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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.The report analyzes the literature about societal acceptance of people with body modifications and perceptions that might potentially interfere with adolescents’ and young adults’ educational and career plans.Finally, guidance is provided to pediatricians and, through the pediatrician, to parents and adolescents and young adults about safety and regulations regarding body modification should they wish to obtain tattoos, piercings, or scarification.Although interest in body modification has increased recently, history teaches us that body modifications are not new.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.Surveys of the US population have shown an increase in the prevalence of tattoos over time.

Individuals who hurt themselves report injuries to many different body parts.Tattoos, piercings, and scarification, also known as “body modifications,” are commonly obtained by adolescents and young adults.Previous reports on those who obtain tattoos, piercings, and scarification have focused mainly on high-risk populations, including at-risk adolescents.In a retrospective analysis from 2007 to 2008, tattoos were associated with alcohol and drug use, violence and weapons carrying, sexual activity, eating disorders, and suicide.As with any adolescent or young adult, for those with piercings and tattoos, it is advised that the pediatrician conduct a careful adolescent psychosocial history with targeted behavioral interventions to assist in decreasing risk behaviors.

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