Tattoo Pain Chart: Which Areas Hurt the Most?

Tattoos have been a popular body art since ancient times. People also use tattoos as permanent make-up; for example, cosmetic tattooing of eyebrows and eyelashes. In recent times, post-surgical medical tattooing has gained acceptance. For instance, after breast cancer surgeries, tattoos are used to reconstruct the nipple-areola complex. Some patients have tattoos around their post-operative scars or trauma wounds. In countries such as Korea, Japan, and Italy, medical facilities offer tattooing as an in-clinic service to patients.

In the U.S., some clinics have followed the trend. Patients commonly ask questions about tattoo pain, i.e., the pain during and after the tattoo. Here, we discuss painful tattoo spots, underlying physiological reasons for the pain, and ways to reduce tattoo pain.

Visual tattoo pain chart by body parts

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Individual pain perception is different for different parts of the body. Tattoo artists or tattoo clinicians show their clients (patients) visual tattoo pain charts to understand the most painful and least painful tattoo spots so people can make an informed decision about the location.

Pain is a complex sensation that is influenced by a variety of factors, such as age, sex, and cognitive factors. Generally, in individuals assigned female at birth, lower pain thresholds may be observed, as some evidence suggests the influence and phase of their menstrual cycle. Hence, some tattoo artists use separate charts for physiological characteristics. However, further research regarding tattoo pain is necessary to validate these distinctions. Based on a survey of tattoo artists and their clients, a research study has developed a chart applicable to all individuals.

Tattoo pain chart applicable to all individuals

Most painful tattoo spots

In a study related to virtual reality and tattooing, patients have reported experiencing more pain in the areas with more nerve endings (e.g., the genital region). Additionally, a study participant reported that areas that lack muscle or fat and are closer to the bone hurt more. When possible, avoid these sensitive skin regions to minimize tattoo discomfort. Here are a few spots that are considered the most painful:

  • Face
  • Elbows
  • Wrists
  • Palms
  • Chest
  • Abdomen

The study had a relatively small sample size, and further studies are necessary to confirm these results. Since the chest and abdomen are considered painful spots, post-surgical tattooing is often done as an in-clinic service with local analgesic medication, as necessary.

Least painful tattoo spots

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Often, people prefer to have tattoos on the least painful spots. These areas are usually covered with muscles and fat and also have fewer nerve endings. Here are a few spots that are considered the least painful:

  • Upper back
  • Lower back
  • Shoulders
  • Upper arms
  • Forearms
  • Thighs

Apart from these, calves, ankles, and feet have moderate pain sensitivity; hence, people often have tattoos on these spots.

Understanding tattoo pain

Most research studies have examined self-reported intensity of tattoo pain. However, anecdotal evidence suggests that clients report different types of pain during tattooing, e.g., sharp, burning, and itchy sensations.

Factors influencing tattoo pain

Here are a few factors based on research studies related to tattoo pain:

  • Tattoo application device. While most artists use a ‘tattoo gun,modern tattooing devices focus on making tattoo procedures more comfortable for patients.
  • Tattoo artist. A skilled tattoo artist can make the procedure less painful by being gentle. 'Heavy-handed' tattoo artists may press tattoo guns to the skin, accidentally inflicting pain on their clients. A skilled tattoo artist monitors pain levels and suggests breaks when necessary.
  • Physiological differences. As mentioned previously, individuals assigned female at birth report more pain compared to individuals assigned male at birth. Some previous evidence suggests that right before the menstrual cycle (the luteal phase), individuals assigned female at birth report more pain. However, there is no consensus about this finding and more research is necessary to understand the exact role of the phase of the menstrual cycle.
  • Mental attitude. Some patients report a lack of pain during the tattooing process. This phenomenon could be attributed to the acceptance of pain as a part of the tattooing process. Additionally, if people have experienced intense pain previously, they have a higher pain tolerance.
  • Environment. People report increased pain threshold when in a pleasurable environment, e.g., tattoos done at a party vs. tattoos done at a neutral setting, such as a tattoo parlor.

How to minimize tattoo pain

Although tattoo pain is common, a few pain management techniques can help. Here are a few tips for your next tattoo appointment:

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  • Consultation. Talk to your doctor or tattoo artist before the tattoo session. Along with tattoo design, discuss your options for pain management before and after tattooing. Plan intermittent breaks after every 45 minutes or so during a long tattoo session.
  • Breathing exercise. Deep breathing exercises may help reduce tattoo pain. Focusing on your breathing takes away attention from painful spots.
  • Music. Favorite music tracks can help in alleviating pain during tattoo sessions.
  • Media/VR. Some people prefer watching a film or a TV show, while some use virtual reality glasses and immerse themselves in a different setting.

Tattoo aftercare

Most tattoos do not need post-tattoo medication, and there are no specific generalized recommendations for tattoo aftercare in the U.S. Tattoo healing happens over 2–3 weeks. However, if a skin reaction occurs, your doctor may prescribe a tattoo aftercare ointment or moisturizer. This is usually applied 2–3 times a day for up to 28 days. Additionally, doctors may recommend medications if any problems arise in the healing process.

Tattoos are becoming a part of post-surgical scar management. People experience tattoo pain during tattooing and several days later. Tattoo pain can be sharp and is described as a burning or itchy sensation, but it can be minimized by breathing exercises, music, and media/VR usage. For post-tattoo care, ointments and medications may be necessary. Talk to your doctor or tattoo artist about care details before you get your next tattoo.

FAQ

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