Agrello dlt Price Prediction

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IoTeX Price Prediction for 2030

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Legal

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Insights Feature

280, but by the end of 2022, the average Chainlink price is expected to be $14. That’s a percentage of your losses back to you every day. A third factor you’ll want to consider is the location of the pool servers. However, much of the coverage is focused on how poorly the crypto space is performing, with pundits throwing around terms like “crypto crash. CELO is a proof of stake PoS token used for transaction fees, governance participation and related activities. The more documentation you provide, the more currency you can buy on Coinmama. The general cryptocurrency market cap now stands at $1. What is Bitcoin Price Prediction 2023. This implies that this coin is a suitable asset and a new addition to your portfolio of coins for long term. Introduction to Stellar Lumens XLM: Cross Border Payments For The Unbanked Stellar Lumens is an altcoin cryptocurrency trading under the symbol. The EOS protocol also includes secure access and authentication, permissioned infrastructure, data hosting, and usage management tools. A significant spike in such transactions often exerts a direct impact on the price of the underlying digital asset and could result in an unfounded increase of market capitalization that gives investors who are monitoring the market a wrong idea about the genuine value of the cryptocurrency. The goal of the Ariva team is to create a global travel network that would allow tourists both to spend cryptocurrency — for example, on booking accommodation — and to receive rewards. The maximum price that we can get is $2.

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Category

When will Monero cost go down. They’re not cryptocurrencies on their own. Furthermore, now is the ideal time to make some price predictions. But, despite the complications and changing regulations on cryptocurrencies, there are plenty of interesting opportunities that may be worth diving into. Competitive odds are available across all sports and you can bet live and pre match. To be clear, these forecasts are not usually the most important factor in making a purchase choice. 10 within the first half of the year, and finish 2029 at $3. For this reason, the bullish price prediction of STEPN GMT in 2022 is $2. Our site uses a custom algorithm based on Deep Learning that helps our users to decide if FIO could be a bad portfolio addition for the future. Finder, or the author, may have holdings in the Algorand or any other cryptocurrency discussed. To trade perpetual contracts on the decentralized platform are not that different from platforms on a centralized exchange. 10 USD price level, as we could see Coti again trading at $0. So I paid the $250 loan back and got $380 profit in just 3 hours. Less than one year since its launch, V2 has facilitated over $135 billion in trading volumes, ranking as one of the largest cryptocurrency spot exchanges in the world. But if we experience similar explosive growth/adoption as Solana I think these are viable targets. Based on the Algorand prediction, the minimum price for the year might be $0. Loopring is a decentralized exchange protocol that enables the trading of ERC 20 tokens on the Ethereum blockchain. No one can, however, predict prices of cryptocurrencies with total certainty, thus it is crucial to understand that the following POWR price predictions serve merely as a suggestion of possible price development and are not intended to be used as investment advice. If we are to believe Walletinvestor prediction promises, then we can expect MBOX to be $27.

How to Choose the best online slot machines

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Abstract

Tattooing the skin as a means of personal expression is a ritualized practice that has been around for centuries across many different cultures. Accordingly, the symbolic meaning of tattoos has evolved over time and is highly individualized, from both the internal perspective of the wearer and the external perspective of an observer. Within modern Western societies through the 1970s, tattoos represented a cultural taboo, typically associated with those outside of the mainstream such as soldiers, incarcerated criminals, gang members, and others belonging to marginalized and counter-cultural groups. This paper aims to review the more recent epidemiology of tattoos in Western culture in order to establish that tattooing has become a mainstream phenomenon. We then review psychological and psychiatric aspects of tattoos, with a goal of revising outmoded stigmas about tattooing and helping clinicians working with tattooed patients to facilitate an exploration of the personal meaning of skin art and self-identity. We suggest that as a kind of augmentation of the physical exam, looking at and talking to patients about their tattoos can provide a valuable window into the psyche, informing clinical practice.

Core tip: Although traditionally associated with deviance and psychopathology in modern Western culture, tattoos have evolved into a mainstream phenomenon, especially among younger adults. While there are myriad motivations for obtaining a tattoo, most individuals seek tattoos as a means of personal expression that provides a potential window into the psyche that can be used to facilitate psychiatric treatment. By reviewing the literature on psychological and psychiatric aspects of tattooing, we suggest that tattoos should be viewed not as signs of pathology, but as opportunities to explore core aspects of self-identity that can be valuable in clinical work.

CASE STUDY

Mr. A is a 31-year-old Caucasian United States Army veteran with post-traumatic stress disorder (PTSD) based on military combat experiences while deployed to Iraq and Afghanistan. He is a divorced father of two, currently in law school, with overall high functioning despite significant life challenges. A tumultuous childhood, including neglect and trauma at the hands of his mother and within the foster care system, led to several suicide attempts as a pre-teen and one psychiatric hospitalization where he was diagnosed with intermittent explosive disorder, bipolar disorder, and obsessive compulsive disorder. While medication titration was attempted during that hospitalization, he was never followed consistently by mental health as a child or adolescent, nor did he take psychiatric medication. Despite these developmental barriers, Mr. A was considered a gifted child with an intellectual capacity well beyond his years and background. At the age of 31, he presented for treatment of PTSD with bilateral full arm tattoos along with visible tattoos on his hands, knuckles, and the back of his neck. Later, he revealed that most of his body was covered with tattoos.

Discussions in psychotherapy revealed that he started getting tattooed at the age of 11, when his father forced him to learn how to fight, subjecting him to physical beatings in order to prepare him for the violent realities of his neighborhood. His first tattoos declared affiliation with his ethnic background, depicting themes of racial affiliation and violence that reflected long-time engagement with racially-based groups for the purpose of enhancing survival on the dangerous streets of his childhood home and within the juvenile corrections system. Other tattoos, including women in bondage, wizards, and skulls, were described as “filler”, while others displaying religious symbols, weapons, references to Greek philosophy, and military themes seemed to be more personal. One tattoo referenced the names of fellow soldiers who were killed in action during the wars in Iraq and Afghanistan.

When asked about his motivation for joining the military he replied, “I needed to find a way to maintain masculinity without being a convict”. Although he claimed to have thrived within military culture, he often clashed with superiors when he felt disrespected. During deployments, he accumulated extensive combat experience where he expected to die. However, he ultimately completed his military service and after an initial period of instability that included intoxicated fighting and divorce, he obtained sobriety and decided to go to law school. At the time of enrolling in treatment, he was living with a long-time girlfriend while maintaining partial custody of two children from his previous marriage. As psychotherapy began, he demonstrated notable difficulty discussing his emotions and was resistant to the therapist’s attempts to delve further into past and current relationships and his symptoms of PTSD.

REVIEW METHODOLOGY

An online search of PubMed and PsycInfo databases was performed using the search terms “tattoos”, “tattooing”, “tattoo”, “skin art”, “epidemiology”, “stigma”, “psychiatric disorders”, “psychology”, “perception”, “self-perception”, “removal”, “depression”, “anxiety”, “self-harm”, “deviance”, “psychopathology”, “prison”, “military”, and “veterans”. Criteria for inclusion were original research involving human subjects, meta-analyses, reviews, published in the English language between January 1, 1990 and February 1, 2016 (with the exception of reference 7 which was included for historical purposes). The bibliographies of articles identified through electronic search were also reviewed for additional relevant publications including online resources such as the Harris Poll and military service regulations. Dissertations were excluded. Articles with a primary focus on dermatological/physical/physiological reactions to tattooing and tattoo removal or on diagnosis and treatment of the infectious sequelae of tattoos were excluded.

EPIDEMIOLOGY

Until recently, tattoos have represented a cultural taboo in modern Western societies, typically associated with those outside of the mainstream such as sailors, soldiers, incarcerated criminals, gang members, prostitutes, and others belonging to marginalized and counter-cultural groups[1,2]. Over the past two decades however, epidemiologic studies have demonstrated that tattooing has become more of a mainstream phenomenon, with decreasing associations with stigma.

A survey of 500 population-representative United States respondents age 18-50 years old performed in 2004 revealed that 24% (n = 120) had tattoos with an additional 21% reporting that they had considered obtaining one[3]. Overall, 65% of tattooed respondents reported obtaining their first tattoo by age 24, with women more likely than men to be > 30 years old when they obtained their first tattoo. Tattooed respondents mostly had their tattoos done within the United States (98%), usually in professional tattoo parlors (80%), with tattoos obtained via homemade tattooing devices or sewing needles more likely to have been obtained at < 18 years of age. No tattooed respondents ever had a tattoo removed. Very few tattooed respondents reported being treated differently in work or social settings due to tattoos, suggesting that stigma surrounding tattoos has faded along with increasing popularity.

A more recent Harris poll of 2225 United States respondents performed in 2015 found that 29% of Americans had at least one tattoo, an increase from 14% in 2008 and 21% in 2012[4]. Tattoos were slightly more common among United States women (31%) than men (27%). Younger respondents were more likely to have tattoos, with nearly half (47%) of those 18-35 years old reporting that they had a tattoo. Regret about having a tattoo was reported in 23% of respondents, an increase from 14%-17% in previous years. Based on limited sample sizes from these two surveys, it therefore appears that tattooing has become much more common in the United States, particularly among young adults where rates may approach 1 in 2.

Looking more globally at industrialized Western societies, Kluger published a review of epidemiologic studies performed in the United States, Canada, Australia, Europe, and South America, reporting that the prevalence of tattooing is around 10%-20%[5]. Consistent with data from the United States, tattooing is more common among younger people globally, with the “tattooed generation” born in the 1970s and early 1980s. Being in a tattooed peer group or having a tattooed family member was linked to higher rates of possessing tattoos (75% and 29% respectively). Although tattoos have been traditionally more common among men, gender divides have lessened to the degree of extinction in recent decades in some countries, with tattooing now more common in women overall compared to men in the United States and more common among women 20-29 years old in Australia. However, women tend to have smaller and less visible tattoos overall and prevalence data might be skewed by the inclusion of cosmetic or “permanent make-up” tattoos.

In addition to general prevalence data, Kruger noted that tattoos remain common in groups most traditionally associated with tattooing[5]. For example, the prevalence of tattoos among United States Navy personnel in World War II was 65%, while the modern prevalence of tattoos among those in the military is cited as ranging widely from 10%-44%. Differences in rates may reflect variations in sanctioning within separate settings, with peer group pressure playing a significant role. In Brazil for example, tattooing was not introduced until 1959 and the practice is illegal for minors in some states[6]. A survey conducted among a sample of 18-year-old Brazilian military recruits (n = 1968) revealed that about 11% of recruits had tattoos, of which 66% had a single tattoo and 21% had two tattoos, with the remainder having > 2 tattoos[6]. A large majority of tattooed recruits (80%) had obtained their first tattoo before the age of 18.

Despite the illegality of getting tattooed in most prisons worldwide, tattooing remains a common practice among inmates, with prevalence rates ranging from 9%-70%, depending on location, and some 40% of all inmates obtaining a tattoo while incarcerated[5]. Tattoos in the incarcerated population serve to align the wearer with a specific group, as a remembrance, as a sign of strength or aggressiveness, or to simply help to pass the time. Due to the makeshift nature of prison tattooing, inmates are at high risk for obtaining blood borne illnesses such as hepatitis C and human immunodeficiency virus (HIV).

WHAT DO TATTOOS TELL US ABOUT THEIR WEARERS?

Evolutionary and historical perspectives

Tattooing has been a human practice for more than 5000 years, leading Carmen et al[2] to examine tattoos through an evolutionary lens. They hypothesized that, regardless of the proximal motivations for getting a tattoo (e.g., commemorating an event or relationship, designating group affiliation, or serving as a marker of individuality), the ultimate evolutionary purpose is by definition rooted in sexual selection. The authors offered two hypotheses to explain how tattooing might have been favored in evolution that they call the “human canvas” and the “upping the ante” theories. The former postulates that tattooing is an expression of human culture based in “symbolic thought”, with the artistic canvas as a means to illustrate one’s personal story and to document history, moving from cave walls to the skin over time. The “upping the ante” theory suggests that tattoos evolved as a fitness indicator, enhancing one’s appearance in the context of intersexual competition, similar to a peacock’s tail. In tracing the evolution of tattooing across history starting from its ritualistic tribal origins, the authors note that the modern rise in the popularity of tattoos within Western culture emerged from individual niches such as military culture during World Wars I and II, the subsequent countercultural movements of the 1960s and 1970s, and the current cultural mainstream as a status quo. Over time, social stigmas have lessened and technical innovations have reduced the infectious risk of tattooing, such that it has become a less “costly” and therefore more common fitness indicator.

Psychoanalytic perspectives

Like Carmen et al[2], Grumet[7] tracked the development of tattoos throughout history, but did so through a lens of psychodynamic psychiatry as opposed to evolution. Although he acknowledged that tattoos could proclaim identity and group allegiance (as with military tattoos), he argued that “tattoo analysis” ought to be used as a kind of “dermal diagnosis”, with tattoos almost uniformly serving as a sign of psychopathology. For example, he suggested that tattoos are rooted in antisociality and exhibitionism and that “outcasts and outlaws” obtain tattoos in order to bolster low self-esteem. He concluded that tattoos should be viewed as “a psychic crutch aimed to repair a crippled self-image, inspire hope, keep noxious emotions at bay, and reduce the discrepancy between the individual and his aspirations”[7].

In a more recent analytic summary of unconscious motivations for tattoos, Karacaoglan[8] utilized a case series to illustrate that “the painful penetration of the skin in the process of tattooing… is a form of acting out” and that tattoos symbolize “an attempt to actively represent and recompense, as it were, an early deficiency” and a “dialectical record of the mother-father relationship”. Highlighting the masochistic nature of tattooing, the author interprets tattooing as an alternative form of expression that patients “resort” to when unable to verbalize “unendurable affect” through language. Like Grumet[7], Karacaoglan[8] ultimately concluded that tattooing is a “form of perversion”.

While we agree on the potential value “dermal diagnosis” in exploring unconscious motivations for obtaining tattoos, these uniformly pathologic interpretations now seem, in light of the ubiquity of tattoos in mainstream culture, like antiquated generalizations. While an individual’s tattoos could indeed be used to inform psychodynamic psychotherapy by tapping into personal self-representation through symbolism, their interpretation need not be restricted to the realm of psychopathology.

Motivations for tattooing

In keeping with the view that tattoos should not be solely regarded as reflections of psychopathology, Wohlrab et al[1] reviewed studies exploring the myriad motivations for obtaining tattoos. additional hints to create and maintain a distinct self-identity by controlling one’s appearance is cited as one of the most common reasons for tattooing. This motivation may be especially age-relevant and helps to explain the desire to obtain a tattoo during adolescence and young adulthood. In addition to the more identity-based, personal narrative, and group-oriented motivations for getting tattoos, some studies suggest that tattoos can also be viewed as a means to embellish the body as a fashion accessory or piece of art to wear on the body. Others have noted that tattooing can serve as a kind of badge that reflects pain tolerance and physical endurance, as a means of emphasizing sexuality, and as an affiliation with a religious or spiritual tradition, while tattoos are also sometimes obtained impulsively for no specific reason.

Based on a literature review, Dickson et al[9] likewise enumerated a variety of motivations for getting tattoos, including body adornment and personal decoration, expressions of individualism and markers of identity, and overcoming difficult emotions as a means of affect management. Motivations for tattooing vary between genders, with women more likely to seek tattoos for personal decoration and to feel more independent, and men more likely to use them as symbols of group identity. Contrary to traditional stereotypes, most adults with tattoos do not associate them with rebelliousness or cultural alienation, do not usually obtain them impulsively or while intoxicated, and do not regret getting them afterwards.

In order to test these generalizations, Dickson et al[9] administered a survey about tattoos to 458 United States college students, including 43% with at least one tattoo. The survey results confirmed that most tattooed respondents had taken months to decide what tattoo to get, obtained the tattoo in a reputable tattoo parlor, spent a significant amount of money on it, and tended to have been ≥ 18 years old at the time of their first tattoo. Respondents tended to view their tattoos as a means of self-distinction, rating them as having significant personal meaning as opposed to symbols of rebelliousness. While respondents reported very high levels of satisfaction with their first tattoo, those with multiple tattoos (60% of the tattooed sample) tended to rate their second or third tattoos, typically obtained a few years after their first, as favorites. This suggests that the process of obtaining multiple tattoos reflects a self-concept that continually evolves with time. For the majority of survey respondents who didn't have tattoos, reasons cited to forgo tattooing included not liking tattoos, concerns about permanency, anticipated disapproval from family, fear of pain, and not knowing what kind of tattoo to get.

Psychopathology and personality traits in tattooed individuals

Although several studies have indicated a greater prevalence of tattoos among psychiatric samples compared to the general population, the data to support this conclusion are largely drawn from older studies based on comparisons of cross-sectional measures of psychopathology among tattooed individuals in either non-psychiatric settings or psychiatric settings with inadequate controls between samples[10]. For example, Birmingham et al[11] reported an association between tattoos and a diagnosis of schizophrenia, but their study was based on a limited sample of male prisoners with visible tattoos. Two studies have reported an association between tattoos and a history of abuse, but both included individuals with body piercings[12,13] and one was based on responses to a survey published in a German body modification magazine[12]. Studies of such specialty populations may have limited generalizability due to other confounds that might better explain associations with psychopathology. Similarly, reported associations between tattoos and risk-taking behaviors such as drug use, early sexual activity, gang affiliation, and violent behavior have typically been drawn from small studies of adolescents, with methodological problems related to sample population and size, survey techniques, and the potential for type I error[5,14]. Taken in aggregate, now that tattooing has become more common and is well-represented amongst adults, any associations with psychopathology are much less clear.

Looking again at recent epidemiologic data from the United States cited above, Laumann et al[3] reported that compared to non-tattooed individuals, tattooed respondents were more likely to use recreational drugs, more likely to have spent ≥ 3 d in jail, and less likely to claim religious affiliation, even when controlling for age[3]. The percentage of tattooed respondents was lower among those who had never consumed alcohol. Among current drinkers, those with tattoos drank significantly more alcohol, although only a small minority of those tattooed had ever obtained their tattoos while intoxicated. Beyond the United States however, Kluger[5] noted that an association between tattoos and alcohol usage has not been detected in surveys from other countries and is therefore not well established. On the other hand, associations between tattoos and both cigarette smoking and recreational drug use (especially cannabis) may be more consistent.

A number of studies have used psychological rating scales to explore potential personality differences between tattooed and non-tattooed individuals, with mixed results[15]. Swami et al[15] administered a battery of inventories measuring various personality traits to a sample of 540 subjects from the southern German-speaking region of central Europe and found that those with tattoos only scored higher on measures of extraversion, experience seeking, and need for uniqueness. Although effect sizes were small to moderate, these results highlight that, if personality differences do exist among those with tattoos compared to the general population, they may not necessarily be dysfunctional or pathological. This conclusion is in keeping with recent findings from the United States in which the Community Body Modification Checklist was given to 213 adult subjects with and without tattoos or non-ear body piercings[16]. Defying hypothesized expectations, Giles-Gorniak et al[16] reported that the only significant difference in mental health history and behavioral choices between the two groups was that those with body modifications were more likely to engage in social and healthy behaviors. Likewise, an Australian study employed the Loyola Generativity Scale to assess “concern for and commitment to the next generation” among 710 adult women and found that those with and without tattoos had equivalent levels of psychosocial health according to this measure[17].

In contrast to these studies involving adults across the lifespan, much of the work to date on personality differences between tattooed and non-tattooed individuals has been performed in samples of college students, with limited generalizability. In order to avoid the methodological limitations of earlier studies, Tate and Shelton measured personality traits with validated scales that assessed for the Big Five Factors of personality (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness), the need for uniqueness, and the desire to be perceived favorably by others[14]. Tattooed participants, as compared to their non-tattooed counterparts, scored significantly lower on agreeableness and conscientiousness and higher on need for uniqueness. However, while these differences were statistically significant, effect sizes were small and personality scores found among tattooed individuals were, with a single exception among women, within published norms. The authors therefore concluded that “it is untenable to refer to tattoos, per se, as signs of social deviance or personality and character flaws”[14].

Suicide, self-injury, and tattoos

Tattooing is an inherently painful ritual that is usually voluntary, with a history of other acts of self-injury and of suicidal ideation sometimes noted anecdotally by recipients. A survey of 432 German adults with tattoos or non-ear body piercings found that 27% of respondents had a history of self-cutting during childhood[18]. Comparing those with and without a history of self-cutting, self-cutters had the same average number of tattoos, but significantly more piercings. Curiously, some respondents reported feeling “healed” and stopping self-injurious behavior following body modification, leading the authors to hypothesize that some use body modification as a “therapeutic substitute” for “autoaggressive acts”[18]. However, the inclusion of those with body piercings and the lack of a control group without body modification limits the generalizability of this conclusion to those with tattoos.

A possible association between eating disorders, self-injury, and tattoos was explored in a study of 65 female patients referred to a specialized unit for the treatment of anorexia, bulimia, and binge eating disorder[19]. In this sample, a history of self-injury was reported in 51% of patients, while 27% had at least one tattoo. Having a tattoo was significantly associated with a history of burning, supporting the authors’ conclusion that body modification might represent a form of self-punishment among those with eating disorders. However, 27% of the sample had tattoos and/or piercings without a history of self-injury and this subgroup had more positive feelings towards their bodies, higher levels of self-esteem, and less impulsivity, depression, anxiety, and social dysfunction than those with a history of self-injury. Therefore, tattoos may sometimes represent positive modifications of body image as opposed to markers of self-injurious behavior.

An association between tattoos and suicide was suggested in a study of 134 completed suicides over a 3-year period in Mobile County, Alabama[20]. In this sample, 21% had one or more tattoos at time of death, with 57% of “young, white suicide” completers having tattoos compared to only 29% for matched accidental deaths. Another study involving a larger series of 438 autopsies in Linn County, Iowa over a 15-year period included 32% subjects with tattoos[21]. Having a tattoo was associated with a significantly younger age at death and greater risk of death by an unnatural manner (e.g., gunshot wound or drug overdose), but not suicide. Taken together, these small, regional studies offer conflicting evidence for tattoos being associated with suicide. Both studies did speculate that tattoos might be a potential marker of risk-taking behaviors and substance use that could in turn be associated with early mortality, but larger, epidemiologic studies are needed to more clearly elucidate associations between tattoos, self-injury, and early death.

Self-perception in tattooed individuals

Given the intimate and relatively permanent nature of tattooing, a tattoo is expected to alter the new wearer’s perception of their body and their identity. However, the effect of the tattoo could depend on motivations for tattooing and the type and meaning of the tattooed image. A 2015 Harris Poll found that although most respondents did not feel that tattoos made them feel more sexy, attractive, rebellious, or spiritual, having a tattoo also did not make them feel less intelligent, respected, employable, or healthy[4]. However, a substantial minority did report that having a tattoo made them feel more sexy (33%), attractive (32%), and rebellious (27%). Tattoos therefore seem to have the ability to positively impact one’s sense of self, with individual variation and many aspects of identity potentially affected.

In an attempt to examine effects of tattoos on self-perception, Swami conducted a prospective study of adults from London who were planning to get their first tattoo by recruiting them in a tattoo shop[22]. Participants (n = 82) were assessed before and after getting their first tattoo and asked to rate or provide information about the following aspects of self-perception: Their own overall physical appearance, anxiety about 16 different body sites, measures related to a positive body image, self-attributed need for uniqueness, social physique anxiety, self-esteem, desire to stand out with appearance, reasons for obtaining the tattoo, schematic outlines of the front and back of their bodies to ascertain tattoo visibility and percentage of body covered by the new tattoo, satisfaction with the tattoo, and likelihood of obtaining future tattoos. Assessments were conducted immediately before and after obtaining the tattoo, and then again after 3 wk. Immediately after getting the tattoo, both men and women reported reduced anxiety and less dissatisfaction around their appearance, effects that were sustained at 3-wk follow up. On 3-wk follow up, both genders also reported an overall increase in self-esteem. This suggests that tattoos can mitigate negative attitudes a wearer might hold about one’s appearance. However, while men demonstrated a sustained decrease in social physique anxiety after obtaining a tattoo, female participants had higher social physique anxiety after 3 wk. The reason for this gender difference is unclear, but may be related to more negative perceptions towards women with tattoos in society. Still, no differences were found between participants with visible tattoos and those easy to conceal, such that “corporeal meaning” appeared to be a more important predictor of self-perception than appearance, or how others might view them.

While this survey reported individuals’ experiences and self-perception immediately before and after being tattooed, it did not examine self-perception in a more longitudinal fashion. It therefore remains unclear whether tattoos truly fulfill one’s need for self-expression or if this need remains unfulfilled over time for some, leading them to find other means, or more tattoos, to validate uniqueness. Collectively however these findings suggest that at least in the short-term, tattoos have the power to improve self-esteem and satisfaction, with their appearance providing fertile ground for exploration in the therapeutic setting.

Tattoo removal

The data presented thus far give lie to the ever-present stereotype of tattoos being obtained by intoxicated youth who regret the act the next day, with up to 83% of wearers satisfied with their tattoos[23]. Still, that leaves an estimated 20% of wearers who are dissatisfied with their tattoos and 6% who eventually opt for removal via surgical excision, dermabrasion, cryosurgery, chemical peels, and laser ablation with scarring, hypopigmentation, and incomplete removal as potential risks.

Armstrong et al[23] surveyed a sample of 196 subjects who sought tattoo removal from 4 clinics across the United States and found that the average person waited 10 years to do so. Frequent reasons for removal included “just decided to remove it”, “suffered embarrassment”, “got tired of it”, “just grew up”, and the need to hide the tattoo due to workplace stigma. Issues surrounding stigma were especially prevalent among women (see below for additional discussion).

Tattoo removal may be on the decline as societal acceptance of tattoos increases, with a 23% reduction in tattoo removal procedures reported by The American Society for Aesthetic Plastic Surgery between 2012 and 2013[24]. This decrease is in contrast to a 52% increase reported by the American Society of Dermatologic Surgery over the same time period. However, tattoo removal does not necessarily reflect an overall dissatisfaction with tattoos. In the study by Armstrong et al[23], a third of subjects seeking removal were interested in getting more tattoos in the future, suggesting that for some the desire of ablation is more about specific tattoos rather than tattoos in general.

TATTOOS IN SPECIFIC POPULATIONS

Adolescents and tattoos

It is important to distinguish between tattoos among adolescents and adults, since motivations for obtaining tattoos may be significantly different between the two groups. In addition, while tattoos have become a more mainstream phenomenon among adults, considerable stigma remains with tattooing as an adolescent[25]. Significant research has been devoted to the study of tattoos in adolescents, highlighting negative associations with risk-taking behaviors such as substance abuse, smoking, sexual activity, violent behavior, and problems in school[5]. However, such associations in adolescents < 18 years old are confounded by the fact that it is illegal for a minor to obtain a tattoo in all 50 of the United States. This suggests that tattooing may indeed be a signal of risk among minors, but those risks should not necessarily be extended to those obtaining tattoos as adults[25].

With these demographic differences in mind, a prospective, longitudinal study followed a national sample of 13101 United States 7^th-12^th graders over 12 to 18 mo, looking at predictors of getting a tattoo[25]. In their sample, adolescents who reported lower levels of parental and/or school attachment, lower grade point averages, and lower religiosity levels were more likely to have tattoos on follow up approximately 1-2 years later. The study also found that adolescents who used alcohol or marijuana and engaged in violent behavior were more likely to be tattooed at follow up. A history of violent victimization was also a significant antecedent of getting a tattoo, suggesting that some adolescents obtain tattoos as a method of self-protection. The authors conceded that the number of adolescents surveyed who later acquired tattoos was small (only 3.6% of sample), precluding any analysis of interaction effects[25]. In addition, they did not take tattoo size, type, or location into account, which is potentially salient since such specifics might reflect different motivations for getting a tattoo (e.g., tattoos signaling affiliation with “conventional institutions” such as a sports team or school likely have very different meanings compared to a gang tattoo on one’s neck). This caveat highlights that specific features of tattoos may have different implications about an individual, such that asking wearers about their tattoos may be a valuable source of information in terms of risk assessment, diagnosis, and general understanding. Methodological limitations aside however, it does appear that tattoos in adolescents can be thought of as representing a potential signal of risk among American adolescents.

Tattoos in the military

In modern Western culture, tattoos have been associated with soldiers for nearly a century, dating back to World Wars I and II[2]. This may have contributed to early associations with tattoos as symbols of machismo or with tattooed individuals being tougher or more dangerous. Among current soldiers, the motivations for getting tattoos and their meanings are varied and diverse, with some important potential distinctions from the general population.

Recent data indicate that about a third of United States soldiers enter the military with pre-existing tattoos[26], potentially reflecting character traits such as increased novelty seeking, extraversion, and a drive for self-individualization that might be associated with both getting a tattoo and joining the military. A survey of tattooed soldiers (n = 122) in the United States Armed Forces found a wide variety of tattoo types, including tattoos reflecting themes of self-identification (military branch or unit designations, patriotic images, ethnic/cultural/tribal symbols), martial themes (weapons, symbols of death), spirituality (religious symbols and quotations, angels, devils), and nature (animals, trees/flowers/plants, and moon/sun/planet/stars)[26].

Gadd conducted a survey of 445 British soldiers who presented to a military-run health clinic in 1990 and found that almost half had tattoos[27]. Peer influence, moreso from male than female friends, was frequently cited as a motivating factor (64%). Nearly a third of tattooed soldiers reported regret associated with their tattoo and considered its removal, with such sentiments significantly more likely among those ≥ 26 years old. These findings suggest that military personnel may face peer pressure to get tattoos that results in higher levels of regret than is reported in the general public. Regret among older soldiers might likewise reflect a change in identity with which the tattoo did not keep pace, or represent reminders of military experiences one might prefer to forget. Tattoos among military personnel and veterans seeking psychiatric treatment might therefore offer especially valuable avenues to gain access to self-identities transformed by war and personal loss.

The United States military has a long history of maintaining strict standards about personal appearance and grooming, with exacting guidelines governing proper attire and hair length. With the modern frequency of tattoos among potential recruits and the evolution of tattoos away from a sign of rebellion, the United States Armed Forces have recently revised their rules about tattoos, representing a shifting balance between codes of discipline or uniformity and evolving societal views about tattoos.

No branch of the United States Armed Forces allows tattoos that are sexist, racist, extremist, or derogatory in content. The United States Army recently provided general rules prohibiting tattoos on the neck, head, face, or wrists, but personnel are allowed to have tattoos everywhere else on their bodies, including the arms and legs, which were historically forbidden[28]. Hand tattoos are only permitted in the form of one ring on each hand in order to allow for tattooed wedding rings. The United States Marine Corps is currently updating its rules, but Marines are still not allowed to have tattoos covering the whole arm (“sleeves”)[29]. The United States Navy’s regulations specify that no tattoos are allowed on the face, neck, scalp, or head[30]. Tattoos exposed by wearing a short sleeve navy uniform shirt may be no larger in size than the wearer’s hand with fingers extended and joined with the thumb touching the base of the index finger. In contrast to the other branches of the United States Armed Forces, the United States Air Force has relatively strict rules, prohibiting excessive tattoos (partially defined as any tattoo that exceeds ¼ of the exposed body part) from being exposed or visible while in uniform[31].

Concerns about tattoos in the United States Armed Forces seem to reflect an emphasis on discipline, uniformity, and a respect for command that might be compromised by obvious external markings that set an individual apart. However, as tattoos have become increasingly common and more societally acceptable, the military has in turn become more tolerant, allowing that tattoos might provide an acceptable symbol not of defiance, but individuation and a potential source of group cohesion.

HOW DO OTHERS PERCEIVE THOSE WITH TATTOOS?

General perceptions

Despite the rapidly changing societal views of tattoos, explicit and implicit biases continue to affect how tattooed individuals are perceived. A 2015 Harris Poll revealed that the majority of respondents stated that there was no difference in perceptions of rebelliousness, sexiness, spirituality, respectability, intelligence, or health for people with or without tattoos[4]. However, for the substantial minority of respondents who did perceive a difference, people with tattoos were rated as more rebellious, but less attractive, sexy, spiritual, respectable, intelligent, and healthy.

Tattoo perceptions appear to vary according to the profession of the wearer, with more discomfort associated with visible tattoos on presidential candidates, judges, primary school teachers, and doctors compared to athletes, information technology technicians, and chefs[4]. Due to the persistent disapproval of visible tattoos in some professional settings, some individuals might forgo tattooing altogether or hide their tattoos at work in order to avoid stigma. In the reverse direction, a 1998 survey found that physicians and registered nurses demonstrated negative biases against those with tattoos[32]. Although the survey did not measure providers’ actual attitudes towards their patients, it is important to be aware of the potential for negative bias as a clinician working with individuals with tattoos.

In reviewing the literature on tattoo perception, Burgess and Clark[33] have noted that most tattoo perception studies to date have failed take into account the type of tattoo a participant possessed. This is an important omission that has likely contributed to generalizations about tattoos that are misleading in current society, where tattoos of all sizes, locations, and thematic imagery can be found. Tattoos can range from those that are concealed or visible only in more casual or intimate settings to prominent markings on the face, neck, and extremities. Designs can range from “small, trendy, and fun”[33] fashion accessories to more complex tattoos displaying more provocative or sexual themes covering large portions of the wearer’s body. Intuitively, such widely varying differences in tattoos are expected to be salient in terms of impacting the perceptions of others. Such perceptions would also be expected to vary based on the gender or age of a wearer.

In order to test such hypotheses, Burgess and Clark[33] performed a study in which 300 British university students were shown images of hypothetical male and female job applicants with either “cute” tattoos, “tribal” tattoos, or no tattoos. No tattoos and cute tattoos were associated with applicants being rated as more friendly and therefore suitable for the job in comparison to those applicants with tribal tattoos, who were perceived as more aggressive and less well suited. Negative dispositional characteristics were attributed exclusively to tribal tattoo wearers, which in turn negatively affected their perceived job suitability. This perception was more strongly held in respondents without tattoos compared to those with tattoos, or those who had considered getting one. This study therefore confirms that the content of a tattoo affects how the wearer is perceived, while also highlighting that tattooed individuals are generally less likely to infer negative attributes about another tattooed person. Therefore, while certain types of tattoos continue to trigger inferences about aggression and deviance, such attitudes may be shifting as more of the populace becomes tattooed.

Gender specific perceptions

Despite the increasing acceptance of tattoos in modern Western culture, women with tattoos still tend to be more negatively perceived than tattooed men. A 2004 survey of Canadian undergraduates reported that both male and female respondents had negative attitudes towards descriptions of women with visible tattoos, and that tattoo size was a predictor of disapproval for respondents who did not have tattoos themselves[34]. Swami et al[35] extended upon this research by using line drawings of women with tattoos that allowed manipulation of tattoo location and the number of tattoos to assess effects on an observer’s ratings of attractiveness, sexual promiscuity, and alcohol consumption. Based on a study sample of 160 British undergraduates, 14% of whom had tattoos, depictions of women with tattoos were rated as significantly less attractive, more sexually promiscuous, and heavier drinkers compared to women without tattoos. The likelihood of these perceptions increased with the number of tattoos, with figures bearing 3 tattoos estimated to drink more than twice the amount of alcohol as those without any tattoos. While the study was limited by the artificiality of the line drawings and the lack of a male figure control, it appears that tattoos among female college undergraduates may signal an increased likelihood of drinking alcohol and sexual activity. Despite these associations, 73% of the sample indicated that they would consider getting a tattoo in the future, and 53% of the sample was female. These caveats might therefore reflect not only less stigmatizing views of tattoos, but also of alcohol and sexual activity (e.g., casual sex and multiple partners) among undergraduates.

Resenhoeft et al[36] similarly used color photographs in two different experiments to assess United States undergraduates' perception of tattooed women. Participants viewed a photograph of a woman with or without a tattoo and then rated her on 13 personality traits including attractiveness, caring, athleticism, honesty, religiosity, and intelligence. The first experiment found that a photograph of a woman with a large, visible dragon tattoo on her upper arm was perceived as less attractive, fashionable, athletic, caring, intelligent, but more creative compared to a control photograph of the same woman without a tattoo. their explanation were not significant in the second experiment that used a photograph of a woman with a smaller, less visible tattoo of a pair of dolphins, with the exception of higher ratings of honesty and religiosity for the non-tattooed control. Although the study findings may have been influenced by using photos of different women dressed in different clothes in the two experiments, the results again seem to indicate negative biases against women with tattoos, even among young college students who might be expected to be more accepting of tattoos.

In an attempt to examine the impact of tattoos on sexual attraction between genders, Wohlrab et al[37] performed an experiment using computer generated virtual images depicting both women and men wearing bathing suits that revealed tribal tattoos in various locations. German university students (n = 278) were asked to rate these images on measures of attractiveness, dominance, aggression, masculinity or femininity, and health. In this study, images of tattooed women were rated as less healthy than women without tattoos, whereas images of men were rated as more dominant than those without. Sex differences among raters were important, with men rating images of women with tattoos as more attractive, while women rated them as more dominant. Conclusions about these findings may be limited to heterosexual perceptions of tribal tattoos among young people, but when considered along with other studies, they support the possibility that ratings of female attractiveness by men reflect biases about tattoos signaling sexual availability.

This conclusion was reinforced by a study performed in France using real women who were rated as highly attractive and who, under experimental conditions, displayed a temporary butterfly tattoo on their lower back while lying on a beach in a swimsuit. The field experiment measured how long it took for anonymous men to approach them[38]. Compared to non-tattooed controls, women with tattoos were more likely to be approached by men and were approached within a shorter time. Subsequent interviews with the men revealed that although tattooed women were not rated as more attractive compared to controls, men gave higher probability estimates of being able to get a date with a tattooed woman and to have sex on the first encounter.

Drawing firm conclusions based on these studies is difficult, given that each utilized different methodologies and featured different women with different clothing and different tattoos. Within-study controls suggest that tattoos in young women have the potential to be interpreted as a signal of sexual availability to young men, but across studies, and in reality, visible tattoos are only one of many aspects that might influence female attractiveness. In addition, the use of different types of tattoos across various studies highlights that different tattoos seem to carry different meanings for both wearers and observers, and cautions against overgeneralization.

Looking beyond the narrow scope of the tattoo effects on ratings of female attractiveness in young people, tattoos may have different implications in other contexts, such as within older populations or professional settings. For example, one study found that female nurses with tattoos were perceived more negatively and rated as less caring, skilled, and knowledgeable than their tattooed male colleagues[39]. Observers’ perceptions of tattoos in women are therefore influenced by a large number of variables, including setting, age, and other aspects of a woman’s appearance, along with tattoo size, location, and content. While such variables are important in considering perceptions about tattoos in both men and women, the impact of such variables can be very different between genders.

CASE STUDY

As psychotherapy progressed, the value of discussing Mr. A’s tattoos first emerged when the therapist asked about the tattooed faces of his children which had been embellished to appear more sinister. With prompting, Mr. A admitted that this was intended to maintain a look of stoic masculinity while still bearing reminders of his children on his body, and he agreed that this reflected a strong aversion to vulnerability. Once this was interpreted, he opened up further. The tattoo referencing fellow soldiers killed in combat, visible on the back of his neck, later proved to be a useful topic of exploration when he explained that it was placed in that location so that he would keep the reminder on his body but would not have to see it unless he wished to do so. He admitted that he felt deep, intolerable grief for the loss of these friends and used the tattoo to project this loss out onto the world because he felt incapable of dealing with it in any other way. This facilitated an actual discussion of Mr. A’s grief, allowing him to share his feelings for the first time. He reported to the therapist that her interest in his tattoos and non-judgmental questioning increased his sense of a therapeutic alliance and his overall engagement in treatment for PTSD. With additional work in therapy, it appeared that for Mr. A tattooing represented a kind of outward manifestation of intellectualization as a defense that prevented others from having emotional access to the fragile and sensitive person beneath his adorned skin.

In further interpreting Mr. A’s tattoos in the context of the modern literature on tattooing, his skin art can be viewed as a “human canvas” which tells the story of his childhood and subsequent formative military experiences. His tattoos overwhelmingly demonstrate dark themes of violent masculinity and pain tolerance, suggesting the need to portray an outward appearance of danger-seeking fearlessness that serves to intimidate or ward off others and that provides some insight into why he was drawn to military service. Now, as a law student and father trying to reconstruct his life with the help of psychotherapy, his tattoos represent a visual depiction of themes relevant to both his past life and present inner existence. While tattoos offer a window into the psyche, it is a window that only tells a partial story. Ultimately, tattoos represent what the patient purposefully reveals on the surface, inviting the therapist to explore that portal in order to access deeper emotions, motivations, and meanings contained within.

CONCLUSION

Over the past century in Western society, tattoos have evolved from cultural taboo to mainstream fashion. Accordingly, historical biases and pathological implications about tattoos warrant revision for present-day tattoo wearers. Although the literature to date on tattooing is informative, the available data are limited to subpopulations drawn from Western industrialized cultures and offer a narrow perspective on the interactions of other characteristics of tattoo wearers (e.g., age, ethnicity, socioeconomic status) on public perception. Clinicians are therefore cautioned against overgeneralization, and are instead encouraged to explore the personal meaning associated with individual patients and their different tattoos. We suggest that as a kind of augmentation of the physical exam, doing so with individuals who are engaged in psychiatric treatment provides a valuable window to the psyche that can reveal core aspects of self-identity and hidden emotions with the potential to facilitate and enhance clinical work.

Abstract

Tattooing the skin as a means of personal expression is a ritualized practice that has been around for centuries across many different cultures. Accordingly, the symbolic meaning of tattoos has evolved over time and is highly individualized, from both the internal perspective of the wearer and the external perspective of an observer. Within modern Western societies through the 1970s, tattoos represented a cultural taboo, typically associated with those outside of the mainstream such as soldiers, incarcerated criminals, gang members, and others belonging to marginalized and counter-cultural groups. This paper aims to review the more recent epidemiology of tattoos in Western culture in order to establish that tattooing has become a mainstream phenomenon. We then review psychological and psychiatric aspects of tattoos, with a goal of revising outmoded stigmas about tattooing and helping clinicians working with tattooed patients to facilitate an exploration of the personal meaning of skin art and self-identity. We suggest that as a kind of augmentation of the physical exam, looking at and talking to patients about their tattoos can provide a valuable window into the psyche, informing clinical practice.

Core tip: Although traditionally associated with deviance and psychopathology in modern Western culture, tattoos have evolved into a mainstream phenomenon, especially among younger adults. While there are myriad motivations for obtaining a tattoo, most individuals seek tattoos as a means of personal expression that provides a potential window into the psyche that can be used to facilitate psychiatric treatment. By reviewing the literature on psychological and psychiatric aspects of tattooing, we suggest that tattoos should be viewed not as signs of pathology, but as opportunities to explore core aspects of self-identity that can be valuable in clinical work.

CASE STUDY

Mr. A is a 31-year-old Caucasian United States Army veteran with post-traumatic stress disorder (PTSD) based on military combat experiences while deployed to Iraq and Afghanistan. He is a divorced father of two, currently in law school, with overall high functioning despite significant life challenges. A tumultuous childhood, including neglect and trauma at the hands of his mother and within the foster care system, led to several suicide attempts as a pre-teen and one psychiatric hospitalization where he was diagnosed with intermittent explosive disorder, bipolar disorder, and obsessive compulsive disorder. While medication titration was attempted during that hospitalization, he was never followed consistently by mental health as a child or adolescent, nor did he take psychiatric medication. Despite these developmental barriers, Mr. A was considered a gifted child with an intellectual capacity well beyond his years and background. At the age of 31, he presented for treatment of PTSD with bilateral full arm tattoos along with visible tattoos on his hands, knuckles, and the back of his neck. Later, he revealed that most of his body was covered with tattoos.

Discussions in psychotherapy revealed that he started getting tattooed at the age of 11, when his father forced him to learn how to fight, subjecting him to physical beatings in order to prepare him for the violent realities of his neighborhood. His first tattoos declared affiliation with his ethnic background, depicting themes of racial affiliation and violence that reflected long-time engagement with racially-based groups for the purpose of enhancing survival on the dangerous streets of his childhood home and within the juvenile corrections system. Other tattoos, including women in bondage, wizards, and skulls, were described as “filler”, while others displaying religious symbols, weapons, references to Greek philosophy, and military themes seemed to be more personal. One tattoo referenced the names of fellow soldiers who were killed in action during the wars in Iraq and Afghanistan.

When asked about his motivation for joining the military he replied, “I needed to find a way to maintain masculinity without being a convict”. Although he claimed to have thrived within military culture, he often clashed with superiors when he felt disrespected. During deployments, he accumulated extensive combat experience where he expected to die. However, he ultimately completed his military service and after an initial period of instability that included intoxicated fighting and divorce, he obtained sobriety and decided to go to law school. At the time of enrolling in treatment, he was living with a long-time girlfriend while maintaining partial custody of two children from his previous marriage. As psychotherapy began, he demonstrated notable difficulty discussing his emotions and was resistant to the therapist’s attempts to delve further into past and current relationships and his symptoms of PTSD.

REVIEW METHODOLOGY

An online search of PubMed and PsycInfo databases was performed using the search terms “tattoos”, “tattooing”, “tattoo”, “skin art”, “epidemiology”, “stigma”, “psychiatric disorders”, “psychology”, “perception”, “self-perception”, “removal”, “depression”, “anxiety”, “self-harm”, “deviance”, “psychopathology”, “prison”, “military”, and “veterans”. Criteria for inclusion were original research involving human subjects, meta-analyses, reviews, published in the English language between January 1, 1990 and February 1, 2016 (with the exception of reference 7 which was included for historical purposes). The bibliographies of articles identified through electronic search were also reviewed for additional relevant publications including online resources such as the Harris Poll and military service regulations. Dissertations were excluded. Articles with a primary focus on dermatological/physical/physiological reactions to tattooing and tattoo removal or on diagnosis and treatment of the infectious sequelae of tattoos were excluded.

EPIDEMIOLOGY

Until recently, tattoos have represented a cultural taboo in modern Western societies, typically associated with those outside of the mainstream such as sailors, soldiers, incarcerated criminals, gang members, prostitutes, and others belonging to marginalized and counter-cultural groups[1,2]. Over the past two decades however, epidemiologic studies have demonstrated that tattooing has become more of a mainstream phenomenon, with decreasing associations with stigma.

A survey of 500 population-representative United States respondents age 18-50 years old performed in 2004 revealed that 24% (n = 120) had tattoos with an additional 21% reporting that they had considered obtaining one[3]. Overall, 65% of tattooed respondents reported obtaining their first tattoo by age 24, with women more likely than men to be > 30 years old when they obtained their first tattoo. Tattooed respondents mostly had their tattoos done within the United States (98%), usually in professional tattoo parlors (80%), with tattoos obtained via homemade tattooing devices or sewing needles more likely to have been obtained at < 18 years of age. No tattooed respondents ever had a tattoo removed. Very few tattooed respondents reported being treated differently in work or social settings due to tattoos, suggesting that stigma surrounding tattoos has faded along with increasing popularity.

A more recent Harris poll of 2225 United States respondents performed in 2015 found that 29% of Americans had at least one tattoo, an increase from 14% in 2008 and 21% in 2012[4]. Tattoos were slightly more common among United States women (31%) than men (27%). Younger respondents were more likely to have tattoos, with nearly half (47%) of those 18-35 years old reporting that they had a tattoo. Regret about having a tattoo was reported in 23% of respondents, an increase from 14%-17% in previous years. Based on limited sample sizes from these two surveys, it therefore appears that tattooing has become much more common in the United States, particularly among young adults where rates may approach 1 in 2.

Looking more globally at industrialized Western societies, Kluger published a review of epidemiologic studies performed in the United States, Canada, Australia, Europe, and South America, reporting that the prevalence of tattooing is around 10%-20%[5]. Consistent with data from the United States, tattooing is more common among younger people globally, with the “tattooed generation” born in the 1970s and early 1980s. Being in a tattooed peer group or having a tattooed family member was linked to higher rates of possessing tattoos (75% and 29% respectively). Although tattoos have been traditionally more common among men, gender divides have lessened to the degree of extinction in recent decades in some countries, with tattooing now more common in women overall compared to men in the United States and more common among women 20-29 years old in Australia. However, women tend to have smaller and less visible tattoos overall and prevalence data might be skewed by the inclusion of cosmetic or “permanent make-up” tattoos.

In addition to general prevalence data, Kruger noted that tattoos remain common in groups most traditionally associated with tattooing[5]. For example, the prevalence of tattoos among United States Navy personnel in World War II was 65%, while the modern prevalence of tattoos among those in the military is cited as ranging widely from 10%-44%. Differences in rates may reflect variations in sanctioning within separate settings, with peer group pressure playing a significant role. In Brazil for example, tattooing was not introduced until 1959 and the practice is illegal for minors in some states[6]. A survey conducted among a sample of 18-year-old Brazilian military recruits (n = 1968) revealed that about 11% of recruits had tattoos, of which 66% had a single tattoo and 21% had two tattoos, with the remainder having > 2 tattoos[6]. A large majority of tattooed recruits (80%) had obtained their first tattoo before the age of 18.

Despite the illegality of getting tattooed in most prisons worldwide, tattooing remains a common practice among inmates, with prevalence rates ranging from 9%-70%, depending on location, and some 40% of all inmates obtaining a tattoo while incarcerated[5]. Tattoos in the incarcerated population serve to align the wearer with a specific group, as a remembrance, as a sign of strength or aggressiveness, or to simply help to pass the time. Due to the makeshift nature of prison tattooing, inmates are at high risk for obtaining blood borne illnesses such as hepatitis C and human immunodeficiency virus (HIV).

WHAT DO TATTOOS TELL US ABOUT THEIR WEARERS?

Evolutionary and historical perspectives

Tattooing has been a human practice for more than 5000 years, leading Carmen et al[2] to examine tattoos through an evolutionary lens. They hypothesized that, regardless of the proximal motivations for getting a tattoo (e.g., commemorating an event or relationship, designating group affiliation, or serving as a marker of individuality), the ultimate evolutionary purpose is by definition rooted in sexual selection. The authors offered two hypotheses to explain how tattooing might have been favored in evolution that they call the “human canvas” and the “upping the ante” theories. The former postulates that tattooing is an expression of human culture based in “symbolic thought”, with the artistic canvas as a means to illustrate one’s personal story and to document history, moving from cave walls to the skin over time. The “upping the ante” theory suggests that tattoos evolved as a fitness indicator, enhancing one’s appearance in the context of intersexual competition, similar to a peacock’s tail. In tracing the evolution of tattooing across history starting from its ritualistic tribal origins, the authors note that the modern rise in the popularity of tattoos within Western culture emerged from individual niches such as military culture during World Wars I and II, the subsequent countercultural movements of the 1960s and 1970s, and the current cultural mainstream as a status quo. Over time, social stigmas have lessened and technical innovations have reduced the infectious risk of tattooing, such that it has become a less “costly” and therefore more common fitness indicator.

Psychoanalytic perspectives

Like Carmen et al[2], Grumet[7] tracked the development of tattoos throughout history, but did so through a lens of psychodynamic psychiatry as opposed to evolution. Although he acknowledged that tattoos could proclaim identity and group allegiance (as with military tattoos), he argued that “tattoo analysis” ought to be used as a kind of “dermal diagnosis”, with tattoos almost uniformly serving as a sign of psychopathology. For example, he suggested that tattoos are rooted in antisociality and exhibitionism and that “outcasts and outlaws” obtain tattoos in order to bolster low self-esteem. He concluded that tattoos should be viewed as “a psychic crutch aimed to repair a crippled self-image, inspire hope, keep noxious emotions at bay, and reduce the discrepancy between the individual and his aspirations”[7].

In a more recent analytic summary of unconscious motivations for tattoos, Karacaoglan[8] utilized a case series to illustrate that “the painful penetration of the skin in the process of tattooing… is a form of acting out” and that tattoos symbolize “an attempt to actively represent and recompense, as it were, an early deficiency” and a “dialectical record of the mother-father relationship”. Highlighting the masochistic nature of tattooing, the author interprets tattooing as an alternative form of expression that patients “resort” to when unable to verbalize “unendurable affect” through language. Like Grumet[7], Karacaoglan[8] ultimately concluded that tattooing is a “form of perversion”.

While we agree on the potential value “dermal diagnosis” in exploring unconscious motivations for obtaining tattoos, these uniformly pathologic interpretations now seem, in light of the ubiquity of tattoos in mainstream culture, like antiquated generalizations. While an individual’s tattoos could indeed be used to inform psychodynamic psychotherapy by tapping into personal self-representation through symbolism, their interpretation need not be restricted to the realm of psychopathology.

Motivations for tattooing

In keeping with the view that tattoos should not be solely regarded as reflections of psychopathology, Wohlrab et al[1] reviewed studies exploring the myriad motivations for obtaining tattoos. additional hints to create and maintain a distinct self-identity by controlling one’s appearance is cited as one of the most common reasons for tattooing. This motivation may be especially age-relevant and helps to explain the desire to obtain a tattoo during adolescence and young adulthood. In addition to the more identity-based, personal narrative, and group-oriented motivations for getting tattoos, some studies suggest that tattoos can also be viewed as a means to embellish the body as a fashion accessory or piece of art to wear on the body. Others have noted that tattooing can serve as a kind of badge that reflects pain tolerance and physical endurance, as a means of emphasizing sexuality, and as an affiliation with a religious or spiritual tradition, while tattoos are also sometimes obtained impulsively for no specific reason.

Based on a literature review, Dickson et al[9] likewise enumerated a variety of motivations for getting tattoos, including body adornment and personal decoration, expressions of individualism and markers of identity, and overcoming difficult emotions as a means of affect management. Motivations for tattooing vary between genders, with women more likely to seek tattoos for personal decoration and to feel more independent, and men more likely to use them as symbols of group identity. Contrary to traditional stereotypes, most adults with tattoos do not associate them with rebelliousness or cultural alienation, do not usually obtain them impulsively or while intoxicated, and do not regret getting them afterwards.

In order to test these generalizations, Dickson et al[9] administered a survey about tattoos to 458 United States college students, including 43% with at least one tattoo. The survey results confirmed that most tattooed respondents had taken months to decide what tattoo to get, obtained the tattoo in a reputable tattoo parlor, spent a significant amount of money on it, and tended to have been ≥ 18 years old at the time of their first tattoo. Respondents tended to view their tattoos as a means of self-distinction, rating them as having significant personal meaning as opposed to symbols of rebelliousness. While respondents reported very high levels of satisfaction with their first tattoo, those with multiple tattoos (60% of the tattooed sample) tended to rate their second or third tattoos, typically obtained a few years after their first, as favorites. This suggests that the process of obtaining multiple tattoos reflects a self-concept that continually evolves with time. For the majority of survey respondents who didn't have tattoos, reasons cited to forgo tattooing included not liking tattoos, concerns about permanency, anticipated disapproval from family, fear of pain, and not knowing what kind of tattoo to get.

Psychopathology and personality traits in tattooed individuals

Although several studies have indicated a greater prevalence of tattoos among psychiatric samples compared to the general population, the data to support this conclusion are largely drawn from older studies based on comparisons of cross-sectional measures of psychopathology among tattooed individuals in either non-psychiatric settings or psychiatric settings with inadequate controls between samples[10]. For example, Birmingham et al[11] reported an association between tattoos and a diagnosis of schizophrenia, but their study was based on a limited sample of male prisoners with visible tattoos. Two studies have reported an association between tattoos and a history of abuse, but both included individuals with body piercings[12,13] and one was based on responses to a survey published in a German body modification magazine[12]. Studies of such specialty populations may have limited generalizability due to other confounds that might better explain associations with psychopathology. Similarly, reported associations between tattoos and risk-taking behaviors such as drug use, early sexual activity, gang affiliation, and violent behavior have typically been drawn from small studies of adolescents, with methodological problems related to sample population and size, survey techniques, and the potential for type I error[5,14]. Taken in aggregate, now that tattooing has become more common and is well-represented amongst adults, any associations with psychopathology are much less clear.

Looking again at recent epidemiologic data from the United States cited above, Laumann et al[3] reported that compared to non-tattooed individuals, tattooed respondents were more likely to use recreational drugs, more likely to have spent ≥ 3 d in jail, and less likely to claim religious affiliation, even when controlling for age[3]. The percentage of tattooed respondents was lower among those who had never consumed alcohol. Among current drinkers, those with tattoos drank significantly more alcohol, although only a small minority of those tattooed had ever obtained their tattoos while intoxicated. Beyond the United States however, Kluger[5] noted that an association between tattoos and alcohol usage has not been detected in surveys from other countries and is therefore not well established. On the other hand, associations between tattoos and both cigarette smoking and recreational drug use (especially cannabis) may be more consistent.

A number of studies have used psychological rating scales to explore potential personality differences between tattooed and non-tattooed individuals, with mixed results[15]. Swami et al[15] administered a battery of inventories measuring various personality traits to a sample of 540 subjects from the southern German-speaking region of central Europe and found that those with tattoos only scored higher on measures of extraversion, experience seeking, and need for uniqueness. Although effect sizes were small to moderate, these results highlight that, if personality differences do exist among those with tattoos compared to the general population, they may not necessarily be dysfunctional or pathological. This conclusion is in keeping with recent findings from the United States in which the Community Body Modification Checklist was given to 213 adult subjects with and without tattoos or non-ear body piercings[16]. Defying hypothesized expectations, Giles-Gorniak et al[16] reported that the only significant difference in mental health history and behavioral choices between the two groups was that those with body modifications were more likely to engage in social and healthy behaviors. Likewise, an Australian study employed the Loyola Generativity Scale to assess “concern for and commitment to the next generation” among 710 adult women and found that those with and without tattoos had equivalent levels of psychosocial health according to this measure[17].

In contrast to these studies involving adults across the lifespan, much of the work to date on personality differences between tattooed and non-tattooed individuals has been performed in samples of college students, with limited generalizability. In order to avoid the methodological limitations of earlier studies, Tate and Shelton measured personality traits with validated scales that assessed for the Big Five Factors of personality (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness), the need for uniqueness, and the desire to be perceived favorably by others[14]. Tattooed participants, as compared to their non-tattooed counterparts, scored significantly lower on agreeableness and conscientiousness and higher on need for uniqueness. However, while these differences were statistically significant, effect sizes were small and personality scores found among tattooed individuals were, with a single exception among women, within published norms. The authors therefore concluded that “it is untenable to refer to tattoos, per se, as signs of social deviance or personality and character flaws”[14].

Suicide, self-injury, and tattoos

Tattooing is an inherently painful ritual that is usually voluntary, with a history of other acts of self-injury and of suicidal ideation sometimes noted anecdotally by recipients. A survey of 432 German adults with tattoos or non-ear body piercings found that 27% of respondents had a history of self-cutting during childhood[18]. Comparing those with and without a history of self-cutting, self-cutters had the same average number of tattoos, but significantly more piercings. Curiously, some respondents reported feeling “healed” and stopping self-injurious behavior following body modification, leading the authors to hypothesize that some use body modification as a “therapeutic substitute” for “autoaggressive acts”[18]. However, the inclusion of those with body piercings and the lack of a control group without body modification limits the generalizability of this conclusion to those with tattoos.

A possible association between eating disorders, self-injury, and tattoos was explored in a study of 65 female patients referred to a specialized unit for the treatment of anorexia, bulimia, and binge eating disorder[19]. In this sample, a history of self-injury was reported in 51% of patients, while 27% had at least one tattoo. Having a tattoo was significantly associated with a history of burning, supporting the authors’ conclusion that body modification might represent a form of self-punishment among those with eating disorders. However, 27% of the sample had tattoos and/or piercings without a history of self-injury and this subgroup had more positive feelings towards their bodies, higher levels of self-esteem, and less impulsivity, depression, anxiety, and social dysfunction than those with a history of self-injury. Therefore, tattoos may sometimes represent positive modifications of body image as opposed to markers of self-injurious behavior.

An association between tattoos and suicide was suggested in a study of 134 completed suicides over a 3-year period in Mobile County, Alabama[20]. In this sample, 21% had one or more tattoos at time of death, with 57% of “young, white suicide” completers having tattoos compared to only 29% for matched accidental deaths. Another study involving a larger series of 438 autopsies in Linn County, Iowa over a 15-year period included 32% subjects with tattoos[21]. Having a tattoo was associated with a significantly younger age at death and greater risk of death by an unnatural manner (e.g., gunshot wound or drug overdose), but not suicide. Taken together, these small, regional studies offer conflicting evidence for tattoos being associated with suicide. Both studies did speculate that tattoos might be a potential marker of risk-taking behaviors and substance use that could in turn be associated with early mortality, but larger, epidemiologic studies are needed to more clearly elucidate associations between tattoos, self-injury, and early death.

Self-perception in tattooed individuals

Given the intimate and relatively permanent nature of tattooing, a tattoo is expected to alter the new wearer’s perception of their body and their identity. However, the effect of the tattoo could depend on motivations for tattooing and the type and meaning of the tattooed image. A 2015 Harris Poll found that although most respondents did not feel that tattoos made them feel more sexy, attractive, rebellious, or spiritual, having a tattoo also did not make them feel less intelligent, respected, employable, or healthy[4]. However, a substantial minority did report that having a tattoo made them feel more sexy (33%), attractive (32%), and rebellious (27%). Tattoos therefore seem to have the ability to positively impact one’s sense of self, with individual variation and many aspects of identity potentially affected.

In an attempt to examine effects of tattoos on self-perception, Swami conducted a prospective study of adults from London who were planning to get their first tattoo by recruiting them in a tattoo shop[22]. Participants (n = 82) were assessed before and after getting their first tattoo and asked to rate or provide information about the following aspects of self-perception: Their own overall physical appearance, anxiety about 16 different body sites, measures related to a positive body image, self-attributed need for uniqueness, social physique anxiety, self-esteem, desire to stand out with appearance, reasons for obtaining the tattoo, schematic outlines of the front and back of their bodies to ascertain tattoo visibility and percentage of body covered by the new tattoo, satisfaction with the tattoo, and likelihood of obtaining future tattoos. Assessments were conducted immediately before and after obtaining the tattoo, and then again after 3 wk. Immediately after getting the tattoo, both men and women reported reduced anxiety and less dissatisfaction around their appearance, effects that were sustained at 3-wk follow up. On 3-wk follow up, both genders also reported an overall increase in self-esteem. This suggests that tattoos can mitigate negative attitudes a wearer might hold about one’s appearance. However, while men demonstrated a sustained decrease in social physique anxiety after obtaining a tattoo, female participants had higher social physique anxiety after 3 wk. The reason for this gender difference is unclear, but may be related to more negative perceptions towards women with tattoos in society. Still, no differences were found between participants with visible tattoos and those easy to conceal, such that “corporeal meaning” appeared to be a more important predictor of self-perception than appearance, or how others might view them.

While this survey reported individuals’ experiences and self-perception immediately before and after being tattooed, it did not examine self-perception in a more longitudinal fashion. It therefore remains unclear whether tattoos truly fulfill one’s need for self-expression or if this need remains unfulfilled over time for some, leading them to find other means, or more tattoos, to validate uniqueness. Collectively however these findings suggest that at least in the short-term, tattoos have the power to improve self-esteem and satisfaction, with their appearance providing fertile ground for exploration in the therapeutic setting.

Tattoo removal

The data presented thus far give lie to the ever-present stereotype of tattoos being obtained by intoxicated youth who regret the act the next day, with up to 83% of wearers satisfied with their tattoos[23]. Still, that leaves an estimated 20% of wearers who are dissatisfied with their tattoos and 6% who eventually opt for removal via surgical excision, dermabrasion, cryosurgery, chemical peels, and laser ablation with scarring, hypopigmentation, and incomplete removal as potential risks.

Armstrong et al[23] surveyed a sample of 196 subjects who sought tattoo removal from 4 clinics across the United States and found that the average person waited 10 years to do so. Frequent reasons for removal included “just decided to remove it”, “suffered embarrassment”, “got tired of it”, “just grew up”, and the need to hide the tattoo due to workplace stigma. Issues surrounding stigma were especially prevalent among women (see below for additional discussion).

Tattoo removal may be on the decline as societal acceptance of tattoos increases, with a 23% reduction in tattoo removal procedures reported by The American Society for Aesthetic Plastic Surgery between 2012 and 2013[24]. This decrease is in contrast to a 52% increase reported by the American Society of Dermatologic Surgery over the same time period. However, tattoo removal does not necessarily reflect an overall dissatisfaction with tattoos. In the study by Armstrong et al[23], a third of subjects seeking removal were interested in getting more tattoos in the future, suggesting that for some the desire of ablation is more about specific tattoos rather than tattoos in general.

TATTOOS IN SPECIFIC POPULATIONS

Adolescents and tattoos

It is important to distinguish between tattoos among adolescents and adults, since motivations for obtaining tattoos may be significantly different between the two groups. In addition, while tattoos have become a more mainstream phenomenon among adults, considerable stigma remains with tattooing as an adolescent[25]. Significant research has been devoted to the study of tattoos in adolescents, highlighting negative associations with risk-taking behaviors such as substance abuse, smoking, sexual activity, violent behavior, and problems in school[5]. However, such associations in adolescents < 18 years old are confounded by the fact that it is illegal for a minor to obtain a tattoo in all 50 of the United States. This suggests that tattooing may indeed be a signal of risk among minors, but those risks should not necessarily be extended to those obtaining tattoos as adults[25].

With these demographic differences in mind, a prospective, longitudinal study followed a national sample of 13101 United States 7^th-12^th graders over 12 to 18 mo, looking at predictors of getting a tattoo[25]. In their sample, adolescents who reported lower levels of parental and/or school attachment, lower grade point averages, and lower religiosity levels were more likely to have tattoos on follow up approximately 1-2 years later. The study also found that adolescents who used alcohol or marijuana and engaged in violent behavior were more likely to be tattooed at follow up. A history of violent victimization was also a significant antecedent of getting a tattoo, suggesting that some adolescents obtain tattoos as a method of self-protection. The authors conceded that the number of adolescents surveyed who later acquired tattoos was small (only 3.6% of sample), precluding any analysis of interaction effects[25]. In addition, they did not take tattoo size, type, or location into account, which is potentially salient since such specifics might reflect different motivations for getting a tattoo (e.g., tattoos signaling affiliation with “conventional institutions” such as a sports team or school likely have very different meanings compared to a gang tattoo on one’s neck). This caveat highlights that specific features of tattoos may have different implications about an individual, such that asking wearers about their tattoos may be a valuable source of information in terms of risk assessment, diagnosis, and general understanding. Methodological limitations aside however, it does appear that tattoos in adolescents can be thought of as representing a potential signal of risk among American adolescents.

Tattoos in the military

In modern Western culture, tattoos have been associated with soldiers for nearly a century, dating back to World Wars I and II[2]. This may have contributed to early associations with tattoos as symbols of machismo or with tattooed individuals being tougher or more dangerous. Among current soldiers, the motivations for getting tattoos and their meanings are varied and diverse, with some important potential distinctions from the general population.

Recent data indicate that about a third of United States soldiers enter the military with pre-existing tattoos[26], potentially reflecting character traits such as increased novelty seeking, extraversion, and a drive for self-individualization that might be associated with both getting a tattoo and joining the military. A survey of tattooed soldiers (n = 122) in the United States Armed Forces found a wide variety of tattoo types, including tattoos reflecting themes of self-identification (military branch or unit designations, patriotic images, ethnic/cultural/tribal symbols), martial themes (weapons, symbols of death), spirituality (religious symbols and quotations, angels, devils), and nature (animals, trees/flowers/plants, and moon/sun/planet/stars)[26].

Gadd conducted a survey of 445 British soldiers who presented to a military-run health clinic in 1990 and found that almost half had tattoos[27]. Peer influence, moreso from male than female friends, was frequently cited as a motivating factor (64%). Nearly a third of tattooed soldiers reported regret associated with their tattoo and considered its removal, with such sentiments significantly more likely among those ≥ 26 years old. These findings suggest that military personnel may face peer pressure to get tattoos that results in higher levels of regret than is reported in the general public. Regret among older soldiers might likewise reflect a change in identity with which the tattoo did not keep pace, or represent reminders of military experiences one might prefer to forget. Tattoos among military personnel and veterans seeking psychiatric treatment might therefore offer especially valuable avenues to gain access to self-identities transformed by war and personal loss.

The United States military has a long history of maintaining strict standards about personal appearance and grooming, with exacting guidelines governing proper attire and hair length. With the modern frequency of tattoos among potential recruits and the evolution of tattoos away from a sign of rebellion, the United States Armed Forces have recently revised their rules about tattoos, representing a shifting balance between codes of discipline or uniformity and evolving societal views about tattoos.

No branch of the United States Armed Forces allows tattoos that are sexist, racist, extremist, or derogatory in content. The United States Army recently provided general rules prohibiting tattoos on the neck, head, face, or wrists, but personnel are allowed to have tattoos everywhere else on their bodies, including the arms and legs, which were historically forbidden[28]. Hand tattoos are only permitted in the form of one ring on each hand in order to allow for tattooed wedding rings. The United States Marine Corps is currently updating its rules, but Marines are still not allowed to have tattoos covering the whole arm (“sleeves”)[29]. The United States Navy’s regulations specify that no tattoos are allowed on the face, neck, scalp, or head[30]. Tattoos exposed by wearing a short sleeve navy uniform shirt may be no larger in size than the wearer’s hand with fingers extended and joined with the thumb touching the base of the index finger. In contrast to the other branches of the United States Armed Forces, the United States Air Force has relatively strict rules, prohibiting excessive tattoos (partially defined as any tattoo that exceeds ¼ of the exposed body part) from being exposed or visible while in uniform[31].

Concerns about tattoos in the United States Armed Forces seem to reflect an emphasis on discipline, uniformity, and a respect for command that might be compromised by obvious external markings that set an individual apart. However, as tattoos have become increasingly common and more societally acceptable, the military has in turn become more tolerant, allowing that tattoos might provide an acceptable symbol not of defiance, but individuation and a potential source of group cohesion.

HOW DO OTHERS PERCEIVE THOSE WITH TATTOOS?

General perceptions

Despite the rapidly changing societal views of tattoos, explicit and implicit biases continue to affect how tattooed individuals are perceived. A 2015 Harris Poll revealed that the majority of respondents stated that there was no difference in perceptions of rebelliousness, sexiness, spirituality, respectability, intelligence, or health for people with or without tattoos[4]. However, for the substantial minority of respondents who did perceive a difference, people with tattoos were rated as more rebellious, but less attractive, sexy, spiritual, respectable, intelligent, and healthy.

Tattoo perceptions appear to vary according to the profession of the wearer, with more discomfort associated with visible tattoos on presidential candidates, judges, primary school teachers, and doctors compared to athletes, information technology technicians, and chefs[4]. Due to the persistent disapproval of visible tattoos in some professional settings, some individuals might forgo tattooing altogether or hide their tattoos at work in order to avoid stigma. In the reverse direction, a 1998 survey found that physicians and registered nurses demonstrated negative biases against those with tattoos[32]. Although the survey did not measure providers’ actual attitudes towards their patients, it is important to be aware of the potential for negative bias as a clinician working with individuals with tattoos.

In reviewing the literature on tattoo perception, Burgess and Clark[33] have noted that most tattoo perception studies to date have failed take into account the type of tattoo a participant possessed. This is an important omission that has likely contributed to generalizations about tattoos that are misleading in current society, where tattoos of all sizes, locations, and thematic imagery can be found. Tattoos can range from those that are concealed or visible only in more casual or intimate settings to prominent markings on the face, neck, and extremities. Designs can range from “small, trendy, and fun”[33] fashion accessories to more complex tattoos displaying more provocative or sexual themes covering large portions of the wearer’s body. Intuitively, such widely varying differences in tattoos are expected to be salient in terms of impacting the perceptions of others. Such perceptions would also be expected to vary based on the gender or age of a wearer.

In order to test such hypotheses, Burgess and Clark[33] performed a study in which 300 British university students were shown images of hypothetical male and female job applicants with either “cute” tattoos, “tribal” tattoos, or no tattoos. No tattoos and cute tattoos were associated with applicants being rated as more friendly and therefore suitable for the job in comparison to those applicants with tribal tattoos, who were perceived as more aggressive and less well suited. Negative dispositional characteristics were attributed exclusively to tribal tattoo wearers, which in turn negatively affected their perceived job suitability. This perception was more strongly held in respondents without tattoos compared to those with tattoos, or those who had considered getting one. This study therefore confirms that the content of a tattoo affects how the wearer is perceived, while also highlighting that tattooed individuals are generally less likely to infer negative attributes about another tattooed person. Therefore, while certain types of tattoos continue to trigger inferences about aggression and deviance, such attitudes may be shifting as more of the populace becomes tattooed.

Gender specific perceptions

Despite the increasing acceptance of tattoos in modern Western culture, women with tattoos still tend to be more negatively perceived than tattooed men. A 2004 survey of Canadian undergraduates reported that both male and female respondents had negative attitudes towards descriptions of women with visible tattoos, and that tattoo size was a predictor of disapproval for respondents who did not have tattoos themselves[34]. Swami et al[35] extended upon this research by using line drawings of women with tattoos that allowed manipulation of tattoo location and the number of tattoos to assess effects on an observer’s ratings of attractiveness, sexual promiscuity, and alcohol consumption. Based on a study sample of 160 British undergraduates, 14% of whom had tattoos, depictions of women with tattoos were rated as significantly less attractive, more sexually promiscuous, and heavier drinkers compared to women without tattoos. The likelihood of these perceptions increased with the number of tattoos, with figures bearing 3 tattoos estimated to drink more than twice the amount of alcohol as those without any tattoos. While the study was limited by the artificiality of the line drawings and the lack of a male figure control, it appears that tattoos among female college undergraduates may signal an increased likelihood of drinking alcohol and sexual activity. Despite these associations, 73% of the sample indicated that they would consider getting a tattoo in the future, and 53% of the sample was female. These caveats might therefore reflect not only less stigmatizing views of tattoos, but also of alcohol and sexual activity (e.g., casual sex and multiple partners) among undergraduates.

Resenhoeft et al[36] similarly used color photographs in two different experiments to assess United States undergraduates' perception of tattooed women. Participants viewed a photograph of a woman with or without a tattoo and then rated her on 13 personality traits including attractiveness, caring, athleticism, honesty, religiosity, and intelligence. The first experiment found that a photograph of a woman with a large, visible dragon tattoo on her upper arm was perceived as less attractive, fashionable, athletic, caring, intelligent, but more creative compared to a control photograph of the same woman without a tattoo. their explanation were not significant in the second experiment that used a photograph of a woman with a smaller, less visible tattoo of a pair of dolphins, with the exception of higher ratings of honesty and religiosity for the non-tattooed control. Although the study findings may have been influenced by using photos of different women dressed in different clothes in the two experiments, the results again seem to indicate negative biases against women with tattoos, even among young college students who might be expected to be more accepting of tattoos.

In an attempt to examine the impact of tattoos on sexual attraction between genders, Wohlrab et al[37] performed an experiment using computer generated virtual images depicting both women and men wearing bathing suits that revealed tribal tattoos in various locations. German university students (n = 278) were asked to rate these images on measures of attractiveness, dominance, aggression, masculinity or femininity, and health. In this study, images of tattooed women were rated as less healthy than women without tattoos, whereas images of men were rated as more dominant than those without. Sex differences among raters were important, with men rating images of women with tattoos as more attractive, while women rated them as more dominant. Conclusions about these findings may be limited to heterosexual perceptions of tribal tattoos among young people, but when considered along with other studies, they support the possibility that ratings of female attractiveness by men reflect biases about tattoos signaling sexual availability.

This conclusion was reinforced by a study performed in France using real women who were rated as highly attractive and who, under experimental conditions, displayed a temporary butterfly tattoo on their lower back while lying on a beach in a swimsuit. The field experiment measured how long it took for anonymous men to approach them[38]. Compared to non-tattooed controls, women with tattoos were more likely to be approached by men and were approached within a shorter time. Subsequent interviews with the men revealed that although tattooed women were not rated as more attractive compared to controls, men gave higher probability estimates of being able to get a date with a tattooed woman and to have sex on the first encounter.

Drawing firm conclusions based on these studies is difficult, given that each utilized different methodologies and featured different women with different clothing and different tattoos. Within-study controls suggest that tattoos in young women have the potential to be interpreted as a signal of sexual availability to young men, but across studies, and in reality, visible tattoos are only one of many aspects that might influence female attractiveness. In addition, the use of different types of tattoos across various studies highlights that different tattoos seem to carry different meanings for both wearers and observers, and cautions against overgeneralization.

Looking beyond the narrow scope of the tattoo effects on ratings of female attractiveness in young people, tattoos may have different implications in other contexts, such as within older populations or professional settings. For example, one study found that female nurses with tattoos were perceived more negatively and rated as less caring, skilled, and knowledgeable than their tattooed male colleagues[39]. Observers’ perceptions of tattoos in women are therefore influenced by a large number of variables, including setting, age, and other aspects of a woman’s appearance, along with tattoo size, location, and content. While such variables are important in considering perceptions about tattoos in both men and women, the impact of such variables can be very different between genders.

CASE STUDY

As psychotherapy progressed, the value of discussing Mr. A’s tattoos first emerged when the therapist asked about the tattooed faces of his children which had been embellished to appear more sinister. With prompting, Mr. A admitted that this was intended to maintain a look of stoic masculinity while still bearing reminders of his children on his body, and he agreed that this reflected a strong aversion to vulnerability. Once this was interpreted, he opened up further. The tattoo referencing fellow soldiers killed in combat, visible on the back of his neck, later proved to be a useful topic of exploration when he explained that it was placed in that location so that he would keep the reminder on his body but would not have to see it unless he wished to do so. He admitted that he felt deep, intolerable grief for the loss of these friends and used the tattoo to project this loss out onto the world because he felt incapable of dealing with it in any other way. This facilitated an actual discussion of Mr. A’s grief, allowing him to share his feelings for the first time. He reported to the therapist that her interest in his tattoos and non-judgmental questioning increased his sense of a therapeutic alliance and his overall engagement in treatment for PTSD. With additional work in therapy, it appeared that for Mr. A tattooing represented a kind of outward manifestation of intellectualization as a defense that prevented others from having emotional access to the fragile and sensitive person beneath his adorned skin.

In further interpreting Mr. A’s tattoos in the context of the modern literature on tattooing, his skin art can be viewed as a “human canvas” which tells the story of his childhood and subsequent formative military experiences. His tattoos overwhelmingly demonstrate dark themes of violent masculinity and pain tolerance, suggesting the need to portray an outward appearance of danger-seeking fearlessness that serves to intimidate or ward off others and that provides some insight into why he was drawn to military service. Now, as a law student and father trying to reconstruct his life with the help of psychotherapy, his tattoos represent a visual depiction of themes relevant to both his past life and present inner existence. While tattoos offer a window into the psyche, it is a window that only tells a partial story. Ultimately, tattoos represent what the patient purposefully reveals on the surface, inviting the therapist to explore that portal in order to access deeper emotions, motivations, and meanings contained within.

CONCLUSION

Over the past century in Western society, tattoos have evolved from cultural taboo to mainstream fashion. Accordingly, historical biases and pathological implications about tattoos warrant revision for present-day tattoo wearers. Although the literature to date on tattooing is informative, the available data are limited to subpopulations drawn from Western industrialized cultures and offer a narrow perspective on the interactions of other characteristics of tattoo wearers (e.g., age, ethnicity, socioeconomic status) on public perception. Clinicians are therefore cautioned against overgeneralization, and are instead encouraged to explore the personal meaning associated with individual patients and their different tattoos. We suggest that as a kind of augmentation of the physical exam, doing so with individuals who are engaged in psychiatric treatment provides a valuable window to the psyche that can reveal core aspects of self-identity and hidden emotions with the potential to facilitate and enhance clinical work.

Abstract

Tattooing the skin as a means of personal expression is a ritualized practice that has been around for centuries across many different cultures. Accordingly, the symbolic meaning of tattoos has evolved over time and is highly individualized, from both the internal perspective of the wearer and the external perspective of an observer. Within modern Western societies through the 1970s, tattoos represented a cultural taboo, typically associated with those outside of the mainstream such as soldiers, incarcerated criminals, gang members, and others belonging to marginalized and counter-cultural groups. This paper aims to review the more recent epidemiology of tattoos in Western culture in order to establish that tattooing has become a mainstream phenomenon. We then review psychological and psychiatric aspects of tattoos, with a goal of revising outmoded stigmas about tattooing and helping clinicians working with tattooed patients to facilitate an exploration of the personal meaning of skin art and self-identity. We suggest that as a kind of augmentation of the physical exam, looking at and talking to patients about their tattoos can provide a valuable window into the psyche, informing clinical practice.

Core tip: Although traditionally associated with deviance and psychopathology in modern Western culture, tattoos have evolved into a mainstream phenomenon, especially among younger adults. While there are myriad motivations for obtaining a tattoo, most individuals seek tattoos as a means of personal expression that provides a potential window into the psyche that can be used to facilitate psychiatric treatment. By reviewing the literature on psychological and psychiatric aspects of tattooing, we suggest that tattoos should be viewed not as signs of pathology, but as opportunities to explore core aspects of self-identity that can be valuable in clinical work.

CASE STUDY

Mr. A is a 31-year-old Caucasian United States Army veteran with post-traumatic stress disorder (PTSD) based on military combat experiences while deployed to Iraq and Afghanistan. He is a divorced father of two, currently in law school, with overall high functioning despite significant life challenges. A tumultuous childhood, including neglect and trauma at the hands of his mother and within the foster care system, led to several suicide attempts as a pre-teen and one psychiatric hospitalization where he was diagnosed with intermittent explosive disorder, bipolar disorder, and obsessive compulsive disorder. While medication titration was attempted during that hospitalization, he was never followed consistently by mental health as a child or adolescent, nor did he take psychiatric medication. Despite these developmental barriers, Mr. A was considered a gifted child with an intellectual capacity well beyond his years and background. At the age of 31, he presented for treatment of PTSD with bilateral full arm tattoos along with visible tattoos on his hands, knuckles, and the back of his neck. Later, he revealed that most of his body was covered with tattoos.

Discussions in psychotherapy revealed that he started getting tattooed at the age of 11, when his father forced him to learn how to fight, subjecting him to physical beatings in order to prepare him for the violent realities of his neighborhood. His first tattoos declared affiliation with his ethnic background, depicting themes of racial affiliation and violence that reflected long-time engagement with racially-based groups for the purpose of enhancing survival on the dangerous streets of his childhood home and within the juvenile corrections system. Other tattoos, including women in bondage, wizards, and skulls, were described as “filler”, while others displaying religious symbols, weapons, references to Greek philosophy, and military themes seemed to be more personal. One tattoo referenced the names of fellow soldiers who were killed in action during the wars in Iraq and Afghanistan.

When asked about his motivation for joining the military he replied, “I needed to find a way to maintain masculinity without being a convict”. Although he claimed to have thrived within military culture, he often clashed with superiors when he felt disrespected. During deployments, he accumulated extensive combat experience where he expected to die. However, he ultimately completed his military service and after an initial period of instability that included intoxicated fighting and divorce, he obtained sobriety and decided to go to law school. At the time of enrolling in treatment, he was living with a long-time girlfriend while maintaining partial custody of two children from his previous marriage. As psychotherapy began, he demonstrated notable difficulty discussing his emotions and was resistant to the therapist’s attempts to delve further into past and current relationships and his symptoms of PTSD.

REVIEW METHODOLOGY

An online search of PubMed and PsycInfo databases was performed using the search terms “tattoos”, “tattooing”, “tattoo”, “skin art”, “epidemiology”, “stigma”, “psychiatric disorders”, “psychology”, “perception”, “self-perception”, “removal”, “depression”, “anxiety”, “self-harm”, “deviance”, “psychopathology”, “prison”, “military”, and “veterans”. Criteria for inclusion were original research involving human subjects, meta-analyses, reviews, published in the English language between January 1, 1990 and February 1, 2016 (with the exception of reference 7 which was included for historical purposes). The bibliographies of articles identified through electronic search were also reviewed for additional relevant publications including online resources such as the Harris Poll and military service regulations. Dissertations were excluded. Articles with a primary focus on dermatological/physical/physiological reactions to tattooing and tattoo removal or on diagnosis and treatment of the infectious sequelae of tattoos were excluded.

EPIDEMIOLOGY

Until recently, tattoos have represented a cultural taboo in modern Western societies, typically associated with those outside of the mainstream such as sailors, soldiers, incarcerated criminals, gang members, prostitutes, and others belonging to marginalized and counter-cultural groups[1,2]. Over the past two decades however, epidemiologic studies have demonstrated that tattooing has become more of a mainstream phenomenon, with decreasing associations with stigma.

A survey of 500 population-representative United States respondents age 18-50 years old performed in 2004 revealed that 24% (n = 120) had tattoos with an additional 21% reporting that they had considered obtaining one[3]. Overall, 65% of tattooed respondents reported obtaining their first tattoo by age 24, with women more likely than men to be > 30 years old when they obtained their first tattoo. Tattooed respondents mostly had their tattoos done within the United States (98%), usually in professional tattoo parlors (80%), with tattoos obtained via homemade tattooing devices or sewing needles more likely to have been obtained at < 18 years of age. No tattooed respondents ever had a tattoo removed. Very few tattooed respondents reported being treated differently in work or social settings due to tattoos, suggesting that stigma surrounding tattoos has faded along with increasing popularity.

A more recent Harris poll of 2225 United States respondents performed in 2015 found that 29% of Americans had at least one tattoo, an increase from 14% in 2008 and 21% in 2012[4]. Tattoos were slightly more common among United States women (31%) than men (27%). Younger respondents were more likely to have tattoos, with nearly half (47%) of those 18-35 years old reporting that they had a tattoo. Regret about having a tattoo was reported in 23% of respondents, an increase from 14%-17% in previous years. Based on limited sample sizes from these two surveys, it therefore appears that tattooing has become much more common in the United States, particularly among young adults where rates may approach 1 in 2.

Looking more globally at industrialized Western societies, Kluger published a review of epidemiologic studies performed in the United States, Canada, Australia, Europe, and South America, reporting that the prevalence of tattooing is around 10%-20%[5]. Consistent with data from the United States, tattooing is more common among younger people globally, with the “tattooed generation” born in the 1970s and early 1980s. Being in a tattooed peer group or having a tattooed family member was linked to higher rates of possessing tattoos (75% and 29% respectively). Although tattoos have been traditionally more common among men, gender divides have lessened to the degree of extinction in recent decades in some countries, with tattooing now more common in women overall compared to men in the United States and more common among women 20-29 years old in Australia. However, women tend to have smaller and less visible tattoos overall and prevalence data might be skewed by the inclusion of cosmetic or “permanent make-up” tattoos.

In addition to general prevalence data, Kruger noted that tattoos remain common in groups most traditionally associated with tattooing[5]. For example, the prevalence of tattoos among United States Navy personnel in World War II was 65%, while the modern prevalence of tattoos among those in the military is cited as ranging widely from 10%-44%. Differences in rates may reflect variations in sanctioning within separate settings, with peer group pressure playing a significant role. In Brazil for example, tattooing was not introduced until 1959 and the practice is illegal for minors in some states[6]. A survey conducted among a sample of 18-year-old Brazilian military recruits (n = 1968) revealed that about 11% of recruits had tattoos, of which 66% had a single tattoo and 21% had two tattoos, with the remainder having > 2 tattoos[6]. A large majority of tattooed recruits (80%) had obtained their first tattoo before the age of 18.

Despite the illegality of getting tattooed in most prisons worldwide, tattooing remains a common practice among inmates, with prevalence rates ranging from 9%-70%, depending on location, and some 40% of all inmates obtaining a tattoo while incarcerated[5]. Tattoos in the incarcerated population serve to align the wearer with a specific group, as a remembrance, as a sign of strength or aggressiveness, or to simply help to pass the time. Due to the makeshift nature of prison tattooing, inmates are at high risk for obtaining blood borne illnesses such as hepatitis C and human immunodeficiency virus (HIV).

WHAT DO TATTOOS TELL US ABOUT THEIR WEARERS?

Evolutionary and historical perspectives

Tattooing has been a human practice for more than 5000 years, leading Carmen et al[2] to examine tattoos through an evolutionary lens. They hypothesized that, regardless of the proximal motivations for getting a tattoo (e.g., commemorating an event or relationship, designating group affiliation, or serving as a marker of individuality), the ultimate evolutionary purpose is by definition rooted in sexual selection. The authors offered two hypotheses to explain how tattooing might have been favored in evolution that they call the “human canvas” and the “upping the ante” theories. The former postulates that tattooing is an expression of human culture based in “symbolic thought”, with the artistic canvas as a means to illustrate one’s personal story and to document history, moving from cave walls to the skin over time. The “upping the ante” theory suggests that tattoos evolved as a fitness indicator, enhancing one’s appearance in the context of intersexual competition, similar to a peacock’s tail. In tracing the evolution of tattooing across history starting from its ritualistic tribal origins, the authors note that the modern rise in the popularity of tattoos within Western culture emerged from individual niches such as military culture during World Wars I and II, the subsequent countercultural movements of the 1960s and 1970s, and the current cultural mainstream as a status quo. Over time, social stigmas have lessened and technical innovations have reduced the infectious risk of tattooing, such that it has become a less “costly” and therefore more common fitness indicator.

Psychoanalytic perspectives

Like Carmen et al[2], Grumet[7] tracked the development of tattoos throughout history, but did so through a lens of psychodynamic psychiatry as opposed to evolution. Although he acknowledged that tattoos could proclaim identity and group allegiance (as with military tattoos), he argued that “tattoo analysis” ought to be used as a kind of “dermal diagnosis”, with tattoos almost uniformly serving as a sign of psychopathology. For example, he suggested that tattoos are rooted in antisociality and exhibitionism and that “outcasts and outlaws” obtain tattoos in order to bolster low self-esteem. He concluded that tattoos should be viewed as “a psychic crutch aimed to repair a crippled self-image, inspire hope, keep noxious emotions at bay, and reduce the discrepancy between the individual and his aspirations”[7].

In a more recent analytic summary of unconscious motivations for tattoos, Karacaoglan[8] utilized a case series to illustrate that “the painful penetration of the skin in the process of tattooing… is a form of acting out” and that tattoos symbolize “an attempt to actively represent and recompense, as it were, an early deficiency” and a “dialectical record of the mother-father relationship”. Highlighting the masochistic nature of tattooing, the author interprets tattooing as an alternative form of expression that patients “resort” to when unable to verbalize “unendurable affect” through language. Like Grumet[7], Karacaoglan[8] ultimately concluded that tattooing is a “form of perversion”.

While we agree on the potential value “dermal diagnosis” in exploring unconscious motivations for obtaining tattoos, these uniformly pathologic interpretations now seem, in light of the ubiquity of tattoos in mainstream culture, like antiquated generalizations. While an individual’s tattoos could indeed be used to inform psychodynamic psychotherapy by tapping into personal self-representation through symbolism, their interpretation need not be restricted to the realm of psychopathology.

Motivations for tattooing

In keeping with the view that tattoos should not be solely regarded as reflections of psychopathology, Wohlrab et al[1] reviewed studies exploring the myriad motivations for obtaining tattoos. additional hints to create and maintain a distinct self-identity by controlling one’s appearance is cited as one of the most common reasons for tattooing. This motivation may be especially age-relevant and helps to explain the desire to obtain a tattoo during adolescence and young adulthood. In addition to the more identity-based, personal narrative, and group-oriented motivations for getting tattoos, some studies suggest that tattoos can also be viewed as a means to embellish the body as a fashion accessory or piece of art to wear on the body. Others have noted that tattooing can serve as a kind of badge that reflects pain tolerance and physical endurance, as a means of emphasizing sexuality, and as an affiliation with a religious or spiritual tradition, while tattoos are also sometimes obtained impulsively for no specific reason.

Based on a literature review, Dickson et al[9] likewise enumerated a variety of motivations for getting tattoos, including body adornment and personal decoration, expressions of individualism and markers of identity, and overcoming difficult emotions as a means of affect management. Motivations for tattooing vary between genders, with women more likely to seek tattoos for personal decoration and to feel more independent, and men more likely to use them as symbols of group identity. Contrary to traditional stereotypes, most adults with tattoos do not associate them with rebelliousness or cultural alienation, do not usually obtain them impulsively or while intoxicated, and do not regret getting them afterwards.

In order to test these generalizations, Dickson et al[9] administered a survey about tattoos to 458 United States college students, including 43% with at least one tattoo. The survey results confirmed that most tattooed respondents had taken months to decide what tattoo to get, obtained the tattoo in a reputable tattoo parlor, spent a significant amount of money on it, and tended to have been ≥ 18 years old at the time of their first tattoo. Respondents tended to view their tattoos as a means of self-distinction, rating them as having significant personal meaning as opposed to symbols of rebelliousness. While respondents reported very high levels of satisfaction with their first tattoo, those with multiple tattoos (60% of the tattooed sample) tended to rate their second or third tattoos, typically obtained a few years after their first, as favorites. This suggests that the process of obtaining multiple tattoos reflects a self-concept that continually evolves with time. For the majority of survey respondents who didn't have tattoos, reasons cited to forgo tattooing included not liking tattoos, concerns about permanency, anticipated disapproval from family, fear of pain, and not knowing what kind of tattoo to get.

Psychopathology and personality traits in tattooed individuals

Although several studies have indicated a greater prevalence of tattoos among psychiatric samples compared to the general population, the data to support this conclusion are largely drawn from older studies based on comparisons of cross-sectional measures of psychopathology among tattooed individuals in either non-psychiatric settings or psychiatric settings with inadequate controls between samples[10]. For example, Birmingham et al[11] reported an association between tattoos and a diagnosis of schizophrenia, but their study was based on a limited sample of male prisoners with visible tattoos. Two studies have reported an association between tattoos and a history of abuse, but both included individuals with body piercings[12,13] and one was based on responses to a survey published in a German body modification magazine[12]. Studies of such specialty populations may have limited generalizability due to other confounds that might better explain associations with psychopathology. Similarly, reported associations between tattoos and risk-taking behaviors such as drug use, early sexual activity, gang affiliation, and violent behavior have typically been drawn from small studies of adolescents, with methodological problems related to sample population and size, survey techniques, and the potential for type I error[5,14]. Taken in aggregate, now that tattooing has become more common and is well-represented amongst adults, any associations with psychopathology are much less clear.

Looking again at recent epidemiologic data from the United States cited above, Laumann et al[3] reported that compared to non-tattooed individuals, tattooed respondents were more likely to use recreational drugs, more likely to have spent ≥ 3 d in jail, and less likely to claim religious affiliation, even when controlling for age[3]. The percentage of tattooed respondents was lower among those who had never consumed alcohol. Among current drinkers, those with tattoos drank significantly more alcohol, although only a small minority of those tattooed had ever obtained their tattoos while intoxicated. Beyond the United States however, Kluger[5] noted that an association between tattoos and alcohol usage has not been detected in surveys from other countries and is therefore not well established. On the other hand, associations between tattoos and both cigarette smoking and recreational drug use (especially cannabis) may be more consistent.

A number of studies have used psychological rating scales to explore potential personality differences between tattooed and non-tattooed individuals, with mixed results[15]. Swami et al[15] administered a battery of inventories measuring various personality traits to a sample of 540 subjects from the southern German-speaking region of central Europe and found that those with tattoos only scored higher on measures of extraversion, experience seeking, and need for uniqueness. Although effect sizes were small to moderate, these results highlight that, if personality differences do exist among those with tattoos compared to the general population, they may not necessarily be dysfunctional or pathological. This conclusion is in keeping with recent findings from the United States in which the Community Body Modification Checklist was given to 213 adult subjects with and without tattoos or non-ear body piercings[16]. Defying hypothesized expectations, Giles-Gorniak et al[16] reported that the only significant difference in mental health history and behavioral choices between the two groups was that those with body modifications were more likely to engage in social and healthy behaviors. Likewise, an Australian study employed the Loyola Generativity Scale to assess “concern for and commitment to the next generation” among 710 adult women and found that those with and without tattoos had equivalent levels of psychosocial health according to this measure[17].

In contrast to these studies involving adults across the lifespan, much of the work to date on personality differences between tattooed and non-tattooed individuals has been performed in samples of college students, with limited generalizability. In order to avoid the methodological limitations of earlier studies, Tate and Shelton measured personality traits with validated scales that assessed for the Big Five Factors of personality (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness), the need for uniqueness, and the desire to be perceived favorably by others[14]. Tattooed participants, as compared to their non-tattooed counterparts, scored significantly lower on agreeableness and conscientiousness and higher on need for uniqueness. However, while these differences were statistically significant, effect sizes were small and personality scores found among tattooed individuals were, with a single exception among women, within published norms. The authors therefore concluded that “it is untenable to refer to tattoos, per se, as signs of social deviance or personality and character flaws”[14].

Suicide, self-injury, and tattoos

Tattooing is an inherently painful ritual that is usually voluntary, with a history of other acts of self-injury and of suicidal ideation sometimes noted anecdotally by recipients. A survey of 432 German adults with tattoos or non-ear body piercings found that 27% of respondents had a history of self-cutting during childhood[18]. Comparing those with and without a history of self-cutting, self-cutters had the same average number of tattoos, but significantly more piercings. Curiously, some respondents reported feeling “healed” and stopping self-injurious behavior following body modification, leading the authors to hypothesize that some use body modification as a “therapeutic substitute” for “autoaggressive acts”[18]. However, the inclusion of those with body piercings and the lack of a control group without body modification limits the generalizability of this conclusion to those with tattoos.

A possible association between eating disorders, self-injury, and tattoos was explored in a study of 65 female patients referred to a specialized unit for the treatment of anorexia, bulimia, and binge eating disorder[19]. In this sample, a history of self-injury was reported in 51% of patients, while 27% had at least one tattoo. Having a tattoo was significantly associated with a history of burning, supporting the authors’ conclusion that body modification might represent a form of self-punishment among those with eating disorders. However, 27% of the sample had tattoos and/or piercings without a history of self-injury and this subgroup had more positive feelings towards their bodies, higher levels of self-esteem, and less impulsivity, depression, anxiety, and social dysfunction than those with a history of self-injury. Therefore, tattoos may sometimes represent positive modifications of body image as opposed to markers of self-injurious behavior.

An association between tattoos and suicide was suggested in a study of 134 completed suicides over a 3-year period in Mobile County, Alabama[20]. In this sample, 21% had one or more tattoos at time of death, with 57% of “young, white suicide” completers having tattoos compared to only 29% for matched accidental deaths. Another study involving a larger series of 438 autopsies in Linn County, Iowa over a 15-year period included 32% subjects with tattoos[21]. Having a tattoo was associated with a significantly younger age at death and greater risk of death by an unnatural manner (e.g., gunshot wound or drug overdose), but not suicide. Taken together, these small, regional studies offer conflicting evidence for tattoos being associated with suicide. Both studies did speculate that tattoos might be a potential marker of risk-taking behaviors and substance use that could in turn be associated with early mortality, but larger, epidemiologic studies are needed to more clearly elucidate associations between tattoos, self-injury, and early death.

Self-perception in tattooed individuals

Given the intimate and relatively permanent nature of tattooing, a tattoo is expected to alter the new wearer’s perception of their body and their identity. However, the effect of the tattoo could depend on motivations for tattooing and the type and meaning of the tattooed image. A 2015 Harris Poll found that although most respondents did not feel that tattoos made them feel more sexy, attractive, rebellious, or spiritual, having a tattoo also did not make them feel less intelligent, respected, employable, or healthy[4]. However, a substantial minority did report that having a tattoo made them feel more sexy (33%), attractive (32%), and rebellious (27%). Tattoos therefore seem to have the ability to positively impact one’s sense of self, with individual variation and many aspects of identity potentially affected.

In an attempt to examine effects of tattoos on self-perception, Swami conducted a prospective study of adults from London who were planning to get their first tattoo by recruiting them in a tattoo shop[22]. Participants (n = 82) were assessed before and after getting their first tattoo and asked to rate or provide information about the following aspects of self-perception: Their own overall physical appearance, anxiety about 16 different body sites, measures related to a positive body image, self-attributed need for uniqueness, social physique anxiety, self-esteem, desire to stand out with appearance, reasons for obtaining the tattoo, schematic outlines of the front and back of their bodies to ascertain tattoo visibility and percentage of body covered by the new tattoo, satisfaction with the tattoo, and likelihood of obtaining future tattoos. Assessments were conducted immediately before and after obtaining the tattoo, and then again after 3 wk. Immediately after getting the tattoo, both men and women reported reduced anxiety and less dissatisfaction around their appearance, effects that were sustained at 3-wk follow up. On 3-wk follow up, both genders also reported an overall increase in self-esteem. This suggests that tattoos can mitigate negative attitudes a wearer might hold about one’s appearance. However, while men demonstrated a sustained decrease in social physique anxiety after obtaining a tattoo, female participants had higher social physique anxiety after 3 wk. The reason for this gender difference is unclear, but may be related to more negative perceptions towards women with tattoos in society. Still, no differences were found between participants with visible tattoos and those easy to conceal, such that “corporeal meaning” appeared to be a more important predictor of self-perception than appearance, or how others might view them.

While this survey reported individuals’ experiences and self-perception immediately before and after being tattooed, it did not examine self-perception in a more longitudinal fashion. It therefore remains unclear whether tattoos truly fulfill one’s need for self-expression or if this need remains unfulfilled over time for some, leading them to find other means, or more tattoos, to validate uniqueness. Collectively however these findings suggest that at least in the short-term, tattoos have the power to improve self-esteem and satisfaction, with their appearance providing fertile ground for exploration in the therapeutic setting.

Tattoo removal

The data presented thus far give lie to the ever-present stereotype of tattoos being obtained by intoxicated youth who regret the act the next day, with up to 83% of wearers satisfied with their tattoos[23]. Still, that leaves an estimated 20% of wearers who are dissatisfied with their tattoos and 6% who eventually opt for removal via surgical excision, dermabrasion, cryosurgery, chemical peels, and laser ablation with scarring, hypopigmentation, and incomplete removal as potential risks.

Armstrong et al[23] surveyed a sample of 196 subjects who sought tattoo removal from 4 clinics across the United States and found that the average person waited 10 years to do so. Frequent reasons for removal included “just decided to remove it”, “suffered embarrassment”, “got tired of it”, “just grew up”, and the need to hide the tattoo due to workplace stigma. Issues surrounding stigma were especially prevalent among women (see below for additional discussion).

Tattoo removal may be on the decline as societal acceptance of tattoos increases, with a 23% reduction in tattoo removal procedures reported by The American Society for Aesthetic Plastic Surgery between 2012 and 2013[24]. This decrease is in contrast to a 52% increase reported by the American Society of Dermatologic Surgery over the same time period. However, tattoo removal does not necessarily reflect an overall dissatisfaction with tattoos. In the study by Armstrong et al[23], a third of subjects seeking removal were interested in getting more tattoos in the future, suggesting that for some the desire of ablation is more about specific tattoos rather than tattoos in general.

TATTOOS IN SPECIFIC POPULATIONS

Adolescents and tattoos

It is important to distinguish between tattoos among adolescents and adults, since motivations for obtaining tattoos may be significantly different between the two groups. In addition, while tattoos have become a more mainstream phenomenon among adults, considerable stigma remains with tattooing as an adolescent[25]. Significant research has been devoted to the study of tattoos in adolescents, highlighting negative associations with risk-taking behaviors such as substance abuse, smoking, sexual activity, violent behavior, and problems in school[5]. However, such associations in adolescents < 18 years old are confounded by the fact that it is illegal for a minor to obtain a tattoo in all 50 of the United States. This suggests that tattooing may indeed be a signal of risk among minors, but those risks should not necessarily be extended to those obtaining tattoos as adults[25].

With these demographic differences in mind, a prospective, longitudinal study followed a national sample of 13101 United States 7^th-12^th graders over 12 to 18 mo, looking at predictors of getting a tattoo[25]. In their sample, adolescents who reported lower levels of parental and/or school attachment, lower grade point averages, and lower religiosity levels were more likely to have tattoos on follow up approximately 1-2 years later. The study also found that adolescents who used alcohol or marijuana and engaged in violent behavior were more likely to be tattooed at follow up. A history of violent victimization was also a significant antecedent of getting a tattoo, suggesting that some adolescents obtain tattoos as a method of self-protection. The authors conceded that the number of adolescents surveyed who later acquired tattoos was small (only 3.6% of sample), precluding any analysis of interaction effects[25]. In addition, they did not take tattoo size, type, or location into account, which is potentially salient since such specifics might reflect different motivations for getting a tattoo (e.g., tattoos signaling affiliation with “conventional institutions” such as a sports team or school likely have very different meanings compared to a gang tattoo on one’s neck). This caveat highlights that specific features of tattoos may have different implications about an individual, such that asking wearers about their tattoos may be a valuable source of information in terms of risk assessment, diagnosis, and general understanding. Methodological limitations aside however, it does appear that tattoos in adolescents can be thought of as representing a potential signal of risk among American adolescents.

Tattoos in the military

In modern Western culture, tattoos have been associated with soldiers for nearly a century, dating back to World Wars I and II[2]. This may have contributed to early associations with tattoos as symbols of machismo or with tattooed individuals being tougher or more dangerous. Among current soldiers, the motivations for getting tattoos and their meanings are varied and diverse, with some important potential distinctions from the general population.

Recent data indicate that about a third of United States soldiers enter the military with pre-existing tattoos[26], potentially reflecting character traits such as increased novelty seeking, extraversion, and a drive for self-individualization that might be associated with both getting a tattoo and joining the military. A survey of tattooed soldiers (n = 122) in the United States Armed Forces found a wide variety of tattoo types, including tattoos reflecting themes of self-identification (military branch or unit designations, patriotic images, ethnic/cultural/tribal symbols), martial themes (weapons, symbols of death), spirituality (religious symbols and quotations, angels, devils), and nature (animals, trees/flowers/plants, and moon/sun/planet/stars)[26].

Gadd conducted a survey of 445 British soldiers who presented to a military-run health clinic in 1990 and found that almost half had tattoos[27]. Peer influence, moreso from male than female friends, was frequently cited as a motivating factor (64%). Nearly a third of tattooed soldiers reported regret associated with their tattoo and considered its removal, with such sentiments significantly more likely among those ≥ 26 years old. These findings suggest that military personnel may face peer pressure to get tattoos that results in higher levels of regret than is reported in the general public. Regret among older soldiers might likewise reflect a change in identity with which the tattoo did not keep pace, or represent reminders of military experiences one might prefer to forget. Tattoos among military personnel and veterans seeking psychiatric treatment might therefore offer especially valuable avenues to gain access to self-identities transformed by war and personal loss.

The United States military has a long history of maintaining strict standards about personal appearance and grooming, with exacting guidelines governing proper attire and hair length. With the modern frequency of tattoos among potential recruits and the evolution of tattoos away from a sign of rebellion, the United States Armed Forces have recently revised their rules about tattoos, representing a shifting balance between codes of discipline or uniformity and evolving societal views about tattoos.

No branch of the United States Armed Forces allows tattoos that are sexist, racist, extremist, or derogatory in content. The United States Army recently provided general rules prohibiting tattoos on the neck, head, face, or wrists, but personnel are allowed to have tattoos everywhere else on their bodies, including the arms and legs, which were historically forbidden[28]. Hand tattoos are only permitted in the form of one ring on each hand in order to allow for tattooed wedding rings. The United States Marine Corps is currently updating its rules, but Marines are still not allowed to have tattoos covering the whole arm (“sleeves”)[29]. The United States Navy’s regulations specify that no tattoos are allowed on the face, neck, scalp, or head[30]. Tattoos exposed by wearing a short sleeve navy uniform shirt may be no larger in size than the wearer’s hand with fingers extended and joined with the thumb touching the base of the index finger. In contrast to the other branches of the United States Armed Forces, the United States Air Force has relatively strict rules, prohibiting excessive tattoos (partially defined as any tattoo that exceeds ¼ of the exposed body part) from being exposed or visible while in uniform[31].

Concerns about tattoos in the United States Armed Forces seem to reflect an emphasis on discipline, uniformity, and a respect for command that might be compromised by obvious external markings that set an individual apart. However, as tattoos have become increasingly common and more societally acceptable, the military has in turn become more tolerant, allowing that tattoos might provide an acceptable symbol not of defiance, but individuation and a potential source of group cohesion.

HOW DO OTHERS PERCEIVE THOSE WITH TATTOOS?

General perceptions

Despite the rapidly changing societal views of tattoos, explicit and implicit biases continue to affect how tattooed individuals are perceived. A 2015 Harris Poll revealed that the majority of respondents stated that there was no difference in perceptions of rebelliousness, sexiness, spirituality, respectability, intelligence, or health for people with or without tattoos[4]. However, for the substantial minority of respondents who did perceive a difference, people with tattoos were rated as more rebellious, but less attractive, sexy, spiritual, respectable, intelligent, and healthy.

Tattoo perceptions appear to vary according to the profession of the wearer, with more discomfort associated with visible tattoos on presidential candidates, judges, primary school teachers, and doctors compared to athletes, information technology technicians, and chefs[4]. Due to the persistent disapproval of visible tattoos in some professional settings, some individuals might forgo tattooing altogether or hide their tattoos at work in order to avoid stigma. In the reverse direction, a 1998 survey found that physicians and registered nurses demonstrated negative biases against those with tattoos[32]. Although the survey did not measure providers’ actual attitudes towards their patients, it is important to be aware of the potential for negative bias as a clinician working with individuals with tattoos.

In reviewing the literature on tattoo perception, Burgess and Clark[33] have noted that most tattoo perception studies to date have failed take into account the type of tattoo a participant possessed. This is an important omission that has likely contributed to generalizations about tattoos that are misleading in current society, where tattoos of all sizes, locations, and thematic imagery can be found. Tattoos can range from those that are concealed or visible only in more casual or intimate settings to prominent markings on the face, neck, and extremities. Designs can range from “small, trendy, and fun”[33] fashion accessories to more complex tattoos displaying more provocative or sexual themes covering large portions of the wearer’s body. Intuitively, such widely varying differences in tattoos are expected to be salient in terms of impacting the perceptions of others. Such perceptions would also be expected to vary based on the gender or age of a wearer.

In order to test such hypotheses, Burgess and Clark[33] performed a study in which 300 British university students were shown images of hypothetical male and female job applicants with either “cute” tattoos, “tribal” tattoos, or no tattoos. No tattoos and cute tattoos were associated with applicants being rated as more friendly and therefore suitable for the job in comparison to those applicants with tribal tattoos, who were perceived as more aggressive and less well suited. Negative dispositional characteristics were attributed exclusively to tribal tattoo wearers, which in turn negatively affected their perceived job suitability. This perception was more strongly held in respondents without tattoos compared to those with tattoos, or those who had considered getting one. This study therefore confirms that the content of a tattoo affects how the wearer is perceived, while also highlighting that tattooed individuals are generally less likely to infer negative attributes about another tattooed person. Therefore, while certain types of tattoos continue to trigger inferences about aggression and deviance, such attitudes may be shifting as more of the populace becomes tattooed.

Gender specific perceptions

Despite the increasing acceptance of tattoos in modern Western culture, women with tattoos still tend to be more negatively perceived than tattooed men. A 2004 survey of Canadian undergraduates reported that both male and female respondents had negative attitudes towards descriptions of women with visible tattoos, and that tattoo size was a predictor of disapproval for respondents who did not have tattoos themselves[34]. Swami et al[35] extended upon this research by using line drawings of women with tattoos that allowed manipulation of tattoo location and the number of tattoos to assess effects on an observer’s ratings of attractiveness, sexual promiscuity, and alcohol consumption. Based on a study sample of 160 British undergraduates, 14% of whom had tattoos, depictions of women with tattoos were rated as significantly less attractive, more sexually promiscuous, and heavier drinkers compared to women without tattoos. The likelihood of these perceptions increased with the number of tattoos, with figures bearing 3 tattoos estimated to drink more than twice the amount of alcohol as those without any tattoos. While the study was limited by the artificiality of the line drawings and the lack of a male figure control, it appears that tattoos among female college undergraduates may signal an increased likelihood of drinking alcohol and sexual activity. Despite these associations, 73% of the sample indicated that they would consider getting a tattoo in the future, and 53% of the sample was female. These caveats might therefore reflect not only less stigmatizing views of tattoos, but also of alcohol and sexual activity (e.g., casual sex and multiple partners) among undergraduates.

Resenhoeft et al[36] similarly used color photographs in two different experiments to assess United States undergraduates' perception of tattooed women. Participants viewed a photograph of a woman with or without a tattoo and then rated her on 13 personality traits including attractiveness, caring, athleticism, honesty, religiosity, and intelligence. The first experiment found that a photograph of a woman with a large, visible dragon tattoo on her upper arm was perceived as less attractive, fashionable, athletic, caring, intelligent, but more creative compared to a control photograph of the same woman without a tattoo. their explanation were not significant in the second experiment that used a photograph of a woman with a smaller, less visible tattoo of a pair of dolphins, with the exception of higher ratings of honesty and religiosity for the non-tattooed control. Although the study findings may have been influenced by using photos of different women dressed in different clothes in the two experiments, the results again seem to indicate negative biases against women with tattoos, even among young college students who might be expected to be more accepting of tattoos.

In an attempt to examine the impact of tattoos on sexual attraction between genders, Wohlrab et al[37] performed an experiment using computer generated virtual images depicting both women and men wearing bathing suits that revealed tribal tattoos in various locations. German university students (n = 278) were asked to rate these images on measures of attractiveness, dominance, aggression, masculinity or femininity, and health. In this study, images of tattooed women were rated as less healthy than women without tattoos, whereas images of men were rated as more dominant than those without. Sex differences among raters were important, with men rating images of women with tattoos as more attractive, while women rated them as more dominant. Conclusions about these findings may be limited to heterosexual perceptions of tribal tattoos among young people, but when considered along with other studies, they support the possibility that ratings of female attractiveness by men reflect biases about tattoos signaling sexual availability.

This conclusion was reinforced by a study performed in France using real women who were rated as highly attractive and who, under experimental conditions, displayed a temporary butterfly tattoo on their lower back while lying on a beach in a swimsuit. The field experiment measured how long it took for anonymous men to approach them[38]. Compared to non-tattooed controls, women with tattoos were more likely to be approached by men and were approached within a shorter time. Subsequent interviews with the men revealed that although tattooed women were not rated as more attractive compared to controls, men gave higher probability estimates of being able to get a date with a tattooed woman and to have sex on the first encounter.

Drawing firm conclusions based on these studies is difficult, given that each utilized different methodologies and featured different women with different clothing and different tattoos. Within-study controls suggest that tattoos in young women have the potential to be interpreted as a signal of sexual availability to young men, but across studies, and in reality, visible tattoos are only one of many aspects that might influence female attractiveness. In addition, the use of different types of tattoos across various studies highlights that different tattoos seem to carry different meanings for both wearers and observers, and cautions against overgeneralization.

Looking beyond the narrow scope of the tattoo effects on ratings of female attractiveness in young people, tattoos may have different implications in other contexts, such as within older populations or professional settings. For example, one study found that female nurses with tattoos were perceived more negatively and rated as less caring, skilled, and knowledgeable than their tattooed male colleagues[39]. Observers’ perceptions of tattoos in women are therefore influenced by a large number of variables, including setting, age, and other aspects of a woman’s appearance, along with tattoo size, location, and content. While such variables are important in considering perceptions about tattoos in both men and women, the impact of such variables can be very different between genders.

CASE STUDY

As psychotherapy progressed, the value of discussing Mr. A’s tattoos first emerged when the therapist asked about the tattooed faces of his children which had been embellished to appear more sinister. With prompting, Mr. A admitted that this was intended to maintain a look of stoic masculinity while still bearing reminders of his children on his body, and he agreed that this reflected a strong aversion to vulnerability. Once this was interpreted, he opened up further. The tattoo referencing fellow soldiers killed in combat, visible on the back of his neck, later proved to be a useful topic of exploration when he explained that it was placed in that location so that he would keep the reminder on his body but would not have to see it unless he wished to do so. He admitted that he felt deep, intolerable grief for the loss of these friends and used the tattoo to project this loss out onto the world because he felt incapable of dealing with it in any other way. This facilitated an actual discussion of Mr. A’s grief, allowing him to share his feelings for the first time. He reported to the therapist that her interest in his tattoos and non-judgmental questioning increased his sense of a therapeutic alliance and his overall engagement in treatment for PTSD. With additional work in therapy, it appeared that for Mr. A tattooing represented a kind of outward manifestation of intellectualization as a defense that prevented others from having emotional access to the fragile and sensitive person beneath his adorned skin.

In further interpreting Mr. A’s tattoos in the context of the modern literature on tattooing, his skin art can be viewed as a “human canvas” which tells the story of his childhood and subsequent formative military experiences. His tattoos overwhelmingly demonstrate dark themes of violent masculinity and pain tolerance, suggesting the need to portray an outward appearance of danger-seeking fearlessness that serves to intimidate or ward off others and that provides some insight into why he was drawn to military service. Now, as a law student and father trying to reconstruct his life with the help of psychotherapy, his tattoos represent a visual depiction of themes relevant to both his past life and present inner existence. While tattoos offer a window into the psyche, it is a window that only tells a partial story. Ultimately, tattoos represent what the patient purposefully reveals on the surface, inviting the therapist to explore that portal in order to access deeper emotions, motivations, and meanings contained within.

CONCLUSION

Over the past century in Western society, tattoos have evolved from cultural taboo to mainstream fashion. Accordingly, historical biases and pathological implications about tattoos warrant revision for present-day tattoo wearers. Although the literature to date on tattooing is informative, the available data are limited to subpopulations drawn from Western industrialized cultures and offer a narrow perspective on the interactions of other characteristics of tattoo wearers (e.g., age, ethnicity, socioeconomic status) on public perception. Clinicians are therefore cautioned against overgeneralization, and are instead encouraged to explore the personal meaning associated with individual patients and their different tattoos. We suggest that as a kind of augmentation of the physical exam, doing so with individuals who are engaged in psychiatric treatment provides a valuable window to the psyche that can reveal core aspects of self-identity and hidden emotions with the potential to facilitate and enhance clinical work.

Abstract

Tattooing the skin as a means of personal expression is a ritualized practice that has been around for centuries across many different cultures. Accordingly, the symbolic meaning of tattoos has evolved over time and is highly individualized, from both the internal perspective of the wearer and the external perspective of an observer. Within modern Western societies through the 1970s, tattoos represented a cultural taboo, typically associated with those outside of the mainstream such as soldiers, incarcerated criminals, gang members, and others belonging to marginalized and counter-cultural groups. This paper aims to review the more recent epidemiology of tattoos in Western culture in order to establish that tattooing has become a mainstream phenomenon. We then review psychological and psychiatric aspects of tattoos, with a goal of revising outmoded stigmas about tattooing and helping clinicians working with tattooed patients to facilitate an exploration of the personal meaning of skin art and self-identity. We suggest that as a kind of augmentation of the physical exam, looking at and talking to patients about their tattoos can provide a valuable window into the psyche, informing clinical practice.

Core tip: Although traditionally associated with deviance and psychopathology in modern Western culture, tattoos have evolved into a mainstream phenomenon, especially among younger adults. While there are myriad motivations for obtaining a tattoo, most individuals seek tattoos as a means of personal expression that provides a potential window into the psyche that can be used to facilitate psychiatric treatment. By reviewing the literature on psychological and psychiatric aspects of tattooing, we suggest that tattoos should be viewed not as signs of pathology, but as opportunities to explore core aspects of self-identity that can be valuable in clinical work.

CASE STUDY

Mr. A is a 31-year-old Caucasian United States Army veteran with post-traumatic stress disorder (PTSD) based on military combat experiences while deployed to Iraq and Afghanistan. He is a divorced father of two, currently in law school, with overall high functioning despite significant life challenges. A tumultuous childhood, including neglect and trauma at the hands of his mother and within the foster care system, led to several suicide attempts as a pre-teen and one psychiatric hospitalization where he was diagnosed with intermittent explosive disorder, bipolar disorder, and obsessive compulsive disorder. While medication titration was attempted during that hospitalization, he was never followed consistently by mental health as a child or adolescent, nor did he take psychiatric medication. Despite these developmental barriers, Mr. A was considered a gifted child with an intellectual capacity well beyond his years and background. At the age of 31, he presented for treatment of PTSD with bilateral full arm tattoos along with visible tattoos on his hands, knuckles, and the back of his neck. Later, he revealed that most of his body was covered with tattoos.

Discussions in psychotherapy revealed that he started getting tattooed at the age of 11, when his father forced him to learn how to fight, subjecting him to physical beatings in order to prepare him for the violent realities of his neighborhood. His first tattoos declared affiliation with his ethnic background, depicting themes of racial affiliation and violence that reflected long-time engagement with racially-based groups for the purpose of enhancing survival on the dangerous streets of his childhood home and within the juvenile corrections system. Other tattoos, including women in bondage, wizards, and skulls, were described as “filler”, while others displaying religious symbols, weapons, references to Greek philosophy, and military themes seemed to be more personal. One tattoo referenced the names of fellow soldiers who were killed in action during the wars in Iraq and Afghanistan.

When asked about his motivation for joining the military he replied, “I needed to find a way to maintain masculinity without being a convict”. Although he claimed to have thrived within military culture, he often clashed with superiors when he felt disrespected. During deployments, he accumulated extensive combat experience where he expected to die. However, he ultimately completed his military service and after an initial period of instability that included intoxicated fighting and divorce, he obtained sobriety and decided to go to law school. At the time of enrolling in treatment, he was living with a long-time girlfriend while maintaining partial custody of two children from his previous marriage. As psychotherapy began, he demonstrated notable difficulty discussing his emotions and was resistant to the therapist’s attempts to delve further into past and current relationships and his symptoms of PTSD.

REVIEW METHODOLOGY

An online search of PubMed and PsycInfo databases was performed using the search terms “tattoos”, “tattooing”, “tattoo”, “skin art”, “epidemiology”, “stigma”, “psychiatric disorders”, “psychology”, “perception”, “self-perception”, “removal”, “depression”, “anxiety”, “self-harm”, “deviance”, “psychopathology”, “prison”, “military”, and “veterans”. Criteria for inclusion were original research involving human subjects, meta-analyses, reviews, published in the English language between January 1, 1990 and February 1, 2016 (with the exception of reference 7 which was included for historical purposes). The bibliographies of articles identified through electronic search were also reviewed for additional relevant publications including online resources such as the Harris Poll and military service regulations. Dissertations were excluded. Articles with a primary focus on dermatological/physical/physiological reactions to tattooing and tattoo removal or on diagnosis and treatment of the infectious sequelae of tattoos were excluded.

EPIDEMIOLOGY

Until recently, tattoos have represented a cultural taboo in modern Western societies, typically associated with those outside of the mainstream such as sailors, soldiers, incarcerated criminals, gang members, prostitutes, and others belonging to marginalized and counter-cultural groups[1,2]. Over the past two decades however, epidemiologic studies have demonstrated that tattooing has become more of a mainstream phenomenon, with decreasing associations with stigma.

A survey of 500 population-representative United States respondents age 18-50 years old performed in 2004 revealed that 24% (n = 120) had tattoos with an additional 21% reporting that they had considered obtaining one[3]. Overall, 65% of tattooed respondents reported obtaining their first tattoo by age 24, with women more likely than men to be > 30 years old when they obtained their first tattoo. Tattooed respondents mostly had their tattoos done within the United States (98%), usually in professional tattoo parlors (80%), with tattoos obtained via homemade tattooing devices or sewing needles more likely to have been obtained at < 18 years of age. No tattooed respondents ever had a tattoo removed. Very few tattooed respondents reported being treated differently in work or social settings due to tattoos, suggesting that stigma surrounding tattoos has faded along with increasing popularity.

A more recent Harris poll of 2225 United States respondents performed in 2015 found that 29% of Americans had at least one tattoo, an increase from 14% in 2008 and 21% in 2012[4]. Tattoos were slightly more common among United States women (31%) than men (27%). Younger respondents were more likely to have tattoos, with nearly half (47%) of those 18-35 years old reporting that they had a tattoo. Regret about having a tattoo was reported in 23% of respondents, an increase from 14%-17% in previous years. Based on limited sample sizes from these two surveys, it therefore appears that tattooing has become much more common in the United States, particularly among young adults where rates may approach 1 in 2.

Looking more globally at industrialized Western societies, Kluger published a review of epidemiologic studies performed in the United States, Canada, Australia, Europe, and South America, reporting that the prevalence of tattooing is around 10%-20%[5]. Consistent with data from the United States, tattooing is more common among younger people globally, with the “tattooed generation” born in the 1970s and early 1980s. Being in a tattooed peer group or having a tattooed family member was linked to higher rates of possessing tattoos (75% and 29% respectively). Although tattoos have been traditionally more common among men, gender divides have lessened to the degree of extinction in recent decades in some countries, with tattooing now more common in women overall compared to men in the United States and more common among women 20-29 years old in Australia. However, women tend to have smaller and less visible tattoos overall and prevalence data might be skewed by the inclusion of cosmetic or “permanent make-up” tattoos.

In addition to general prevalence data, Kruger noted that tattoos remain common in groups most traditionally associated with tattooing[5]. For example, the prevalence of tattoos among United States Navy personnel in World War II was 65%, while the modern prevalence of tattoos among those in the military is cited as ranging widely from 10%-44%. Differences in rates may reflect variations in sanctioning within separate settings, with peer group pressure playing a significant role. In Brazil for example, tattooing was not introduced until 1959 and the practice is illegal for minors in some states[6]. A survey conducted among a sample of 18-year-old Brazilian military recruits (n = 1968) revealed that about 11% of recruits had tattoos, of which 66% had a single tattoo and 21% had two tattoos, with the remainder having > 2 tattoos[6]. A large majority of tattooed recruits (80%) had obtained their first tattoo before the age of 18.

Despite the illegality of getting tattooed in most prisons worldwide, tattooing remains a common practice among inmates, with prevalence rates ranging from 9%-70%, depending on location, and some 40% of all inmates obtaining a tattoo while incarcerated[5]. Tattoos in the incarcerated population serve to align the wearer with a specific group, as a remembrance, as a sign of strength or aggressiveness, or to simply help to pass the time. Due to the makeshift nature of prison tattooing, inmates are at high risk for obtaining blood borne illnesses such as hepatitis C and human immunodeficiency virus (HIV).

WHAT DO TATTOOS TELL US ABOUT THEIR WEARERS?

Evolutionary and historical perspectives

Tattooing has been a human practice for more than 5000 years, leading Carmen et al[2] to examine tattoos through an evolutionary lens. They hypothesized that, regardless of the proximal motivations for getting a tattoo (e.g., commemorating an event or relationship, designating group affiliation, or serving as a marker of individuality), the ultimate evolutionary purpose is by definition rooted in sexual selection. The authors offered two hypotheses to explain how tattooing might have been favored in evolution that they call the “human canvas” and the “upping the ante” theories. The former postulates that tattooing is an expression of human culture based in “symbolic thought”, with the artistic canvas as a means to illustrate one’s personal story and to document history, moving from cave walls to the skin over time. The “upping the ante” theory suggests that tattoos evolved as a fitness indicator, enhancing one’s appearance in the context of intersexual competition, similar to a peacock’s tail. In tracing the evolution of tattooing across history starting from its ritualistic tribal origins, the authors note that the modern rise in the popularity of tattoos within Western culture emerged from individual niches such as military culture during World Wars I and II, the subsequent countercultural movements of the 1960s and 1970s, and the current cultural mainstream as a status quo. Over time, social stigmas have lessened and technical innovations have reduced the infectious risk of tattooing, such that it has become a less “costly” and therefore more common fitness indicator.

Psychoanalytic perspectives

Like Carmen et al[2], Grumet[7] tracked the development of tattoos throughout history, but did so through a lens of psychodynamic psychiatry as opposed to evolution. Although he acknowledged that tattoos could proclaim identity and group allegiance (as with military tattoos), he argued that “tattoo analysis” ought to be used as a kind of “dermal diagnosis”, with tattoos almost uniformly serving as a sign of psychopathology. For example, he suggested that tattoos are rooted in antisociality and exhibitionism and that “outcasts and outlaws” obtain tattoos in order to bolster low self-esteem. He concluded that tattoos should be viewed as “a psychic crutch aimed to repair a crippled self-image, inspire hope, keep noxious emotions at bay, and reduce the discrepancy between the individual and his aspirations”[7].

In a more recent analytic summary of unconscious motivations for tattoos, Karacaoglan[8] utilized a case series to illustrate that “the painful penetration of the skin in the process of tattooing… is a form of acting out” and that tattoos symbolize “an attempt to actively represent and recompense, as it were, an early deficiency” and a “dialectical record of the mother-father relationship”. Highlighting the masochistic nature of tattooing, the author interprets tattooing as an alternative form of expression that patients “resort” to when unable to verbalize “unendurable affect” through language. Like Grumet[7], Karacaoglan[8] ultimately concluded that tattooing is a “form of perversion”.

While we agree on the potential value “dermal diagnosis” in exploring unconscious motivations for obtaining tattoos, these uniformly pathologic interpretations now seem, in light of the ubiquity of tattoos in mainstream culture, like antiquated generalizations. While an individual’s tattoos could indeed be used to inform psychodynamic psychotherapy by tapping into personal self-representation through symbolism, their interpretation need not be restricted to the realm of psychopathology.

Motivations for tattooing

In keeping with the view that tattoos should not be solely regarded as reflections of psychopathology, Wohlrab et al[1] reviewed studies exploring the myriad motivations for obtaining tattoos. additional hints to create and maintain a distinct self-identity by controlling one’s appearance is cited as one of the most common reasons for tattooing. This motivation may be especially age-relevant and helps to explain the desire to obtain a tattoo during adolescence and young adulthood. In addition to the more identity-based, personal narrative, and group-oriented motivations for getting tattoos, some studies suggest that tattoos can also be viewed as a means to embellish the body as a fashion accessory or piece of art to wear on the body. Others have noted that tattooing can serve as a kind of badge that reflects pain tolerance and physical endurance, as a means of emphasizing sexuality, and as an affiliation with a religious or spiritual tradition, while tattoos are also sometimes obtained impulsively for no specific reason.

Based on a literature review, Dickson et al[9] likewise enumerated a variety of motivations for getting tattoos, including body adornment and personal decoration, expressions of individualism and markers of identity, and overcoming difficult emotions as a means of affect management. Motivations for tattooing vary between genders, with women more likely to seek tattoos for personal decoration and to feel more independent, and men more likely to use them as symbols of group identity. Contrary to traditional stereotypes, most adults with tattoos do not associate them with rebelliousness or cultural alienation, do not usually obtain them impulsively or while intoxicated, and do not regret getting them afterwards.

In order to test these generalizations, Dickson et al[9] administered a survey about tattoos to 458 United States college students, including 43% with at least one tattoo. The survey results confirmed that most tattooed respondents had taken months to decide what tattoo to get, obtained the tattoo in a reputable tattoo parlor, spent a significant amount of money on it, and tended to have been ≥ 18 years old at the time of their first tattoo. Respondents tended to view their tattoos as a means of self-distinction, rating them as having significant personal meaning as opposed to symbols of rebelliousness. While respondents reported very high levels of satisfaction with their first tattoo, those with multiple tattoos (60% of the tattooed sample) tended to rate their second or third tattoos, typically obtained a few years after their first, as favorites. This suggests that the process of obtaining multiple tattoos reflects a self-concept that continually evolves with time. For the majority of survey respondents who didn't have tattoos, reasons cited to forgo tattooing included not liking tattoos, concerns about permanency, anticipated disapproval from family, fear of pain, and not knowing what kind of tattoo to get.

Psychopathology and personality traits in tattooed individuals

Although several studies have indicated a greater prevalence of tattoos among psychiatric samples compared to the general population, the data to support this conclusion are largely drawn from older studies based on comparisons of cross-sectional measures of psychopathology among tattooed individuals in either non-psychiatric settings or psychiatric settings with inadequate controls between samples[10]. For example, Birmingham et al[11] reported an association between tattoos and a diagnosis of schizophrenia, but their study was based on a limited sample of male prisoners with visible tattoos. Two studies have reported an association between tattoos and a history of abuse, but both included individuals with body piercings[12,13] and one was based on responses to a survey published in a German body modification magazine[12]. Studies of such specialty populations may have limited generalizability due to other confounds that might better explain associations with psychopathology. Similarly, reported associations between tattoos and risk-taking behaviors such as drug use, early sexual activity, gang affiliation, and violent behavior have typically been drawn from small studies of adolescents, with methodological problems related to sample population and size, survey techniques, and the potential for type I error[5,14]. Taken in aggregate, now that tattooing has become more common and is well-represented amongst adults, any associations with psychopathology are much less clear.

Looking again at recent epidemiologic data from the United States cited above, Laumann et al[3] reported that compared to non-tattooed individuals, tattooed respondents were more likely to use recreational drugs, more likely to have spent ≥ 3 d in jail, and less likely to claim religious affiliation, even when controlling for age[3]. The percentage of tattooed respondents was lower among those who had never consumed alcohol. Among current drinkers, those with tattoos drank significantly more alcohol, although only a small minority of those tattooed had ever obtained their tattoos while intoxicated. Beyond the United States however, Kluger[5] noted that an association between tattoos and alcohol usage has not been detected in surveys from other countries and is therefore not well established. On the other hand, associations between tattoos and both cigarette smoking and recreational drug use (especially cannabis) may be more consistent.

A number of studies have used psychological rating scales to explore potential personality differences between tattooed and non-tattooed individuals, with mixed results[15]. Swami et al[15] administered a battery of inventories measuring various personality traits to a sample of 540 subjects from the southern German-speaking region of central Europe and found that those with tattoos only scored higher on measures of extraversion, experience seeking, and need for uniqueness. Although effect sizes were small to moderate, these results highlight that, if personality differences do exist among those with tattoos compared to the general population, they may not necessarily be dysfunctional or pathological. This conclusion is in keeping with recent findings from the United States in which the Community Body Modification Checklist was given to 213 adult subjects with and without tattoos or non-ear body piercings[16]. Defying hypothesized expectations, Giles-Gorniak et al[16] reported that the only significant difference in mental health history and behavioral choices between the two groups was that those with body modifications were more likely to engage in social and healthy behaviors. Likewise, an Australian study employed the Loyola Generativity Scale to assess “concern for and commitment to the next generation” among 710 adult women and found that those with and without tattoos had equivalent levels of psychosocial health according to this measure[17].

In contrast to these studies involving adults across the lifespan, much of the work to date on personality differences between tattooed and non-tattooed individuals has been performed in samples of college students, with limited generalizability. In order to avoid the methodological limitations of earlier studies, Tate and Shelton measured personality traits with validated scales that assessed for the Big Five Factors of personality (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness), the need for uniqueness, and the desire to be perceived favorably by others[14]. Tattooed participants, as compared to their non-tattooed counterparts, scored significantly lower on agreeableness and conscientiousness and higher on need for uniqueness. However, while these differences were statistically significant, effect sizes were small and personality scores found among tattooed individuals were, with a single exception among women, within published norms. The authors therefore concluded that “it is untenable to refer to tattoos, per se, as signs of social deviance or personality and character flaws”[14].

Suicide, self-injury, and tattoos

Tattooing is an inherently painful ritual that is usually voluntary, with a history of other acts of self-injury and of suicidal ideation sometimes noted anecdotally by recipients. A survey of 432 German adults with tattoos or non-ear body piercings found that 27% of respondents had a history of self-cutting during childhood[18]. Comparing those with and without a history of self-cutting, self-cutters had the same average number of tattoos, but significantly more piercings. Curiously, some respondents reported feeling “healed” and stopping self-injurious behavior following body modification, leading the authors to hypothesize that some use body modification as a “therapeutic substitute” for “autoaggressive acts”[18]. However, the inclusion of those with body piercings and the lack of a control group without body modification limits the generalizability of this conclusion to those with tattoos.

A possible association between eating disorders, self-injury, and tattoos was explored in a study of 65 female patients referred to a specialized unit for the treatment of anorexia, bulimia, and binge eating disorder[19]. In this sample, a history of self-injury was reported in 51% of patients, while 27% had at least one tattoo. Having a tattoo was significantly associated with a history of burning, supporting the authors’ conclusion that body modification might represent a form of self-punishment among those with eating disorders. However, 27% of the sample had tattoos and/or piercings without a history of self-injury and this subgroup had more positive feelings towards their bodies, higher levels of self-esteem, and less impulsivity, depression, anxiety, and social dysfunction than those with a history of self-injury. Therefore, tattoos may sometimes represent positive modifications of body image as opposed to markers of self-injurious behavior.

An association between tattoos and suicide was suggested in a study of 134 completed suicides over a 3-year period in Mobile County, Alabama[20]. In this sample, 21% had one or more tattoos at time of death, with 57% of “young, white suicide” completers having tattoos compared to only 29% for matched accidental deaths. Another study involving a larger series of 438 autopsies in Linn County, Iowa over a 15-year period included 32% subjects with tattoos[21]. Having a tattoo was associated with a significantly younger age at death and greater risk of death by an unnatural manner (e.g., gunshot wound or drug overdose), but not suicide. Taken together, these small, regional studies offer conflicting evidence for tattoos being associated with suicide. Both studies did speculate that tattoos might be a potential marker of risk-taking behaviors and substance use that could in turn be associated with early mortality, but larger, epidemiologic studies are needed to more clearly elucidate associations between tattoos, self-injury, and early death.

Self-perception in tattooed individuals

Given the intimate and relatively permanent nature of tattooing, a tattoo is expected to alter the new wearer’s perception of their body and their identity. However, the effect of the tattoo could depend on motivations for tattooing and the type and meaning of the tattooed image. A 2015 Harris Poll found that although most respondents did not feel that tattoos made them feel more sexy, attractive, rebellious, or spiritual, having a tattoo also did not make them feel less intelligent, respected, employable, or healthy[4]. However, a substantial minority did report that having a tattoo made them feel more sexy (33%), attractive (32%), and rebellious (27%). Tattoos therefore seem to have the ability to positively impact one’s sense of self, with individual variation and many aspects of identity potentially affected.

In an attempt to examine effects of tattoos on self-perception, Swami conducted a prospective study of adults from London who were planning to get their first tattoo by recruiting them in a tattoo shop[22]. Participants (n = 82) were assessed before and after getting their first tattoo and asked to rate or provide information about the following aspects of self-perception: Their own overall physical appearance, anxiety about 16 different body sites, measures related to a positive body image, self-attributed need for uniqueness, social physique anxiety, self-esteem, desire to stand out with appearance, reasons for obtaining the tattoo, schematic outlines of the front and back of their bodies to ascertain tattoo visibility and percentage of body covered by the new tattoo, satisfaction with the tattoo, and likelihood of obtaining future tattoos. Assessments were conducted immediately before and after obtaining the tattoo, and then again after 3 wk. Immediately after getting the tattoo, both men and women reported reduced anxiety and less dissatisfaction around their appearance, effects that were sustained at 3-wk follow up. On 3-wk follow up, both genders also reported an overall increase in self-esteem. This suggests that tattoos can mitigate negative attitudes a wearer might hold about one’s appearance. However, while men demonstrated a sustained decrease in social physique anxiety after obtaining a tattoo, female participants had higher social physique anxiety after 3 wk. The reason for this gender difference is unclear, but may be related to more negative perceptions towards women with tattoos in society. Still, no differences were found between participants with visible tattoos and those easy to conceal, such that “corporeal meaning” appeared to be a more important predictor of self-perception than appearance, or how others might view them.

While this survey reported individuals’ experiences and self-perception immediately before and after being tattooed, it did not examine self-perception in a more longitudinal fashion. It therefore remains unclear whether tattoos truly fulfill one’s need for self-expression or if this need remains unfulfilled over time for some, leading them to find other means, or more tattoos, to validate uniqueness. Collectively however these findings suggest that at least in the short-term, tattoos have the power to improve self-esteem and satisfaction, with their appearance providing fertile ground for exploration in the therapeutic setting.

Tattoo removal

The data presented thus far give lie to the ever-present stereotype of tattoos being obtained by intoxicated youth who regret the act the next day, with up to 83% of wearers satisfied with their tattoos[23]. Still, that leaves an estimated 20% of wearers who are dissatisfied with their tattoos and 6% who eventually opt for removal via surgical excision, dermabrasion, cryosurgery, chemical peels, and laser ablation with scarring, hypopigmentation, and incomplete removal as potential risks.

Armstrong et al[23] surveyed a sample of 196 subjects who sought tattoo removal from 4 clinics across the United States and found that the average person waited 10 years to do so. Frequent reasons for removal included “just decided to remove it”, “suffered embarrassment”, “got tired of it”, “just grew up”, and the need to hide the tattoo due to workplace stigma. Issues surrounding stigma were especially prevalent among women (see below for additional discussion).

Tattoo removal may be on the decline as societal acceptance of tattoos increases, with a 23% reduction in tattoo removal procedures reported by The American Society for Aesthetic Plastic Surgery between 2012 and 2013[24]. This decrease is in contrast to a 52% increase reported by the American Society of Dermatologic Surgery over the same time period. However, tattoo removal does not necessarily reflect an overall dissatisfaction with tattoos. In the study by Armstrong et al[23], a third of subjects seeking removal were interested in getting more tattoos in the future, suggesting that for some the desire of ablation is more about specific tattoos rather than tattoos in general.

TATTOOS IN SPECIFIC POPULATIONS

Adolescents and tattoos

It is important to distinguish between tattoos among adolescents and adults, since motivations for obtaining tattoos may be significantly different between the two groups. In addition, while tattoos have become a more mainstream phenomenon among adults, considerable stigma remains with tattooing as an adolescent[25]. Significant research has been devoted to the study of tattoos in adolescents, highlighting negative associations with risk-taking behaviors such as substance abuse, smoking, sexual activity, violent behavior, and problems in school[5]. However, such associations in adolescents < 18 years old are confounded by the fact that it is illegal for a minor to obtain a tattoo in all 50 of the United States. This suggests that tattooing may indeed be a signal of risk among minors, but those risks should not necessarily be extended to those obtaining tattoos as adults[25].

With these demographic differences in mind, a prospective, longitudinal study followed a national sample of 13101 United States 7^th-12^th graders over 12 to 18 mo, looking at predictors of getting a tattoo[25]. In their sample, adolescents who reported lower levels of parental and/or school attachment, lower grade point averages, and lower religiosity levels were more likely to have tattoos on follow up approximately 1-2 years later. The study also found that adolescents who used alcohol or marijuana and engaged in violent behavior were more likely to be tattooed at follow up. A history of violent victimization was also a significant antecedent of getting a tattoo, suggesting that some adolescents obtain tattoos as a method of self-protection. The authors conceded that the number of adolescents surveyed who later acquired tattoos was small (only 3.6% of sample), precluding any analysis of interaction effects[25]. In addition, they did not take tattoo size, type, or location into account, which is potentially salient since such specifics might reflect different motivations for getting a tattoo (e.g., tattoos signaling affiliation with “conventional institutions” such as a sports team or school likely have very different meanings compared to a gang tattoo on one’s neck). This caveat highlights that specific features of tattoos may have different implications about an individual, such that asking wearers about their tattoos may be a valuable source of information in terms of risk assessment, diagnosis, and general understanding. Methodological limitations aside however, it does appear that tattoos in adolescents can be thought of as representing a potential signal of risk among American adolescents.

Tattoos in the military

In modern Western culture, tattoos have been associated with soldiers for nearly a century, dating back to World Wars I and II[2]. This may have contributed to early associations with tattoos as symbols of machismo or with tattooed individuals being tougher or more dangerous. Among current soldiers, the motivations for getting tattoos and their meanings are varied and diverse, with some important potential distinctions from the general population.

Recent data indicate that about a third of United States soldiers enter the military with pre-existing tattoos[26], potentially reflecting character traits such as increased novelty seeking, extraversion, and a drive for self-individualization that might be associated with both getting a tattoo and joining the military. A survey of tattooed soldiers (n = 122) in the United States Armed Forces found a wide variety of tattoo types, including tattoos reflecting themes of self-identification (military branch or unit designations, patriotic images, ethnic/cultural/tribal symbols), martial themes (weapons, symbols of death), spirituality (religious symbols and quotations, angels, devils), and nature (animals, trees/flowers/plants, and moon/sun/planet/stars)[26].

Gadd conducted a survey of 445 British soldiers who presented to a military-run health clinic in 1990 and found that almost half had tattoos[27]. Peer influence, moreso from male than female friends, was frequently cited as a motivating factor (64%). Nearly a third of tattooed soldiers reported regret associated with their tattoo and considered its removal, with such sentiments significantly more likely among those ≥ 26 years old. These findings suggest that military personnel may face peer pressure to get tattoos that results in higher levels of regret than is reported in the general public. Regret among older soldiers might likewise reflect a change in identity with which the tattoo did not keep pace, or represent reminders of military experiences one might prefer to forget. Tattoos among military personnel and veterans seeking psychiatric treatment might therefore offer especially valuable avenues to gain access to self-identities transformed by war and personal loss.

The United States military has a long history of maintaining strict standards about personal appearance and grooming, with exacting guidelines governing proper attire and hair length. With the modern frequency of tattoos among potential recruits and the evolution of tattoos away from a sign of rebellion, the United States Armed Forces have recently revised their rules about tattoos, representing a shifting balance between codes of discipline or uniformity and evolving societal views about tattoos.

No branch of the United States Armed Forces allows tattoos that are sexist, racist, extremist, or derogatory in content. The United States Army recently provided general rules prohibiting tattoos on the neck, head, face, or wrists, but personnel are allowed to have tattoos everywhere else on their bodies, including the arms and legs, which were historically forbidden[28]. Hand tattoos are only permitted in the form of one ring on each hand in order to allow for tattooed wedding rings. The United States Marine Corps is currently updating its rules, but Marines are still not allowed to have tattoos covering the whole arm (“sleeves”)[29]. The United States Navy’s regulations specify that no tattoos are allowed on the face, neck, scalp, or head[30]. Tattoos exposed by wearing a short sleeve navy uniform shirt may be no larger in size than the wearer’s hand with fingers extended and joined with the thumb touching the base of the index finger. In contrast to the other branches of the United States Armed Forces, the United States Air Force has relatively strict rules, prohibiting excessive tattoos (partially defined as any tattoo that exceeds ¼ of the exposed body part) from being exposed or visible while in uniform[31].

Concerns about tattoos in the United States Armed Forces seem to reflect an emphasis on discipline, uniformity, and a respect for command that might be compromised by obvious external markings that set an individual apart. However, as tattoos have become increasingly common and more societally acceptable, the military has in turn become more tolerant, allowing that tattoos might provide an acceptable symbol not of defiance, but individuation and a potential source of group cohesion.

HOW DO OTHERS PERCEIVE THOSE WITH TATTOOS?

General perceptions

Despite the rapidly changing societal views of tattoos, explicit and implicit biases continue to affect how tattooed individuals are perceived. A 2015 Harris Poll revealed that the majority of respondents stated that there was no difference in perceptions of rebelliousness, sexiness, spirituality, respectability, intelligence, or health for people with or without tattoos[4]. However, for the substantial minority of respondents who did perceive a difference, people with tattoos were rated as more rebellious, but less attractive, sexy, spiritual, respectable, intelligent, and healthy.

Tattoo perceptions appear to vary according to the profession of the wearer, with more discomfort associated with visible tattoos on presidential candidates, judges, primary school teachers, and doctors compared to athletes, information technology technicians, and chefs[4]. Due to the persistent disapproval of visible tattoos in some professional settings, some individuals might forgo tattooing altogether or hide their tattoos at work in order to avoid stigma. In the reverse direction, a 1998 survey found that physicians and registered nurses demonstrated negative biases against those with tattoos[32]. Although the survey did not measure providers’ actual attitudes towards their patients, it is important to be aware of the potential for negative bias as a clinician working with individuals with tattoos.

In reviewing the literature on tattoo perception, Burgess and Clark[33] have noted that most tattoo perception studies to date have failed take into account the type of tattoo a participant possessed. This is an important omission that has likely contributed to generalizations about tattoos that are misleading in current society, where tattoos of all sizes, locations, and thematic imagery can be found. Tattoos can range from those that are concealed or visible only in more casual or intimate settings to prominent markings on the face, neck, and extremities. Designs can range from “small, trendy, and fun”[33] fashion accessories to more complex tattoos displaying more provocative or sexual themes covering large portions of the wearer’s body. Intuitively, such widely varying differences in tattoos are expected to be salient in terms of impacting the perceptions of others. Such perceptions would also be expected to vary based on the gender or age of a wearer.

In order to test such hypotheses, Burgess and Clark[33] performed a study in which 300 British university students were shown images of hypothetical male and female job applicants with either “cute” tattoos, “tribal” tattoos, or no tattoos. No tattoos and cute tattoos were associated with applicants being rated as more friendly and therefore suitable for the job in comparison to those applicants with tribal tattoos, who were perceived as more aggressive and less well suited. Negative dispositional characteristics were attributed exclusively to tribal tattoo wearers, which in turn negatively affected their perceived job suitability. This perception was more strongly held in respondents without tattoos compared to those with tattoos, or those who had considered getting one. This study therefore confirms that the content of a tattoo affects how the wearer is perceived, while also highlighting that tattooed individuals are generally less likely to infer negative attributes about another tattooed person. Therefore, while certain types of tattoos continue to trigger inferences about aggression and deviance, such attitudes may be shifting as more of the populace becomes tattooed.

Gender specific perceptions

Despite the increasing acceptance of tattoos in modern Western culture, women with tattoos still tend to be more negatively perceived than tattooed men. A 2004 survey of Canadian undergraduates reported that both male and female respondents had negative attitudes towards descriptions of women with visible tattoos, and that tattoo size was a predictor of disapproval for respondents who did not have tattoos themselves[34]. Swami et al[35] extended upon this research by using line drawings of women with tattoos that allowed manipulation of tattoo location and the number of tattoos to assess effects on an observer’s ratings of attractiveness, sexual promiscuity, and alcohol consumption. Based on a study sample of 160 British undergraduates, 14% of whom had tattoos, depictions of women with tattoos were rated as significantly less attractive, more sexually promiscuous, and heavier drinkers compared to women without tattoos. The likelihood of these perceptions increased with the number of tattoos, with figures bearing 3 tattoos estimated to drink more than twice the amount of alcohol as those without any tattoos. While the study was limited by the artificiality of the line drawings and the lack of a male figure control, it appears that tattoos among female college undergraduates may signal an increased likelihood of drinking alcohol and sexual activity. Despite these associations, 73% of the sample indicated that they would consider getting a tattoo in the future, and 53% of the sample was female. These caveats might therefore reflect not only less stigmatizing views of tattoos, but also of alcohol and sexual activity (e.g., casual sex and multiple partners) among undergraduates.

Resenhoeft et al[36] similarly used color photographs in two different experiments to assess United States undergraduates' perception of tattooed women. Participants viewed a photograph of a woman with or without a tattoo and then rated her on 13 personality traits including attractiveness, caring, athleticism, honesty, religiosity, and intelligence. The first experiment found that a photograph of a woman with a large, visible dragon tattoo on her upper arm was perceived as less attractive, fashionable, athletic, caring, intelligent, but more creative compared to a control photograph of the same woman without a tattoo. their explanation were not significant in the second experiment that used a photograph of a woman with a smaller, less visible tattoo of a pair of dolphins, with the exception of higher ratings of honesty and religiosity for the non-tattooed control. Although the study findings may have been influenced by using photos of different women dressed in different clothes in the two experiments, the results again seem to indicate negative biases against women with tattoos, even among young college students who might be expected to be more accepting of tattoos.

In an attempt to examine the impact of tattoos on sexual attraction between genders, Wohlrab et al[37] performed an experiment using computer generated virtual images depicting both women and men wearing bathing suits that revealed tribal tattoos in various locations. German university students (n = 278) were asked to rate these images on measures of attractiveness, dominance, aggression, masculinity or femininity, and health. In this study, images of tattooed women were rated as less healthy than women without tattoos, whereas images of men were rated as more dominant than those without. Sex differences among raters were important, with men rating images of women with tattoos as more attractive, while women rated them as more dominant. Conclusions about these findings may be limited to heterosexual perceptions of tribal tattoos among young people, but when considered along with other studies, they support the possibility that ratings of female attractiveness by men reflect biases about tattoos signaling sexual availability.

This conclusion was reinforced by a study performed in France using real women who were rated as highly attractive and who, under experimental conditions, displayed a temporary butterfly tattoo on their lower back while lying on a beach in a swimsuit. The field experiment measured how long it took for anonymous men to approach them[38]. Compared to non-tattooed controls, women with tattoos were more likely to be approached by men and were approached within a shorter time. Subsequent interviews with the men revealed that although tattooed women were not rated as more attractive compared to controls, men gave higher probability estimates of being able to get a date with a tattooed woman and to have sex on the first encounter.

Drawing firm conclusions based on these studies is difficult, given that each utilized different methodologies and featured different women with different clothing and different tattoos. Within-study controls suggest that tattoos in young women have the potential to be interpreted as a signal of sexual availability to young men, but across studies, and in reality, visible tattoos are only one of many aspects that might influence female attractiveness. In addition, the use of different types of tattoos across various studies highlights that different tattoos seem to carry different meanings for both wearers and observers, and cautions against overgeneralization.

Looking beyond the narrow scope of the tattoo effects on ratings of female attractiveness in young people, tattoos may have different implications in other contexts, such as within older populations or professional settings. For example, one study found that female nurses with tattoos were perceived more negatively and rated as less caring, skilled, and knowledgeable than their tattooed male colleagues[39]. Observers’ perceptions of tattoos in women are therefore influenced by a large number of variables, including setting, age, and other aspects of a woman’s appearance, along with tattoo size, location, and content. While such variables are important in considering perceptions about tattoos in both men and women, the impact of such variables can be very different between genders.

CASE STUDY

As psychotherapy progressed, the value of discussing Mr. A’s tattoos first emerged when the therapist asked about the tattooed faces of his children which had been embellished to appear more sinister. With prompting, Mr. A admitted that this was intended to maintain a look of stoic masculinity while still bearing reminders of his children on his body, and he agreed that this reflected a strong aversion to vulnerability. Once this was interpreted, he opened up further. The tattoo referencing fellow soldiers killed in combat, visible on the back of his neck, later proved to be a useful topic of exploration when he explained that it was placed in that location so that he would keep the reminder on his body but would not have to see it unless he wished to do so. He admitted that he felt deep, intolerable grief for the loss of these friends and used the tattoo to project this loss out onto the world because he felt incapable of dealing with it in any other way. This facilitated an actual discussion of Mr. A’s grief, allowing him to share his feelings for the first time. He reported to the therapist that her interest in his tattoos and non-judgmental questioning increased his sense of a therapeutic alliance and his overall engagement in treatment for PTSD. With additional work in therapy, it appeared that for Mr. A tattooing represented a kind of outward manifestation of intellectualization as a defense that prevented others from having emotional access to the fragile and sensitive person beneath his adorned skin.

In further interpreting Mr. A’s tattoos in the context of the modern literature on tattooing, his skin art can be viewed as a “human canvas” which tells the story of his childhood and subsequent formative military experiences. His tattoos overwhelmingly demonstrate dark themes of violent masculinity and pain tolerance, suggesting the need to portray an outward appearance of danger-seeking fearlessness that serves to intimidate or ward off others and that provides some insight into why he was drawn to military service. Now, as a law student and father trying to reconstruct his life with the help of psychotherapy, his tattoos represent a visual depiction of themes relevant to both his past life and present inner existence. While tattoos offer a window into the psyche, it is a window that only tells a partial story. Ultimately, tattoos represent what the patient purposefully reveals on the surface, inviting the therapist to explore that portal in order to access deeper emotions, motivations, and meanings contained within.

CONCLUSION

Over the past century in Western society, tattoos have evolved from cultural taboo to mainstream fashion. Accordingly, historical biases and pathological implications about tattoos warrant revision for present-day tattoo wearers. Although the literature to date on tattooing is informative, the available data are limited to subpopulations drawn from Western industrialized cultures and offer a narrow perspective on the interactions of other characteristics of tattoo wearers (e.g., age, ethnicity, socioeconomic status) on public perception. Clinicians are therefore cautioned against overgeneralization, and are instead encouraged to explore the personal meaning associated with individual patients and their different tattoos. We suggest that as a kind of augmentation of the physical exam, doing so with individuals who are engaged in psychiatric treatment provides a valuable window to the psyche that can reveal core aspects of self-identity and hidden emotions with the potential to facilitate and enhance clinical work.

Impotenza Psicologica: Che significa e Come Risolverla?

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Esistono https://para-farmacia-biofarma.com/viagra-super-active/ diversi rimedi per incrementare le prestazioni sessuali e superare eventuali deficit. Merito della protodioscina, che fa del Tribulus Terrestris un rimedio efficiente in caso di infertilità o impotenza. “Il liquido seminale, sia nella sua componente liquida che cellulare sottolinea il Dott. Euro 25 per i soci SIDA; Non soci euro 25 + IVA 4% = euro 26. Si tratta di disfunzioni situazionali, che non sempre hanno risvolti gravi e a lungo termine. Spesso gli uomini, soprattutto in un rapporto di coppia duraturo, tendono ad avere un’immagine statica della propria compagna e finiscono per non riuscire più a proporre fantasie, pensieri o immagini che eccitano la propria mente: quando poi riescono finalmente a raccontarsi senza eccessivi timori scoprono un “terreno fertile” nella propria compagna che spesso accoglie favorevolmente cambiamenti nelle abitudini della sessualità di coppia. E Covid 19 potrebbe esacerbare le condizioni cardiovascolari aumentando ulteriormente il rischio. Al fine di inquadrare la condizione fisica e psicologica che porta al sospetto di una possibile disfunzione erettile o impotenza, è necessario conoscere il sintomo che è quella condizione fisica e psicologica in cui si ha l’incapacità a raggiungere e mantenere l’erezione necessaria a condurre un rapporto sessuale soddisfacente. L’ansia da prestazione sessuale, nell’uomo, può causare disfunzione erettile ed eiaculazione precoce. Questi farmaci sono controindicati nei casi in cui vi è una terapia con nitrati usati nell’angina pectoris, in quanto la loro associazione potrebbe amplificare l’effetto vasodilatore degli stessi, con conseguente effetto rebaund estremamente pericoloso. Le terapie sono diverse a seconda del tipo di impotenza. Innanzitutto va valutata l’entità del deficit. Si hanno anche casi di natura endocrina caratterizzate da ipogonadismo. Exploring the relationship between depression and erectile dysfunction in aging men. Quando la malattia è in fase conclamata, invece, si possono effettuare iniezioni locali di farmaco che hanno lo scopo di ridurre la sintomatologia dolorosa. Spesso gli aspetti organici e psicologici si combinano, per cui un piccolo problema fisico rende più difficile l’erezione, da qui nasce la paura di fallire che contribuisce a peggiorare le cose. Tra tutte, il fumo, strettamente collegato ai problemi erettili, soprattutto se si soffre di diabete. Scopri come i tuoi dati vengono elaborati. Farmacoterapia intracavernosaQuesta terapia invasiva, in quanto comporta la iniezione di farmaco vasoattivo nei corpi cavernosi del pene, determinando un erezione. Anche uno stile di vita sregolato può pesare sulle prestazioni sessuali. Diabete e risposta sessuale. Le cause psicologiche sono molteplici e vanno ricercate nella storia di individuale e di coppia del paziente. Per completare l’acquisto è necessario scorrere fino in fondo alla pagina del prodotto e compilare il form di contatto con i propri dati anagrafici, di residenza e numero di telefono. Le iniezioni intracavernose sono un trattamento consigliato nel caso in cui le terapie precedenti, come ad esempio cambiamenti più salutari dello stile di vita o utilizzo degli inibitori della fosfodiesterasi 5 non abbiano dato i risultati sperati. L’infertilità è definita come il fallimento al concepimento di una coppia dopo almeno 12 mesi di rapporti regolari non protetti.

Ci dispiace Non siamo riusciti a determinare la tua posizione

La tecnica chirurgica nerve sparing risparmio dei nervi ha la finalità di mantenere intatti i nervi responsabili delle disfunzioni eiaculatorie durante l’intervento di asportazione dei linfonodi nelle neoplasie del testicolo ed, estesa alla maggioranza degli interventi su tumori prostatici, consente di preservare la potenza sessuale, a condizione che il tumore sia di dimensioni ridotte e a uno stadio precoce di sviluppo. Attualmente noi disponiamo di 3 diverse i diverse linee di terapia o farmaco protesi. Farmacoterapia intracavernosaQuesta terapia invasiva, in quanto comporta la iniezione di farmaco vasoattivo nei corpi cavernosi del pene, determinando un’erezione. Da cosa può dipendere. Quando le iniezioni intracavernose sono sconsigliate. Nel successivo controllo, in relazione al punteggio del questionario IIFR e il risultato ditali esami ematochimici e ormonali, lo specialista decide se proseguire gli accertamenti di II° livello che comprendono. Farmacoterapia intracavernosaQuesta terapia invasiva, in quanto comporta la iniezione di farmaco vasoattivo nei corpi cavernosi del pene, determinando un’erezione. Oggi si conoscono adeguatamente i fattori di rischio, che possono essere promoventi e responsabili della comparsa della disfunzione erettile pertanto, possono essere elencati, nei seguenti gruppi. Per maggiori informazioni consultare l’informativa privacy e la cookie policy. Terapia di seconda linea. Inserisci una risposta in cifre. Tutti i contenuti del sito. Per utilizzare correttamente Rhino Gold Gel basta dosare il gel da applicare, solitamente va bene la quantità per riempire l’estremità del dito indice e dell’anulare. Tutti i contenuti del sito, il quotidiano e gli allegati in digitale. Una volta raccolta l’anamnesi del paziente e riconosciuta la presenza del disturbo erettivo, l’obiettivo della diagnosi è quello di definire la natura della disfunzione, nelle sue forme: organica, psicologica o mista. Grazie a questi ingredienti di origine naturale, Eretron Aktiv è completamente sicuro e non ha effetti collaterali. IT00876481003 © Copyright ANSA Tutti i diritti riservati. “Il varicocele è una delle patologie più frequenti che affliggono l’uomo giovane e si stima che la sua incidenza sia superiore al 15%”. Inoltre alcune tecniche mentali possono essere di aiuto, nel ripristinare il collegamento neurologico tra il cervello e l’area genitale, che viene compromesso dagli eccessi di zuccheri e dal diabete. Tuttavia, qualsiasi sia la causa, preoccuparsi eccessivamente o pensare di essere una caso unico e raro o grave non è né una soluzione né un atteggiamento mentale che possa essere di aiuto. Il consiglio, in particolare, è quello di prediligere una dieta sana ed equilibrata, e cibi in grado di accrescere la libido, come. In questi casi è importante comunicare al proprio partner quello che si sta vivendo e non rimandare il problema a “momenti migliori”. L’incidenza di tale disfunzione dell’apparato genitale maschile, risulta poco frequente al di sotto dei 40 anni, ma la sua percentuale aumenta rapidamente fino ad arrivare al 50% nell’età compresa tra i 40 ed i 70 anni e al 65% negli uomini oltre i 70 anni. L’erezione è un complesso fenomeno neurovascolare sotto controllo ormonale; nel momento in cui si viene ad instaurare una disfunzione erettile, sia essa psicogena , organica o mista, se non correttamente individuata e diagnosticata, può avere un’evoluzione in alcuni casi irreversibile. Da cosa può dipendere.

Le cure per la disfunzione erettile

Solo quelli chesono veramente essenziali serviranno a delimitare l’area energeticareale e soprattutto il suo nucleo per confrontarlo con il rimedioallo scopo di stabilire l’analogia. Sotto i 40 anni di età è circa il 5 10% a lamentare una qualche tipologia di forma di impotenza. La terapia dell’impotenza o deficit erettile, prevede diversi approcci terapeutici che hanno lo scopo di consentire alla coppia un rapporto soddisfacente. 3,99€/settimana prezzo bloccato. Scopriamolo attraverso le parole di una sostenitrice. > Cure Ormonali: correzione di eventuali disequilibri di testosterone o prolattina per rigenerare la libido. Farmacoterapia intracavernosaQuesta terapia invasiva, in quanto comporta la iniezione di farmaco vasoattivo nei corpi cavernosi del pene, determinando un’erezione. Ma, in questi nostri tempi frenetici e competitivi, il dolce far niente è un’arte che va rieducata. Terapia ormonaleL’utilizzo terpeutico degli ormoni, prevede l’utilizzo di testosterone solo e soltanto nei casi in cui sia dimostrata una reale carenza, al fine di ristabilire un corretto equilibrio. Diverse ricerche, infatti, hanno provato che l’Arginina è un toccasana per la qualità e la motilità degli spermatozoi negli uomini che soffrono di oligospermia.

Le cure per l’eiaculazione precoce

Alcuni integratori, assunti per via sistemica, possono essere utili nelle fasi iniziali, quando la malattia non preclude il normale atto sessuale ed hanno lo scopo di evitare un peggioramento della malattia. Questa terapia orale fornisce, quindi nel rapporto una”spontaneità” vantaggiosa che agisce anche psicologicamente. Quando e perché l’obesità favorisce il diabete. Il chewing gum dell’amore, secondo gli andrologi, è particolarmente gradito grazie alle sue peculiarità: il 60% degli uomini ritiene la rapidità d’azione uno dei vantaggi maggiori, l’8,5% ne apprezza la possibilità di assunzione con il cibo, il 6,8% i minori effetti collaterali. Ora che questa visita di screening non viene più eseguita, non è infrequente trovare soggetti che presentano un’infertilità legata ad un varicocele non diagnosticato”. Questo stato fisico e psichico di deficit, può essere anche di modesta o media gravità e presentarsi a ogni età, ma la sua frequenza aumenta proporzionalmente con l’età. > A livello endocrino vi possono essere squilibri ormonali che inibiscono la libido, per esempio l’eccesso di prolattina o un deficit di testosterone. Solo questo potrà aiutare l’uomo ad affrontare quello che, bisogna ricordarlo, è lo spettro più pauroso dell’universo maschile, capace di investire non solo la sfera sessuale, ma l’intera identità. Gli studi pre clinici hanno dimostrato che gli ormoni tiroidei possono concorrere alla regolazione la funzione sessuale attraverso tre meccanismi putativi: il controllo della secrezione di testosterone da parte del cellule del Leydig, soprattutto in epoca peri puberale; il controllo periferico sulla muscolatura liscia dei corpi cavernosi, attraverso il legame con le identificate isoforme recettoriali TRα1 e TRα2; e il controllo periferico sulla muscolatura liscia delle vescichette seminali, delle ampolle deferenziali e della muscolatura periprostatica modulando la funzione dei recettori adrenergici e l’attività simpatica. Di Urologia dell’Istituto Clinico Città di Brescia: “Conoscerle e prevenirle significa offrire uno stile di vita ed un benessere che interessa l’uomo a 360°. > A volte la vascolarizzazione è corretta ma esistono problematiche neurologiche: gli stimoli dal sistema nervoso simpatico e parasimpatico non vengono processati, l’erezione stenta a manifestarsi del tutto o è insufficiente. “L’eiaculazione precoce conclude il Dott. Terapia di terza linea. L’approccio principale nel percorso diagnostico è un’intervista con la somministrazione di un questionario IIEF Index International erectile function, il cui scopo è quello di individuare l’attività sessuale e le abitudini di vita. In base a questi elementi, si è soliti classificare la disfunzione erettile secondo i parametri stabiliti dalla SIU e SIA in. “Questa non è pubblicità ingannevole. I campi obbligatori sono contrassegnati. Alcuni di questi disturbi possono essere connessi a specifiche circostanze o persone. Eroxel è un nuovo tipo di capsule organiche con una formula per gli uomini che può farli sentire molto più forti, energici. Il sonno, grande alleato della sessualità di lui e di lei. Tutti i contenuti del sito.

Articolo rivisto

Quest’ultima, attraverso gli inibitori della fosfodiesterasi 5, rappresenta il primo approccio insieme all’utilizzo delle onde d’urto focali a bassa intensità che hanno la proprietà di rigenerare il tessuto vascolare determinando un aumento dell’afflusso di sangue al tessuto erettile. I ricercatori hanno trovato casi di ipertiroidismo manifesto ridotto TSH ed elevato FT4 in 9 individui 0. La disfunzione erettile è un disagio sempre più diffuso negli uomini, inoltre, sempre più uomini lo dichiarano apertamente rispetto al passato. E lo facciamo non soltanto esaminando il tema con articoli di esperti, ma addirittura proponendo questo opuscolo, che proprio perché destinato ai diabetici viene affidato a veri esperti, come l’ex presidente dell’Associazione medici diabetologi AMD, Marco Comaschi, e al consulente scientifico di “Tuttodiabete”, Paolo Brunetti, ex presidente della Società italiana di diabetologia SID, entrambi due autorevoli rappresentanti del mondo diabetologico italiano. Testata giornalistica registrata presso ilTribunale di Palermo n. Disturbi psicologici, come la già citata ansia da prestazione, sono tra i risvolti tipici, in grado di “rovinare” l’intimità. L’intervento e le altre terapie per i tumori della prostata, del testicolo e della vescica , per esempio, qualche volta possono influire negativamente sull’attività sessuale e sulla continenza urinaria: imparare a parlarne è il primo passo per cercare una soluzione, che oggi si può quasi sempre trovare. “La sintomatologia è spesso assente o, quando presente, si manifesta con un fastidio al testicolo in regione inguinale o alla faccia interna della coscia. In sostanza, il prodotto è un valido aiuto soprattutto per le persone anziane che vogliono continuare ad avere una vita sessuale attiva e soddisfacente con il proprio partner stabile. Da Verrazano 15, 28100 Novara Italia. Una delle condizioni che esclude una possibile causa organica è la presenza di erezioni notturne. È vietata la riproduzione. I vasodilatatori attivi sulla disfunzione erettile, per indurre l’erezione, hanno bisogno che sia vivo nel maschio il desiderio, la “libido”, insomma un’adeguata eccitazione sessuale. L’infertilità è definita come il fallimento al concepimento di una coppia dopo almeno 12 mesi di rapporti regolari non protetti. Ecco una lista dei più efficaci. A eiaculazione avvenuta le vene si riaprono, il sangue defluisce e i corpi cavernosi si rilassano”. La problematica emerge dopo la pubertà e può essere causa di dolore o difficoltà nel rapporto. Il sesso può ancora essere bello e sorprendente dopo i 60. La conseguenza di queste due lacune sommate è che vi sarà un impedimento al regolare rilascio della muscolatura liscia, e all’afflusso di sangue nel pene, con conseguente disfunzione erettile. Ecco, dunque, che uno stato d’umore alterato può ostacolare la possibilità di un rapporto sessuale che, a sua volta, dopo i primi fallimenti può essere vissuto come un evento “pericoloso” e scatenare una reazione di allarme, provocando e mantenendo la disfunzione sessuale e, viziosamente, lo stesso stato ansioso/depressivo. Questi farmaci non determinano una erezione diretta e passiva, ma una amplificazione della risposta dei corpi cavernosi ad uno stimolo erogeno naturale. Clicca qui per maggiori dettagli. Una volta raccolta l’anamnesi del paziente e riconosciuta la presenza del disturbo erettivo, l’obiettivo della diagnosi è quello di definire la natura della disfunzione, nelle sue forme: organica, psicologica o mista. Soci SIDA Bau Hui = € 50Non soci: Euro 50 + IVA 4% = € 52. Attualmente noi disponiamo di 3 diverse i diverse linee di terapia o farmaco protesi. Scopri le nostre news. De Agostini Editore S. Essendo però un fenomeno trasversale diffuso, poteva essere considerato ininfluente. Questa meccanica consente al pene di inturgidirsi e di aumentare le dimensioni.

A cura del Dr Giorgio Federico

Il segreto è svegliarsi presto. In realtà, anche se non sono disponibili dati statistici certi, la frequenza del disturbo risulta distribuita in modo crescente nelle diverse fasce d’età, rimanendo comunque sia sempre più alta, a parità di età, nei diabetici. L’impotenza è la conseguenza di diverse cause. Nelle donne in post menopausa, i problemi che originano dall’atrofia urogenitale, che si manifesta con sintomi vaginali prurito, secchezza, bruciore, dolore durante i rapporti sessuali e urinari frequenza, nicturia, urgenza, disuria, possono rendere meno desiderabile l’attività sessuale. L’incidenza di tale disfunzione dell’apparato genitale maschile, risulta poco frequente al di sotto dei 40 anni, ma la sua percentuale aumenta rapidamente fino ad arrivare al 50% nell’età compresa tra i 40 ed i 70 anni e al 65% negli uomini oltre i 70 anni. Il danno vascolare generalizzato è la più seria conseguenza dell’iperglicemia cronica e si riscontra in tutti i pazienti diabetici, anche se la gravità può variare; secondo le statistiche la sua frequenza va dal 20 al all’85%. Oggi si conoscono adeguatamente i fattori di rischio, che possono essere promoventi e responsabili della comparsa della disfunzione erettile pertanto, possono essere elencati, nei seguenti gruppi. Può nascere in questomodo un circolo vizioso, per cui più si prova ansia, più aumentano le probabilità che la situazione siripeta, esattamente come un cane che si morde la coda. Successivamente si esegue un accurato esame obbiettivo e la prescrizione degli esami di I° livello, che comprendono. La terapia dell’impotenza o deficit erettile, prevede diversi approcci terapeutici che hanno lo scopo di consentire alla coppia un rapporto soddisfacente. Di certo, è consigliato seguire una dieta sana ed equilibrata, priva di eccessi, in cui lasciare spazio a cibi che stuzzicano la libido come. Le sostanze terapeutiche farmacologiche utilizzate sono: Prostglandine e Papaverina. Anche in questo caso, quindi, meglio chiedere prima al medico. Al fine di inquadrare la condizione fisica e psicologica che porta al sospetto di una possibile disfunzione erettile o impotenza, è necessario conoscere il sintomo che è quella condizione fisica e psicologica in cui si ha l’incapacità a raggiungere e mantenere l’erezione necessaria a condurre un rapporto sessuale soddisfacente. Gli specialisti del sesso maschile sono i primi a consultarsi quando si desidera una vera consulenza su prodotti come Eretron Aktiv. Siamo nella sfera sessuale maschile e per impotenza si intende una disfunzione erettile che non consente un rapporto sessuale normale e soddisfacente per la coppia. Periodico on line di medicina, informazione, salute e prevenzione iscritto al n. La diagnosi è semplice e viene riferita dal paziente che spesso può presentare difficoltà, dolore, o impossibilità nel rapporto sessuale”. Ottieni una visita medica dove e quando vuoi, in video o in un centro medico a te vicino. L’ansia percepita va a determinare uno squilibrio neuroendocrino di tipo adrenergico e, di conseguenza, blocca l’erezione del pene, influendo la sua durata. La fibrosi può evolvere in una placca calcifica dura che porta ad un incurvamento del pene in erezione. Pesce salmone, tonno, olio d’oliva e avocado, fonti di Omega 3 che abbassano il colesterolo e sono un toccasana per il buon funzionamento dell’apparato cardiovascolare;. L’intervento chirurgico consiste nel inserire delle protesi idrauliche, nei corpi cavernosi. E, in un secondo momento, intervenire coi rimedi più efficaci, che spaziano dall’alimentazione agli integratori, dall’esercizio fisico ad un corretto stile di vita. Queste schede informative non possono in alcun modo sostituirsi al rapporto medico paziente, né essere utilizzate senza esplicito parere medico. Circa il 15% è rappresentato da una fascia di uomini under 40 e piuttosto giovani. E’ indubbio come nella premessa che la terapia psicosessuale è fondamentale anche nei casi di disfunzione organica o mista in quanto riesce ad ridurre lo stato di ansia e di disagio. Sicuramente la novità più rilevante è l’utilizzo di fascette di materiale sintetico dette sling disposte come un’amaca sotto l’uretra, ancorate sulla parete addominale anteriore e sul bacino, che esercitando una pressione continua determinano un miglioramento delle perdite fino al 90 per cento dei casi. Anche la respirazione è importante: ispirazione ed espirazione contribuiscono al rilassamento di mente e corpo. Tutte queste forme condividono un sentiero finale comune: l’ansia da prestazione.

La neonata prematura che si aggrappa alla mano dell’infermiera

La terapia della disfunzione erettile, prevede diversi approcci terapeutici che hanno lo scopo di consentire alla coppia un rapporto soddisfacente. “L’obiettivo del trattamento è quello di ridurre i sintomi ed arginare l’evoluzione della malattia. Per esempio si può perdere l’interesse per il sesso e verificarsi la necessità di una prolungata stimolazione per ottenere e mantenere l’erezione. Riporto quanto definito tecnicamente in andrologia: “L’erezione è un meccanismo neuro emodinamico. I farmaci più comuni sono: la papaverina, la fentolamina, il peptide intestinale vasoattivo, l’atropina e la forscolina. La terapia non è generica, ma viene individuata dal medico in base alle cause dell’impotenza. Le cause psicologiche sono molteplici e vanno ricercate nella storia di individuale e di coppia del paziente. Nelle forme organiche e miste si ricorre alla terapia medica o all’iniezione intracavernosa di prostaglandina. Non è sufficiente ingerire una pastiglia per risolvere il problema, anzi in caso di problematiche cardiache e di pressione si rischia anche la vita. Nella forma psicogena, si ricorre alla psicoterapia sessuale mansionale individuale o di coppia; in quella idiopatica delle persone anziane è utile, prima di procedere a una scelta terapeutica, sostenere un counseling sessuologico. Nelle giuste dosi, l’ozio agisce come un’autocura rigenerante per mente e corpo. Le cause psicologiche sono molteplici e vanno ricercate nella storia di individuale e di coppia del paziente. Ora che questa visita di screening non viene più eseguita, non è infrequente trovare soggetti che presentano un’infertilità legata ad un varicocele non diagnosticato”. 142 del Registro stampa del Tribunale di Treviso del 10/05/2010 Direttore responsabile Marco Toffolatti De Marchi Edito da Pubblivision S. Il meccanismo fisiologico che regola l’erezione può essere alterato da diverse cause che si possono distinguere e suddividere nei seguenti gruppi.

Sindrome Autistica e trattamenti terapeutici dell’Autismo

Il consiglio, in particolare, è quello di prediligere una dieta sana ed equilibrata, e cibi in grado di accrescere la libido, come. In particolare, di seguito si riportano alcuni sintomi, che possono essere utili al fine di individuare una condizione in cui può sussistere lo stato di disfunzione erettile o impotenza, ad esempio. E questo, oltre che un problema sull’autostima del maschio, diventa spesso anche un problema di coppia e relazionale. Soci SIDA Bau Hui = € 80Non soci: Euro 80 + IVA 4% = 83. Deficit di passaggio, o inconvenienti che magari la coppia non considera degni di nota, e che pertanto non vanno considerati come fattori clinici veri e propri. 000 uomini dati AIRTUM, I numeri del cancro 2014, si diagnostica soprattutto in pazienti sopra i 50 anni. Deficit di passaggio, o inconvenienti che magari la coppia non considera degni di nota, e che pertanto non vanno considerati come fattori clinici veri e propri. Ai suggerimenti sopracitati, è possibile associare integratori a base di estratti naturali e principi attivi, capaci di garantire maggiore forza e resistenza durante la prestazione sessuale. Uomo dottore medico cancro tumore alla prostata consulto impotenza afp. Ho letto e accetto le Politiche privacy GDPR. In due parole: eiaculazione precoce. La ragione principale tuttavia sembra essere che l’uomo, in generale, ha meno cura di se stesso rispetto alla donna. “La induratio penis plastica è una malattia del tessuto connettivo del pene caratterizzata da una fibrosi localizzata nella guaina che riveste i corpi cavernosi del pene spiega il Dott. Terapia psicosessualeNei casi in cui la disfunzione erettile sia di verosimile natura psicogena, l’intervento psicosessuale è indispensabile al fine di individuare e rimuovere i fattori che l’hanno causata.

Nozioni di base

La terapia dell’impotenza o deficit erettile, prevede diversi approcci terapeutici che hanno lo scopo di consentire alla coppia un rapporto soddisfacente. Anche in questo caso le onde d’urto possono svolgere un ruolo importante determinando una rottura della placca con conseguente miglioramento sintomatologico. Fattori che sono diversi e molteplici. 142 del Registro stampa del Tribunale di Treviso del 10/05/2010 Direttore responsabile Marco Toffolatti De Marchi Edito da Pubblivision S. Uova, capaci di bilanciare i livelli ormonali. 08 aprile 2008ultima modifica: 29 novembre 2010. Tale condizione è tra le esperienze più frustranti, umilianti e distruttive. Anche in questo caso le onde d’urto possono svolgere un ruolo importante determinando una rottura della placca con conseguente miglioramento sintomatologico. L’approccio principale nel percorso diagnostico è un’intervista con la somministrazione di un questionario IIEF Index International erectile function, il cui scopo è quello di individuare l’attività sessuale e le abitudini di vita.

Bonanni

Circa il 15% è rappresentato da una fascia di uomini under 40 e piuttosto giovani. Sono le cosiddette disfunzioni situazionali, spesso a breve termine. Gli utenti sono gli unici responsabili dell’utilizzo delle informazioni presenti in questo sito. In Italia Il 45% degli uomini soffre di disfunzione erettile. Zani è soggetto a molti fattori esterni che ne possono compromettere la sua funzione. Lorenzo Verlato, Direttore di “Tuttodiabete”. L’insorgenza improvvisa è facilmente correlabile ad un evento scatenante e traumatico che rischia di rompere un equilibrio psicologico. Impotenza: trovato legame tra ipertiroidismo e disfunzione erettile 14/12/2012. Riguardo la diagnosi, il corretto approccio prevede un’anamnesi e un esame obiettivo volti a identificare: le possibili cause, le terapie farmacologiche concomitanti o le patologie a prevalente componente psico relazionale interferenti con la funzione sessuale. Lo scarso afflusso di sangue al pene o all’interno del tessuto cavernoso, caratteristico di diverse malattie cardiovascolari come l’aterosclerosi, può, a sua volta, influire significativamente, tanto quanto terapie ormonali, interventi chirurgici alla pelvi, e abuso di farmaci antidepressivi o antipertensivi. Innanzitutto va valutata l’entità del deficit. Per favore utilizza un browser moderno come Edge, Firefox, Chrome o uno qualunque degli altri a disposizione gratuitamente. L’erezione è un complesso fenomeno neurovascolare sotto controllo ormonale; nel momento in cui si viene ad instaurare una disfunzione erettile, sia essa psicogena , organica o mista, se non correttamente individuata e diagnosticata, può avere un’evoluzione in alcuni casi irreversibile. E l’afflusso di sangue nella zona genitale è migliorabile attraverso opportune tecniche fisiche, le quali non richiedono l’utilizzo di farmaci. L’Organizzazione Mondiale della Sanità stima che circa il 15% delle coppie in età fertile nei paesi occidentali ne è affetta e in circa il 30% delle coppie infertili si riconosce un fattore maschile. Cocci riceve pressoFirenze, Prato e Milano. Oggi si conoscono adeguatamente i fattori di rischio, che possono essere promoventi e responsabili della comparsa della disfunzione erettile pertanto, possono essere elencati, nei seguenti gruppi. Dopo tre mesi, infatti, con la chirurgia classica per l’asportazione della prostata circa quattro pazienti su dieci soffrono di incontinenza urinaria e dopo un anno il sintomo persiste in più di due casi su dieci. Insorge più frequentemente a sinistra, per cause di ordine anatomico, ma può essere presente anche a destra oppure essere bilaterale. Soci SIDA Bau Hui = € 120Non soci: Euro 120+ IVA 4% = € 124. Terapia ormonaleL’utilizzo terpeutico degli ormoni, prevede l’utilizzo di testosterone solo e soltanto nei casi in cui sia dimostrata una reale carenza, al fine di ristabilire un corretto equilibrio. Contribuiscono anche a malattie croniche e problemi di salute, che recentemente sono diventati proprietà di uomini piuttosto giovani. Infatti, definire l’area energetica di un individuo condisfunzioni sessuali non è facile. Endocrine: ipogonadismo bassi livelli di testosterone e iperprolattinemia eccesso di prolattina. Pesce salmone, tonno, olio d’oliva e avocado, fonti di Omega 3 che abbassano il colesterolo e sono un toccasana per il buon funzionamento dell’apparato cardiovascolare;.

Curcuma: proprietà, valori nutrizionali,

Association of sexual problems with social, psychological, and physical problems in men and women: a cross sectional population survey. Vanno anche incluse le forme iatrogene, dovute alla chirurgia aorto iliaca, alla chirurgia vescicoprostatica, TURP, alla chirurgia addomino perineale. Povera di calorie e ricca di nutrienti, la zucca garantisce un alto apporto di caroteni, minerali e vitamine. Inoltre, è indicato per le donne in menopausa, ed essendo un ottimo tonificante, anche per chi pratica attività fisica in palestra. I campi obbligatori sono contrassegnati. Entrambi i metodi non sono dolorosi, determinano una buona erezione riducendo il rischio di effetti collaterali, soprattutto cardiovascolari, di cui occorre tenere invece conto con l’uso dei farmaci per via orale. Nei soggetti alcolisti è stato evidenziato un significativo aumento di FSH, LH ed estrogeni e una significativa riduzione dei livelli di testosterone. Il risultato è un decremento della potenzialità erettile ma anche della fertilità». Alcuni integratori, assunti per via sistemica, possono essere utili nelle fasi iniziali, quando la malattia non preclude il normale atto sessuale ed hanno lo scopo di evitare un peggioramento della malattia. La vasectomia detta anche sterilizzazione maschile rappresenta di fatti l’unica forma efficace e sicura nonché. Utilizziamo i cookie per personalizzare contenuti, per fornire funzionalità dei social network e per analizzare il traffico sul nostro sito. Il consiglio, in particolare, è quello di prediligere una dieta sana ed equilibrata, e cibi in grado di accrescere la libido, come. Farmacoterapia intracavernosaQuesta terapia invasiva, in quanto comporta la iniezione di farmaco vasoattivo nei corpi cavernosi del pene, determinando un’erezione. “L’eiaculazione precoce può essere secondaria a cause organiche quali anomalie anatomiche del frenulo, stati infiammatori, uretriti, vescicoliti, prostatiti, sclerosi multipla, tumori midollari, stress o ipertiroidismo, ma, nella maggior parte dei casi, non è riscontrabile una causa precisa se non quella psicogena”. Si chiama, in questo caso, impotenza erettile neurogenica o disfunzione erettile neurogenica. Sappiamo bene quanti turbamenti possano accompagnarsi a questo problema, spesso rimosso, spesso negato anche con le persone con cui si dovrebbe, invece, condividerlo. E’ indubbio come nella premessa che la terapia psicosessuale è fondamentale anche nei casi di disfunzione organica o mista in quanto riesce ad ridurre lo stato di ansia e di disagio. > Cure vascolari: sotto controllo e prescrizione medica si cura in primis la pressione arteriosa in caso di ipertensione, correzione della dieta, riduzione fino a totale eliminazione del fumo, e poi introduzione di una terapia vascolare, come quella tanto rinomata. Le cause dell’impotenza maschile possono essere diverse. Ecco le novità dell’ultimo anno di attività, quello della ripartenza. Si hanno anche casi di natura endocrina caratterizzate da ipogonadismo. Informativa sul trattamento dei dati personali Con la presente informativa sul trattamento dei dati personali, redatta ai sensi del Regolamento UE 679/2016, InSanitas, in qualità di autonomo titolare del trattamento, La informa che tratterà i dati personali da Lei forniti unicamente per rispondere al messaggio da Lei inviato. L’intervento chirurgico consiste nel inserire delle protesi idrauliche, nei corpi cavernosi. Consulta la Cookie Policy. 2% dello studio UNIFI, numeri che sono in linea con quelli della popolazione generale. La sua formulazione combina quattro super ingredienti con un effetto sorprendente. Oppure in alcuni casi, per vincere l’imbarazzo, escono sotto forma di battute e di frecciate, rischiando di ferire profondamente l’uomo che si trova già in difficoltà. Negli ultimi anni si è assistito ad una maggior presa di coscienza da parte dell’uomo delle proprie problematiche di salute ed in particolare di quelle andrologiche.

Primi piatti invernali e vegani

Siamo nella sfera sessuale maschile e per impotenza si intende una disfunzione erettile che non consente un rapporto sessuale normale e soddisfacente per la coppia. La disfunzione sessuale negli anziani è frequentemente provocata da condizioni e malattie che possono essere trattate efficacemente. Una valutazione specialistica in un centro in grado di offrire tecniche di fecondazione assistita, in cui vi sia una stretta collaborazione tra andrologo e ginecologo, può offrire alle coppie il miglior approccio diagnostico terapeutico senza inutili perdite di tempo”. Forum Role: Participant. “L’erezione continua il Responsabile dell’U. Lo stato psicologico di ciascuno dei due partner influenza molto la vista sessuale della coppia. In caso di disturbi e/o malattie rivolgiti al tuo medico di base o ad uno specialista. Questo fenomeno in Italia si concretizza in circa 3 milioni di uomini che soffrono di questa patologia, vale a dire il 10 15% della popolazione maschile italiana. E non soltanto attraverso le pagine di un giornale, dove il colloquio è fin troppo generico e generalizzato, ma anche nell’intimità di un dialogo professionale, tipico del rapporto medico paziente, risulta diffusa questa ritrosia ad affrontare un argomento così personale. Una delle condizioni che esclude una possibile causa organica è la presenza di erezioni notturne. Come si effettua un’iniezione intracavernosa. Il totale del tuo carrello è 29 punti può essere convertito in un voucher di: 0,73 €. Lecausedell’impotenzapossono essere diverse e di varia natura. La vasectomia detta anche sterilizzazione maschile rappresenta di fatti l’unica forma efficace e sicura nonché. Lorenzo Verlato, Direttore di “Tuttodiabete”. ATTENZIONE: Ogni terapia va individualizzata e monitorata in ciascuna paziente dal medico specialista esperto nel campo. Danilo Zani consiste nel presentarsi, persistente o occasionale, di eiaculazione in seguito a stimolazione sessuale anche minima oppure prima, durante o poco dopo la penetrazione e comunque prima di quando il soggetto desidererebbe. Il motivo è semplice, solo il produttore vi garantisce la qualità dell’originale e vi permette quindi di evitare la frode di Eretron Aktiv che siti come Amazon vendono. Iscriviti per ricevere info su salute, ricerca, eventi e attività. In base a questi elementi, si è soliti classificare la disfunzione erettile secondo i parametri stabiliti dalla SIU e SIA in. Il loro utilizzo è indicato, nei casi di fallimento della terapia orale o nella rieducazione dopo intervento di prostatectoia radicale. L’impotenzaè un problema serio che non va sottovalutato. Ai suggerimenti sopracitati, è possibile associare integratori a base di estratti naturali e principi attivi, capaci di garantire maggiore forza e resistenza durante la prestazione sessuale. Nel successivo controllo, in relazione al punteggio del questionario IIFR e il risultato ditali esami ematochimici e ormonali, lo specialista decide se proseguire gli accertamenti di II° livello che comprendono.

Mediatore familiare: Ruoli, Competenze ed Ambiti di intervento

Fare l’amore è uno dei piaceri che regala la vita. L’erezione è un complesso fenomeno neurovascolare sotto controllo ormonale; nel momento in cui si viene ad instaurare una disfunzione erettile, sia essa psicogena , organica o mista, se non correttamente individuata e diagnosticata, può avere un’evoluzione in alcuni casi irreversibile. Inoltre, il vissuto appreso nella propria famiglia di origine gioca un certo peso nel significato che l’uomo attribuisce all’impotenza, in genere, associata “all’incapacità di essere uomo”, idea che può nascere dalla reale o presunta compromissione di una virilità che costituisce sempre un parametro soggettivo. PUBBLICATO IL 26 NOVEMBRE 2020. Alimentazione e dieta Cistite Depressione / Tono e disturbi dell’umore Diabete Disturbi del desiderio Disturbi dell’eccitazione Disturbi dell’orgasmo / Anorgasmia Infiammazione Inositoli Metformina Peso e sovrappeso Secchezza vaginale Sonno, insonnia e disturbi del sonno Vaginite. Una volta accertatisi che non ci sono motivi organici gravi alla base del problema, tanti sono i modi per provare ad affrontare il problema. Spesso la responsabilità è della partner, che avanza richieste esigenti. Articolo rivisto dal Comitato di GuidaPsicologi. L’impotenza erigendi o meglio conosciuta scientificamente con il termine di Deficit Erettile, è quella condizione prettamente maschile, che viene definita secondo ISS International Society of sexual e OMS organizzazione mondiale della sanità, come l’incapacità di raggiungere o mantenere l’erezione al fine di avere un rapporto soddisfacente. È utile non solo per riaccendere la passione sessuale, ma anche per riacquistare fiducia e autostima. Una valutazione specialistica in un centro in grado di offrire tecniche di fecondazione assistita, in cui vi sia una stretta collaborazione tra andrologo e ginecologo, può offrire alle coppie il miglior approccio diagnostico terapeutico senza inutili perdite di tempo”. Sempre di più i mezzi di informazione insistono sui rischi legati a comportamenti errati e ad esposizioni di fattori di rischio che ormai sono noti: fumo di sigaretta, abuso di sostanze, malattie sessualmente trasmissibili. La terapia dell’impotenza o deficit erettile, prevede diversi approcci terapeutici che hanno lo scopo di consentire alla coppia un rapporto soddisfacente. “Sono quelli noti: obesità, fumo, assenza di attività fisica, ipercolesterolemia e sindrome metabolica. Scopri le nostre news. Questa terapia orale fornisce, quindi nel rapporto una”spontaneità” vantaggiosa che agisce anche psicologicamente. Le diverse fasi della risposta sessuale si basano su specifiche modificazioni del sistema vascolare che risponde all’impulso neurologico, a sua volta sostenuto dalla componente endocrina.

Cosa sono le Malattie Infiammatorie Croniche Intestinali

Questo avviene perché, per via della scarsa informazione riguardo questo disturbo sessuale, si è portati a credere erroneamente che si possano avere problemi erettivi solo nella terza età. Sentirete il bisogno di fare l’amore entro un’ora. Le informazioni condivise su questo sito, si rivolgono a persone sane e qualsiasi regime alimentare o esercizio fisico prima di essere svolto deve essere approvato e supervisionato dalla figura competente ai termini della legge italiana. 1 Una grande quantità di alcol nel sangue annebbia le funzioni del cervello e può provocare un torpore tale da rendere difficile il raggiungimento dell’orgasmo. Le onde d’urto, sottolineano gli esperti, potrebbero dunque sostituire l’azione “on demand” dei farmaci a favore di un risultato duraturo contro l’impotenza. Una delle condizioni che esclude una possibile causa organica è la presenza di erezioni notturne. Salute dell’uomo: l’esperto risponde. Il diabete può essere anche causa di ipogonadismo e scarsa produzione di testosterone. Sono comunque rimedi naturali la cui efficacia è espletata se abbinati a corretto stile di vita, alimentazione e, all’occorrenza, adeguata attività fisica. Bisogna osservare, ascoltare, cercare di comprendere, valutaretutti i sintomi anche quelli poco significativi o addirittura”offerti” inconsciamente per sviare la diagnosi. Numero REA: CH 100281Partiva IVA: 01628730697Via Pescara, 4666041 Atessa CH. Si tratta di problematiche che, a lungo andare, possono compromettere l’equilibrio psicofisico di una coppia. Per contro non è stata trovata la relazione inversa, cioè il fatto di avere problemi di disfunzione erettile non ha evidenziato un maggiore rischio di ipertiroidismo. Soci SIDA Bau Hui = € 25Non soci: Euro 25 + IVA 4% = € 26. La terapia dell’impotenza o deficit erettile, prevede diversi approcci terapeutici che hanno lo scopo di consentire alla coppia un rapporto soddisfacente. Non aspettare più, ordina ora e ottieni lo sconto. Le terapie sono diverse a seconda del tipo di impotenza. Il loro utilizzo è indicato, nei casi di fallimento della terapia orale o nella rieducazione dopo intervento di prostatectoia radicale. © 2020 Testata di proprietà del Ministero della Salute. Oggi si conoscono adeguatamente i fattori di rischio, che possono essere promoventi e responsabili della comparsa della disfunzione erettile pertanto, possono essere elencati, nei seguenti gruppi. La diagnosi viene effettuata mediante un’accurata raccolta anamnestica, un esame obiettivo e l’esecuzione di indagini di funzione ormonale. Anche un giornale come “Tuttodiabete”, che in rispetto a una testata così onnicomprensiva, dovrebbe trattare a fondo tutti i problemi che riguardano il diabete, ha dedicato a questa “complicanza” molto meno spazio che a tante altre. > Cure Ormonali: correzione di eventuali disequilibri di testosterone o prolattina per rigenerare la libido. Dalle recensioni degli utenti, i tablet sono in grado di agire istantaneamente, ripristinare completamente la potenza ed eliminare la disfunzione sessuale. Bisogna sottolineare che non esiste una sola terapia risolutiva dell’impotenza, spesso la terapia efficace deve essere sempre ponderata e prevedere, anche un approccio di natura psicosessuale, indipendentemente dalla causa, sia essa, psicogena, organica e mista organica e psicogena insieme. Utilizziamo i cookie per rendere migliore la tua esperienza di navigazione. Ovviamente, l’impotenza può avere un effetto estremamente distruttivo in una relazione di coppia, ma può anche originarsi da una relazione che era in sé distruttiva.

После вакцинации Спутником V повышается потенция

Любая физическая активность хороша не только для общего здоровья, но и для сексуального. К тридцати они немного успокаиваются, в их интимной жизни появляется размеренность. Скорее всего, переболевшим. Непонятно что вообще всём вкололи, но явно не вакцину от короны. Езжу на велосипеде, сколько себя помню. Однако переизбыток этого микроэлемента способен навредить организму мужчины. В качестве основы, нужно следить за рационом своего питания. Врач обладает большим багажом специальных методик обследования и сможет безупречно определить тактику последующего https://town-pharmacies.com/kamagra/ лечения. К врачу было стыдно идти, поэтому решил воспользоваться народными средствами, чтобы оживить половой орган. Даже при поцелуе с девушкой – будь она уже женой или малознакомой особой на первом свидании – мужчина все таки подумывает: а не заразит ли она меня сейчас ковидом. Ученые из Польши и Чехии провели еще более любопытное исследование, оказывается активные курильщики в возрасте 45 лет, занимаются сексом примерно 1 раз в 7 дней, а средняя продолжительность самого акта – около 4 минут, а вот их некурящие ровесники уделяли этому занятию минимум 2 дня в неделю и гораздо больше времени. Принцип ее работы заключается в том, чтобы «доставить» внутрь клетки организма кусочек гена коронавируса, чтобы белок его шипа S белок, это и есть антиген был синтезирован «силами» самой клетки. Одни дилетанты думают, что проблемы с потенцией связаны только с половым членом. Если нарушение имеет психологическую основу, в той или иной степени набухший половой член натянет полоску, и она порвется. Но я был поражен средством Extaz Pills. Живем с женой уже более 15 лет. Завышенные ожидания женщин: «Хочу новый BMW, норковую шубу и на Мальдивы. 1985, 1987; Kocvara S. Продолжая работу с сайтом, вы соглашаетесь с использованием нами cookies и политикой конфиденциальности. Жёсткое седло «типа Brooks», но отечественного производства, в сравнении с дорогим гелевым — как паркет в Ливадийском дворце в сравнении с линолеумом в списываемом вагоне РЖД. В частности, специалисты отметили, что у этих участников была нарушена половая функция, качество оргазма снижалось, а также наблюдались признаки депрессии. Но и, например, проблемы со щитовидной железой. Копания ООО Юнифар представляет ГРИПАКС линейку средств при заложенности носа и дискофо. Ru/articles/12 kak pravilno ispolzovat vosk dlja depiljacii. К примеру, целительница В. Таким образом, глицин помогает нейронам лучше работать на фоне стресса. Хорошо сидящие спортивные трусы, желательно с вставками из высококачественной замши, обеспечат вам максимальный комфорт.

Мята и мужская потенция

Сегодня вакцинировалась ковид ваком , у нас в Краснодаре им колят , пока не каких нет побочных эффектов. Не представляется возможным точно ответить на вопрос. Данный элемент необходим для связывания молекул кислорода. С Китаем поддерживаются дружественные отношения и есть возможность при остром дефиците вакцин в мире приобретать эту вакцину. От Ивлеевой до Татарки: 2021 год на обложках Playboy. Сексуальное здоровье мужчины определяется еще с самого периода внутриутробного развития. Со временем мальчики взрослеют, и появляется опыт сексуальных отношений с противоположным полом, поэтому потребность самоудовлетворяться исчезает. Интересно а какими вакцинами будут ревакцинировать. Сексуальное влечение остается высоким, но для его реализации приходится затрачивать больше усилий. Силовые нагрузки считаются лучшим способом стимуляции тестостерона и предотвращения образования жира. Частота половых актов на саму потенция не оказывает никакого воздействия. Несмотря на то, что статистически значимых различий в изменениях здоровья между велосипедистами, пловцами и бегунами не было выявлено, некоторые велосипедистки сообщали об инфекциях мочевыводящих путей, а некоторые велосипедисты упоминали потертости в паху и онемение. Скажем, в международном разделении труда Россия постепенно может вообще провалиться в яму. Не призываю колоться. Наш сайт использует файлы cookies, чтобы улучшить работу и повысить эффективность сайта. Смотрите также: Неотомизм Акт. По статистике, около 50% мужского населения старше 40 лет имеют проблемы с эрекцией. Причем чем старше мужчина и чем больше у него стаж курильщика, тем выше риск бесплодия или рождения ребенка, страдающего от заболеваний дыхательной, сердечно сосудистой и других систем. Интересует, как у других. Именно поэтому вопрос повышения потенции у мужчин всегда актуален. Поэтому чтобы подобрать адекватную схему терапии, врач сначала должен выяснить причины, вызвавшие сексуальную дисфункцию. Нарушение эректильных функций все чаше диагностируют у мужчин в возрасте 35 40 лет. Стал видеть цветные сны3. Смотрите также: Неотомизм Акт. Но дело не только в ухудшении сексуальной жизни: низкая эрекция может быть первым признаком опасных заболеваний, в том числе диабета и атеросклероза. На первичной консультации предположили, что проблема с простатой.

Нижегородцы пожаловались на ухудшение эрекции после прививки от COVID 19

Подпишитесь на обновления ПРАЙМ в вашем браузере. Каждый препарат или народное средство имеет свой механизм действия. Операции «Золотого стандарта». Кардиолог прописывает человеку лекарство для снижения кровяного давления, побочное действие которого — снижение потенции. Курение повышает уровень холестерина, способствует развитию устойчивости к инсулину, активизирует окислительные процессы, приводящие к повреждению клеточных мембран. Упражнения, диета, лекарства, народные средства и другие методы. Есть же поговорка – семь раз отмерь, один раз отрежь. Посмотрим, что будет дальше. На международном конгрессе урологов в 1999 году подсчитали, что около 100 миллионов мужчин на планете имеют проблемы с эрекцией. Зачастую мальчики пробуют сигареты в 12 13 лет, не осознавая. Коэффициент сложности. Каждый организм индивидуален.

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А так, велосипед, это мой образ жизни, всегда езжу на нем. Ru, охраняются в соответствии с законодательством РФ, в том числе об авторском праве и смежных правах. Так что стоит выпивать те самые полтора два литра воды в день – в том числе и ради отличного секса. Народные средства от импотенции используются в качестве вспомогательной терапии для борьбы с эректильной дисфункцией. Поэтому чтобы подобрать адекватную схему терапии, врач сначала должен выяснить причины, вызвавшие сексуальную дисфункцию. В исследовании, которое проходило с марта по июнь 2021 года, приняли участие 60 мужчин. Рассказали бы про спутник ви, побочные эффекты, смерти и т. Имеет хорошую усваиваемость 58%. Все права на материалы, находящиеся на сайте, охраняются в соответствии с законодательством РФ,в том числе об авторском праве и смежных правах. Циркадные ритмы и выработка тестостерона зависят от того, легли мы спать до 22—23 часов или нет. При снижении образования глобулина, связывающего половые гормоны печенью в связи с ее «ожирением», снижается и уровень общего тестостерона в крови. Поголовно удлинять половой член – это неправильная тактика. Далее, есть специальные опросники, например, Международный индекс эректильной функции, который помогает оценить ситуацию. Не отрицая значения дисфункции корково подкорковых взаимоотношений в генезе ночного приапизма, мы , считаем ведущим фактором в его возникновении усиление гиперемии предстательной железы вследствие увеличения стаза в венах пузырного и предстательного сплетений во время сна. Комментариев: 10 / Написать комментарий. Факторы, вызывающие эректильную дисфункцию, могут быть такие. Клинические проявления эректильной дисфункции – специфические, поэтому у врачей не возникает сложностей с дифференциальной диагностикой. Негативное влияние курения на организм мужчины нарастает постепенно. Препарат обладает слишком мягким, практически незаметным эффектом. При нарушении эрекции причины стоит искать в физиологическом и психологическом состоянии пациента. В итоге было выяснено, что у каждого пятого участника отмечалась эректильная дисфункция. В целом проблемы со здоровьем помолодели. Супруга заявила, что даже в молодости такого не было.

Отзывы курильщиков

Однако с возрастом все эти факторы «объединяются», трансформируясь в патологические нарушения, что в свою очередь снижает сексуальные способности мужчин. Группа “Анонс” хит на все времена “ОЛЯ И КОВИД” =пользуйтесь масками фирмы “адидас”. Также его польза заключается в выработке ферментов в поджелудочной и синтезе белков. Когда вдыхается сигаретный дым в организм проникают смолы, никотин, угарный газ и некоторые другие компоненты, которые не дают в полной мере расслабиться сосудам. Негативных пунктов у частой мастурбации будет гораздо больше, чем плюсов. Автор статьи — Кумец Алина Сергеевна — Врач уролог. В первые 8 часов после отказа от курения в организме нормализуется уровень углекислоты. Они были опубликованы в одном из авторитетнейших мировых журналов — The Lancet.

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Ответим на ваши вопросы. Смотришь, бывало, на случайно подвернувшиеся фото с шибари и думаешь: хорошо то как. Если даже мужчине кажется, что у него все в порядке, то не факт, что это действительно так. Эректильная дисфункция часто возникает при малоподвижном образе жизни, курении и злоупотреблении алкоголем. Как правило, таким пациентам назначаются медикаментозные препараты и сеансы психотерапии беседы с психотерапевтом и/или с сексологом. Во первых, нужно уделить пациенту достаточно времени, чтобы он смог рассказать обо всех нюансах своей жизни: когда, при каких условиях все началось, в чем причина. Технология производства векторной вакцины существует уже длительное время. После 1го компонента было, как в анонимном отзыве, такое же давление, слабость, темнело в глазах, нельзя встать, и это кроме температуры. Пытаются лучше выглядеть даже в моих глазах. На самом деле, мужчина может заниматься сексом до глубокой старости. А вот легкий и изысканный запах иланг иланг добавит уверенности в себе и успокоит нервную систему. Кончили по несколько раз с женой. К тому же я заметил, что они помогают убрать неприятные ощущения в области паха. Датой празднования была выбрана дата смерти 28. Вторую ставил уже с учётом все нормально. В итоге у многих создалось ощущение, что ее стоит полностью исключить из своего рациона, чтобы не нанести урон сексуальной активности. Особенно в таком жанре, как авторские колонки. На теу БАДов ы уже говорили, но хотелось бы поговорить на нее снова, только несколько в друго форате. Да и стимулирующие чаи тоже лучше принимать после обсуждения с лечащим врачом, ведь в некоторых ситуациях они могут быть просто противопоказаны. При физиологической эректильной дисфункции наоборот проблемы возникают постепенно.

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Большинству очень хочется одну большую кнопку на экране. Только к шестидесяти годам в крови мужчины серьезно снижается уровень тестостерона. Об этом заявили директор Национального исследовательского центра эпидемиологии и микробиологии имени Н. Повысить потенцию можно, устранив причины возникновения эректильной дисфункции и вылечив сопутствующие заболевания. В студии Delfi старший аналитик BISS Вадим Можейко. Член растет на глазах. Однако цинк из растительной пищи хуже усваивается организмом. Интересует, как у других. Если ваш мужчина здоров физиологически или у него есть небольшие отклонения, ваша инициативность ему придется по душе. Министр иностранных дел Литвы Габриэлюс Ландсбергис. Задумываетесь, какой активности отдать предпочтение. В 2005 году эта цифра поднялась уже до 200 миллионов. В течение суток любой человек может терять около 100 волосинок, и этот процесс является вполне естественным.

ОПЫТНЫЕ СПЕЦИАЛИСТЫ

Было выяснено, что у 53% мужчин наблюдаются проблемы с циркуляцией крови. Подписывайтесь оставайтесь в курсе происходящего. Что влияет на продолжительность возбуждения. При развитии депрессии необходимо сделать следующее. То есть, из за снижения уровня мужского гормона начинают преобладать женские начала. Показания, противопоказания, режим дозирования, побочное действие, передозировка, лекарственное взаимодействие Ст. Часто эта причина бывает напрямую связана и с соматическим заболеванием, например нарушением кровообращения. Ранее в социальных сетях же появилась информация о том, что вакцина «Спутник V» может влиять на повышение потенции у мужчин. Невозможность вести полноценную сексуальную жизнь для мужчины будет ударом, он может впасть в депрессию и замкнуться в себе. Как поднять потенцию знают специалисты медицинского центра «Андроцентр». Потенция Половая потенция — возможность, в медицине — способность организма к половому акту. Утром оцените результат. Одновременный прием других средств для потенции не рекомендован. БРАХИТЕРАПИЯ: радикальное лечение рака простаты радиоактивными зернамиМалоинвазиный метод лечения рака предстательной железы РПЖ, равен по эффективности большой операции – радикальной простатэктомии В нашей клинике. Мне всегда было плевать, слышал о таких бреднях раньше, но никогда не обращал внимание — мне нравится кататься, я знаю, что это полезно — остальное не важно. В прошлом эффективная терапия нарушений потенции была связана с интракавернозным введением препаратов, сейчас же увеличилось количество высокоэффективных пероральных лекарственных средств. Регулярные ночные смены, высокий стресс, отсутствие движения, талия шире 94 сантиметров — наверняка у мужчины уже начинается метаболический синдром, проблемы с сердцем и давлением. Прививку Гам КОВИД Вак перенесла отлично. Слышал про афродизиаки, но не пользовался, а тут вот узнал они в составе этих таблеток, но совершенно натуральные фрукты, пряности. Максимальная суточная доза равна 100 мг. Не существует определенных норм, которые определяют время возбуждения и какая эрекция считается нормой. Конечно, подобные вещества осуществляют помощь лишь на психологическом уровне, то есть такое повышение потенции эффективно только при отсутствии органических нарушений. Нажимая, я соглашаюсь с условиями и политикой обработки персональных данных.

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Это в общей структуре пациентов, которые обращаются к урологу в том числе и с воспалениями, мочекаменными болезнями или для оперативного вмешательства. Москва, переулок Партийный, д. Опытные курильщики ничего подобного уже не замечают, но сам процесс никуда не уходит и повторяется каждый раз, когда человек прикуривает. В ходе многочисленных исследований ученые доказали, что регулярные занятия сексом не только улучшают качество сперматозоидов и увеличивают их количество, но и улучшают потенцию. Результаты исследований вакцины «Спутник V» включают в себя наблюдение за 45 000 пациентов. Ничто так не убивает мужскую потенцию, как. Она может возникать даже без сексуального возбуждения, например при длительном сидении, особенно в транспорте. А беречь свое мужское здоровье нужно смолоду. Автор статьи: клинический психолог, сексолог клиники Mental Health Center — Евгений Сапрыкин. Два миллиона лет мужик пахал, добывал еду на охоте, двигался, а последние 50 лет сидит, и сегодня уже еду заказывает по телефону. После перенесенного коронавируса люди сталкиваются с осложненияи. Мурашко отмечал, что у некоторых женщин из этой категории коронавирусная инфекция протекает крайне тяжело, поэтому специалисты к концу июня одобрят применение «Спутника V» для профилактики. Попутно ты еще и улучшишь свое кровообращение и получишь заряд эндорфинов, которые помогут снизить уровень стресса а ты сам знаешь, как он плох для твоей половой жизни. Любая физическая активность хороша не только для общего здоровья, но и для сексуального. Методы восстановления потенции у мужчин направлены на излечение полной или частично импотенции. Топ средство для стойкости твоего дружка.

Хелатные формы минералов что это и есть ли у них преимущества?

Хотя, периодические «сбои системы» могут сигнализировать о грядущих проблемах. Какие у нас ответственные граждане, молодцы, а ж слезы наворачиваются, спасибо вам и президенту нашему, если бы не вы то кто. Это может зависеть от увиденной красивой картинки и т. Верните дружбу в ваш союз. Нередко производители используют цинк в косметических средствах, которые предназначены для жирной или проблемной кожи, склонной к воспалениям. Очередная желтуха в стиле экспресс газеты. В случае психологического фактора причинами отсутствия эрекции могут стать стрессы, депрессия, эмоциональное перенапряжение. После четырех месяцев войны, никто из нас не в порядке. Потому провалы в интимной жизни – это катастрофа. Умеренные физические нагрузки — вскапывание огорода, ношение сумок с продуктами, бег, плавание, йога — повышают потенцию; бодибилдинг и другие выматывающие постоянные нагрузки — ограничивают половые возможности мужчины.

Услуги

Если все идет по плану, то прочная оболочка пениса, которая при возбуждении хорошо прощупывается под кожей, натягивается на полнокровный член. Спонтанные эрекции при этом виде импотенции сохраняются. Учитывая тот ажиотаж, который в последние годы существует вокруг регулярной и качественной сексуальной жизни, у курильщиков есть все шансы оказаться вне тренда. Медикаментозные пероральные препараты – не единственный способ восстановить потенцию. Но все таки, более привычно в обращении понятие потенция. Коэффициент сложности. Если имеется огромное желание вылечить заболевание, первым делом требуется пройти диагностику и устранить провоцирующий фактор. Этот естественный иммуномодулятор принимает участие в построении клеточного иммунитета. Вопрос о влияние курения на сексуальную функцию человека изучен не так глубоко. Купить Андрогель гель 1% 5г №30 по цене от 2705 руб. Прививке нет еще и года, соответственно, никто не мог оценить риски развития бесплодия», — пояснил медик. Курение рано или поздно приведет не только к импотенции, но и к падению либидо, то есть мужчине секс сам по себе будет не нужен. Обсуждать проблему с другими людьми. Причем хорошая новость. Слово потенция происходит от латинского potentia, что означает «возможность». Они сумеют вовремя обнаружить изменения в предстательной железе, помогут устранить начинающиеся проблемы с потенцией. Игнорировать проблему мужа. История повествует на о то вреени, когда Сириус Блек и Джейс Поттер были ученикаи Хогвартса.

Ультразвуковая эластография и ее применение в гастроэнтерологии

Современное урологическое отделение оснащено полным комплексом лечебного, диагностического и лабораторного оборудования. Пожалуй, самым оптимальным образом на репродуктивную систему действует цитрат цинка. Автоматизированная электронная система управления финансовыми потоками и активами. Почти у половины мужчин с сахарным диабетом отмечается ослабление эрекции. Причины эректильной дисфункции. Слишком легкий доступ к многочисленным визуальным стимулам. И чем раньше это сделать – тем лучше. Другие считают, ссылаясь на «свидетельства» знакомых врачей и неназванных биологов вирусологов что вакцина ударит по мужской системе чуть позже. Вначале внесу уточнения по поводу термина. Его замысел реализует вся иерархия его компании, от ближайшего зама, наиболее полно видящего весь процесс, до охранника у входной двери, который просто выполняет свою малую функцию,видит только входящих людей и даже может толком не знать чем занимается организация. Она дарила счастье и покровительство всем влюбленным, так богиня оживила статую девушки, сделанную из слоновой кости кипрским художником Пигмалеоном, который об этом искренне и страстно попросил богов. Роман Алиев рекомендует мужчинам всех возрастных групп внимательно следить за своим здоровьем и не пренебрегать профилактическими осмотрами, а также не сидеть на холодном. Шипучки Extaz Pills вернули меня в большой секс. У знакомых, тоже все было хорошо. Рассказываем, почему это хорошая идея. Голосеевская, 13А тел: 044 502 33 03, 068 502 33 03 e mail:. Как оказывать первую медицинскую помощь. Во первых это могут быть психологические проблемы мужчины, во вторых 一 серьезные заболевание, в третьих 一 влияние образа жизни. Есть такое выражение. Запись на прием к урологу андрологу Хлебову Андрею Олеговичу. Возможно, где то остатки распределят и всё. Однозначно, с течением возраста эректильные способности у представителей сильного пола слабеют, но когда наступит момент их полного угасания. Бухгалтерия против морали.

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В организме мужчины цинк играет далеко не последнюю роль. Наличие такого психологического фактора усугубляет проблему потенции. Также желательно сократить объем употребления или вообще отказаться от алкоголя и сигарет. В эту скрининговую программу входят лабораторные исследования, включая определение гормонального статуса, уровня тестостерона, инсулина и холестерина, консультации уролога, эндокринолога и терапевта. Да и стимулирующие чаи тоже лучше принимать после обсуждения с лечащим врачом, ведь в некоторых ситуациях они могут быть просто противопоказаны. Уточнит у вас все детали и мы отправим ваш заказ. Тем, кто искал ответ на вопрос о том, как повысить потенцию в домашних условиях за 1 день, мы советуем набраться терпения. Воспользуйтесь советами, описанными выше. Тестостерон, кстати, ещё и главный жиросжигающий гормон. Он вырабатывается надпочечниками и яичками, и именно он необходим для развития мускулатуры, появления волос в местах на теле, характерных только для мужчин. Для мужчин любого возраста потенция очень важна, т. Лучшие упражнения для потенции направлены на прокачку. Результаты показали, что езда на велосипеде не оказала негативного влияния на сексуальную функцию и женское здоровье даже самых фанатичных велосипедисток. Мужская интимная состоятельность зависит и от качества питания молодого человека.

Ультразвуковая эластография и ее применение в гастроэнтерологии

При условии планового посещения врача и профилактике заболеваний вы избавитесь от этих проблем. Пробовал приличное количество средств, в качестве эксперимента приобрел и Extaz Pills. По оптимистическим прогнозам Всемирной Организации Здравоохранения проблема неполноценной мужской половой потенции будет окончательно решена в 2018 году. В семейной жизни есть некоторые кризисные периоды, которые по утверждению психологов избежать трудно. Если каждый день употреблять неограниченное количество мяты в чаях, отварах и других средствах, то она безусловно окажет негативный эффект на мужской организм. При органическом нарушении эрекции, спонтанная эрекция не произойдет. Все, что ниже этого порога, считалось «преждевременным». Ученые исследователи рекомендуют мужчинам, планирующим отцовство сдать спермограмму, MAR тест на антиглобулиновую реакцию и анализ ДНК фрагментации сперматозоидов. Они влияют на кровообращение и могут усугубить ситуацию. Зачастую соблазн поддаться желанию закурить сигарету и собраться вечером с друзьями за бокалом пива преобладает над желанием отправиться в спортзал, на пробежку или просто на прогулку. Довольно часто для выявления корня проблемы требуется присутствие партнерши, которая поможет мужчине избавиться от внутренних страхов, расслабиться и вернуть уверенность в себе. Искал витамины себе для поднятия общего тонуса и наткнулся на Extaz Pills для потенции. Делитесь забавными историями. По истечениичаса в ход идет пылесос и все, готово – квартира благоухает необычайно приятнойсвежестью. К процессу вакцинации есть множество вопросов. Комплексное лечение предполагает очень индивидуальный подход к каждому больному. Видимо, у них, помимо разового воздействия, есть еще некий накопительный эффект. Однозначно, воздействие должно осуществляться годами, и статистика говорит, что курящий мужчина более подвержен различным сексуальным расстройствам. Политикика конфиденциальности. Информация о погоде предоставлена Центром «ФОБОС». Сетевое издание Ньюс НН. Действительно, отказ от вредной привычки может значительно улучшить мужское здоровье. 🙂 Абсолютное большинство считают велосипед детским баловством, и уж вряд ли пойдут гуглить в интернеты. Более того, мужчины в возрасте от 45 до 55 лет, которые борются с паническими атаками из за возраста и боязни потерять сексуальный статус, только. Читайте все о технике и технологиях на ichip. «Андроцентр» располагает всем необходимым для успешного решения деликатной проблемы: опытным и тактичным персоналом, современным оборудованием, качественными медикаментами. Так же Вас могут заинтересовать.

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А 87 процентов мужчин с выраженной эректильной дисфункцией – заядлые курильщики. Так, имеются наблюдения, что у молодых людей частота поствакцинальных реакций несколько выше, чем у более старших возрастных групп. И если этот процесс начинается снизу, в более узких артериях, то скоро может подняться выше. И сохраняется она значительно меньше. Нет ничего дороже общения. Правила мужского здоровья исключают курение. Подписывайтесь на наши новости и будьте в курсе самых свежих и интересных из них. Наш сайт использует файлы cookies, чтобы улучшить работу и повысить эффективность сайта. Адекватное потребление AI. Что такое потенция у мужчин и от чего она зависит. Первый компонент в регионе уже получила пятая часть жителей, а полностью привиты 16% населения. Реальному человеку, который вколол жижу зачем здесь писать. Какую связь имеет курение с потенцией и как влияет на здоровье мужчин эта вредная привычка, а также какой вред курильщику могут нанести сигареты и иные средства, и как восстанавливается организм. Есть множество различных медикаментозных, аппаратных и психологических методов лечения данного недуга. Если Вы умеете кататься и у Вас нет проблем с вестибулярным аппаратом и координацией, то это не значит, что остальные люди точно такие же и не испытывают в чем то проблем. Частые перемены настроения и поражения слизистой желудочно кишечного тракта также могут свидетельствовать о нехватке цинка в организме. Между тем, следование здоровым советам по питанию и отказ от вредных привычек позволяет не только сохранять вес и нормальное давление. Необходимо отметить, что не стоит придумывать специфические диеты или покупать дорогостоящие уникальные добавки для стимуляции мужского здоровья, вся помощь питания заключается в разумном использовании того, что есть у нас под руками. Ru» функционирует при финансовой поддержке Министерства цифрового развития, связи и массовых коммуникаций Российской Федерации. В теории весь процесс восстановления от курения выглядит гладко и просто, но на практике он сопровождается очень серьезными неврозами, психическими расстройствами, из за которых мужчина нередко лишается семьи, работы, социальных связей мало кто выдержит постоянно психующего или депрессирующего мужа, сотрудника или приятеля. Семенович рекламирует Тонгкат. У женщин – в коже однако это касается и представителей мужской половины. С этой целью диетологи рекомендуют съедать мужчинам не более 6 орехов в день, лучше всего грецких или бразильских. Иллюстрированный энциклопедический словарь.

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“При температуре тела выше 38 градусов рекомендуется принять жаропонижающие и обезболивающие парацетамол или ибупрофен, а если температура тела выше 39 градусов и не снижается в течение четырех часов после приема медикаментов, то необходимо вызвать врача”, — отмечается в памятке. WhatsApp + 7 916 311 85 21. Причина недомогания: угасание чувств. Помимо влияния на уровень тестостерона, «ожирение» печени в большинстве случаев сочетается с гипертонической болезнью, высоким уровнем холестерина и сахара в крови и повышает риск развития болезней сосудов, которые вносят свой дополнительный вклад в негативное влияние на потенцию. Хорошие таблетки, при проблемах с потенцией помогают. Сейчас я все свои половые проблемы оставил в прошлом – я чувстчую себя сильным, здоровым и уверенным в себе мужчиной. Что характерно, у молодых ребят 20—25 лет в 20% случаев уже наблюдались проблемы. Или у него нервный стресс и переживания. И это говорит о том, что пора обратиться к специалистам. Но если вы проводите в седле по несколько часов каждый день, ваша эрекция может пострадать. Вы увлечены спортом, хотите сохранить активность без вреда для мужской силы. Идиопатически когда причину обнаружить не удается. Вы лучше про это пишите. Врач хирург, проктолог, флеболог. Причина недомогания: отсутствие новизны в сексе. Прямая связь между работой мозга и мускулатурой определяет и качество половой жизни. Стоит отметить, что в лечении импотенции важна именно первая консультация у сексопатолога, поскольку конкретно в этот момент формируются доверительные взаимоотношения между врачом и пациентом, которые являются залогом успешного результата в виде повышения потенции. Сеченова Сеченовский Университет. Всю ночь и следующмй день температура 38. Чтобы удовлетворять любимую пришлось принимать специальные препараты, от которых возникали головные боли, тошнота и недомогание. Простатит, эректильная дисфункция, короткая уздечка. В недостаточной наполняемости пещеристых тел члена кровью, что делает его недостаточно твердым в период эрекции. Активный образ жизни, регулярные занятия спортом усиливает кровообращение и тем самым улучшает состояние всех сосудов, в том числе и тех, которые питают половой член. У нас же в России это очень распространённое заболевание», — подчеркнул врач. Второй поражающий фактор, о котором думают непричастные люди — долгое сидение в седле вызывает застой в промежности, а отсюда проблемы в половой сфере велосипедистов. АнкетаКонтактыОбразовательная деятельностьНовости и акции. Устойчивая эрекция возникает лишь на фоне выраженного сексуального возбуждения спонтанные утренние эрекции или эрекции во сне не в счет: у них иной механизм появления. 7 советов для жен, чьи мужья страдают эректильной дисфункцией. Что эквивалентно 2 3 чашкам натурального кофе.

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Тогда нужно сдать анализы крови: уровень холестерина и сахара, биохимию, печеночные показатели, исследование гормонов — тестостерон общий, свободный, фолликулостимулирующий гормон, глобулин, пролактин, гормоны щитовидной железы. Потребность в нем повышается при больших физических нагрузках, а также частых эякуляциях. Главное, чтобы оба партнера получали удовольствие, а у каждого это очень индивидуально. А что насчет таблеток, которые решают проблему мгновенно, которые поднимают боевой дух мужчины здесь и сейчас. Выход — одеваться по погоде, не стремиться одеть летнюю форму уже ранней весной. Лишние килограммы негативно влияют на сосуды и сердце, у многих людей с полным весом слабая потенция встречается более чаще, чем у других. Возраст перестанет быть помехой для вашей сексуальной жизни. Психологические эректильные дисфункции повторяются при определенных обстоятельствах. Пойди вдвоем к психологу или сексологу и поговорить о происходящем в постели будет правильным решением, как и записаться вдвоем к доктору урологу. И эта мысль засела у него в голове. А если учитывать тот факт, что эрекция основана на постоянном наполнении кровью пещеристых тел – не стоит удивляться проблемам, возникающим с этим процессом. Качество сексуальной жизни значительно улучшилось, продолжительность полового акта увеличилась. Пандемия — это страх за свою жизнь, тревожность, риск потери работы или отношений, невозможность назначить свидание, встретиться с партнершей, в конце концов, удушающая близость в семье, когда все вынужденно заперты в одной квартире и нет возможности отдохнуть друг от друга. До этого проблем не было. Возраст перестанет быть помехой для вашей сексуальной жизни. Многие опросы и исследования подтверждают, что каждый второй мужчина в мире старше 40 лет страдает эректильной дисфункцией. Снижается уровень тестостерона, что чревато апатией и даже выраженными депрессивными расстройствами. Фентоламин — неселективный ингибитор. Где же защита при вакцинации. На курсе BeHardLover вы узнаете очень много нового и полезного по сохранению мужского здоровья. Хуже того, на подобный самообман теряется драгоценное время, что приводит к ухудшению состояния и переходу болезни в хроническую форму. Капсаицин – вещество, придающее перцу остроту – способствует выделению особых химических веществ, увеличивающих частоту сердечных сокращений, стимулирующих либидо и возбуждение. Потенция и велосипед – это взаимосвязанные вещи. Опираясь на медицинскую статистику можно сказать, что «синдром ожидания неудачи» — это не редкость, а вполне обыденность современного ритма жизни. Матеріали, позначені значками: “Р”, “Позиція”, “Бізнес”, “ПР”, “PR” розміщують на правах реклами або партнерства.