All professions have their currencies and for me as a family doctor this is probably bare flesh - acres and acres of the stuff. As a result, I have long been accustomed to seeing what people do to their bodies in the name of fashion, art, rebellion or drunkenness and over the years I have taken a passing interest in body adornment, witnessing a dramatic rise in the incidence of all types of body art but especially tattoos.

At one time the vast majority of tattoos I saw were amateurish, monochromatic, and usually meant the owner had either been in the regular forces or the merchant navy. These had faded over the years to become illegible, and were hardly noticed by their owners. However, as professional tattooists grew in number, the colour and variety of tattoos increased accordingly, and the number of women sporting them became more noticeable.

Basically, tattoos are collections of pigment pushed deep into the dermis of the skin, which are held there permanently by a wall of collagen-based scar tissue. These range from the tiny flowers or patterns seen on women’s shoulders, ankles or thighs to people who only have their face, hands and feet free of tattoos. (The most memorable I have seen was a full picture of a fox- hunt down someone’s back, with the fox disappearing into an unusual place for safety.) Henna has recently become popular with people who want a ‘temporary’ tattoo but even here I have seen patients with severe local allergic reactions to this and who have ended up being scarred. There have also been many instances where deep pigmentation has occurred where the henna has been applied and so occasionally I see patients who have a permanent mark as a result of henna tattooing.

Apart from the possible risks of blood-borne infection during tattooing – especially hepatitis - I mainly deal with people who want to get rid of their body art, either because they no longer like it or they have got older and it just looks silly. I have seen horrific scars caused by people trying to remove them themselves, and the only way to have any chance of removal is with laser treatment. This is normally only available at private clinics, can be very expensive, and certain pigments may not respond to it. Scarring can occur and it may take up to 8 weeks for treated areas to lose their inflammation and whatever laser is used, a ‘ghost’ of the tattoo always remains. Unfortunately, techniques in tattoo removal have not really moved on in the last decade and any technique - such as surgery, laser or dermabrasion – will cause scarring to some degree. There simply is no way you can ever get tattooed skin looking pristine again despite what anyone may say.

It is not only tattoos that can cause problems. Body piercing is unquestionably fashionable at the moment, and there can be no part of the body - male or female - that I have not seen pierced. However, the risks of infection and blood loss should be considered before pieces of metal are pushed into places they are not meant to go!

I have recently seen a lot of infections that have occurred as a result of a body piercing and these can range from simple earlobe infections (sometimes in children as young as 3 or 4) to very nasty genital abscesses that can cause long-term problems and misery and regret on the part of the patient.

We can also now add the bizarre practice of branding to tattooing and body piercing and this seems to have been imported from America. It is exactly as it sounds - a design is branded onto the skin, just as in branding cattle. This is highly dangerous, can produce terrible scarring , and should be avoided completely .

Body adornment is as individual as people are, but will that interesting Japanese quotation (which you think means something mystical but which actually says something quite different!) or full-length Elvis look quite as fetching on you when you are 60?

Not from where I’m sitting they don’t. Think twice.