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Permanent tattoos are applied using a small electric machine with a needle bar that holds from one to 14 needles, each in its own tube. Tattoo needles are regulated by the FDA.

The tattooing machine operates like a mini-sewing machine: The needle bar moves up and down as it penetrates the superficial (epidermis) and middle layer (dermis) of the skin. The tattooist holds the machine steady while guiding it along the skin. The electric current is controlled by a foot switch.

The needles protrude only a couple of millimeters from the tubes, so they don't penetrate deep into the skin. Each needle has it own tube, which enables the needle bar shaft to operate smoothly without damaging the needles. A single needle is used to make fine, delicate lines. A row of needles is used for shading and denser lines.

The end of the needle tube is dipped in a small amount of ink. As the tattooist guides the machine - not the tube - over the skin, the needle moves up and down, puncturing the skin and depositing ink along the way. Excess ink, and the small amount of blood that oozes from the skin puncture, are continuously removed with absorbent tissues.

Before beginning a tattoo, the tattooist, wearing medical latex gloves, inspects the customer's skin to make sure there are no open cuts or scrapes. The skin is sprayed with an antiseptic and the hairs in the area are shaved (the tattooist should immediately dispose of razors in a special container).

The tattooist then makes a stencil transfer of the tattoo outline onto the skin, or draws the outline on the skin with a pen. A thin layer of ointment such as petroleum jelly is spread over the area to be tattooed.

Getting a tattoo can be painful. The severity of the pain depends on the site of the tattoo and the person's level of pain tolerance. Small tattoos (up to three inches) can generally be completed within an hour. Larger ones may take several hours or more, and may be done in more than one sitting.

Once the tattoo is completed, the area is washed with mild soap and water and covered with an antiseptic ointment. Customers are instructed to keep the area clean, leave it exposed to the air when possible, and apply a mild hand cream to keep the tattooed area moist until healing is complete (usually 7 - 10 days days). It is recommended to keep the tattoo moistened for 30 days to preserve the colors.

The tattoo should not be exposed to direct sunlight for at least two weeks to prevent sunburn or pigment changes. Sunscreen should be applied during subsequent sun exposure to prevent fading of pigments. Swimming in fresh, salt or chlorinated pool water is also discouraged during the first few weeks after the application of a tattoo to prevent the pigments from leaching out.