin" they're going to give you a 20% discount
code on your first initial purchase there. We'll put that link in the description, and while
you're down there you might as well comment, subscribe, and smash that like button. That takes care of the most important layer
when it comes to tattooing, the Dermis. However, we mentioned Epidermis, Dermis,
and the Hypodermis or Subcutaneous Layer. That Hypodermis or Subcutaneous Layer is
still important to some topics with tattooing, specifically a topic known as blowout
or when the tattoo lines start to blur. Let's dive into that. So again let's go back to our skin dissection
here and here was the Dermal edge here. I'm going to rotate it over and if you
look closely you can see some yellowy tissue especially down here on the bottom edge. That is the Hypodermis. The Hypodermis, again made out of a
different tissue than the two above, is made of Adipose Tissue or fatty tissue. If I go to the other dissection
you can see it even better. You can see all of that yellowy tissue is
the Hypodermis, and again fatty tissue. Now the nature of this tissue is kind
of more of an oily type of a tissue, and if ink gets down into that layer because of
the nature of the oily tissue it can kind of blur the lines — or it almost looks like it kind of
dissipates into the skin, a little bit more. Think of the interactions between oils
— which would be fats and other liquid substances — and you can kind of get that
idea of why it might start to blur the lines. Now there's another really important concept
to think about as far as why some areas are more at risk for blurring than others, and
that is a discussion of skin thickness. When we're talking about skin thickness, I love
to show these two cadaver dissections because this skin dissection, and this one right here
that I'll bring a little closer in a second, are from the same cadaver. Look at the thickness of the Dermis here. This is from the mid back of a cadaver, and then
I come to this, and you can see it's just so much more flimsy and that edge is mostly the Dermal
tissue from the same person or same cadaver. This came from the lower leg. Now I'm not a tattoo artist but
when I've talked to tattoo artists they talk about the idea of what
causes a blurred line or blowout.
That tends to deal with (how much
pressure) they push on the skin.
If you push harder, the idea is some of
that ink might get more likely pushed down into the Hypodermis, but it's also
influenced just on the region. You almost have more "give" — or more room
for error in the Dermis on the mid-back as opposed to say something on the lower
leg where the Dermal tissue is thinner. So it wouldn't take as much pressure to
get the ink down into the Hypodermis and potentially cause some of
that blurring or blow out. So now we've made it through all three
layers of the skin and gave us this idea about how important the nature of the tissue is
in influencing what happens with the tattoo ink. We know with the Epidermis, if anything gets in
those cells, it flakes off after about four weeks. The Dermis is where we want
all the majority of that ink. It's the most stable for permanence
and nice crisp artwork.
We now know the Hypodermis is more at
risk for bleeding out or blurring or that blowout because of the nature of the
adipose and that oily tissue underneath. Thanks for watching the video everyone!
Thank you again to Saniderm
for sponsoring this video. Remember, go to saniderm.com
and use the coupon code iohaskin to get 20% off some
amazing skin care products. We'll put the link in the description below as well as the associated information and
while you're down there go ahead like, leave a comment, and if you're feeling up
to it go ahead and subscribe to our channel. We'll see you in the next video.