Well, here is the persistently asked question from clients to us tattooers: Do you do hand and foot tattoos. And, do they last?

I am in a bit of a goofy mood while writing this post so the tone may be different than usual. I apologize if it makes the reading difficult.

Sweet Jesus, there is a plethora of misinformation out there as to how and why we do/don’t do finger tattoos. Today, I hope to put this to rest!

Hand tattoos – What Gives?

So you have a client that walks in and says,

               Client: Hey. Do y’all do hand tattoos?

You: **Nonsensical garbled answer because you really don’t want to do one but.. damn, you gotta pay them bills**

To dissect this problem, let’s dig right into the fucking dirt of what your skin looks like and how it’s different on the hands and feet. Then we will jump into why finger tattoos may or may not heal up, what to look for in your fingers/feet that help make a good choice about placement and how the healing is different for these areas of the body.

“Boom”

God

That means, let’s get onto the science!

Skin Composition – What’s the skinny on them layers?

I was am going to skip all the technical mumbo-jumbo about skin layers and what not but I ended up writing all about it.

Here is what people who are not tattoo artists thinks their hands look like. It may also be what we all assume every person’s hands will look like when they come in to get a tattoo blasted on the digits:

probably younger hands

In all reality, here is what we tattooers deal with on the daily:

old ass hands

If you look at your hands (just do it) and compare the skin on them to the rest of your body, you will notice a few things that are different.

  1. The backs of your hands have very little fat (adipose tissue)
  2. The palms of your hands are thick (Like…what if your whole body was like that?)
  3. There are transitional areas that line the sides of your fingers and palms.
  4. The skin takes a ton of abuse and you may have some rad scars.

What does that have to do with the tattooing procedure and how can I accurately assess the possible healed tattoo from people who want their hands/feet tattooed?

It’s easy young padawan. You just must understand the why’s before getting to the how’s.

Skin Construction

So, let’s have a short primer for all those out there who may not have taken an A&P class in college.

Here are the layers of your skin, broken down Scooby style for ease of reading.

  • Epidermis – about 0.1 mm in thickness.
    • Water proofing and barrier for the body. Made up of basal cells and keratinocytes.
      • Keratinocytes – a bunch of different proteins, enzymes, lipids and defense peptides that protect the body. They absorb water and don’t divide like normal cells do after they have been “selected” during a maturation stage. (more information found by following this link)
      • Basal Cells – Keratinocytes that are found in the basal layer of the epidermis.
  • Dermis – on average about 2 mm in thickness
    • The living part of your skin in that it supplies all the cells for the epidermis. It also contains vascular bodies, structural cells that give skin its physical properties, immune cells and specific fat cells called adipocytes.
  • Subcutaneous tissues – anywhere from 2 mm in thickness up to greater than 18 mm (> 18 mm)
    • This is fat. The subcutaneous tissues give structure like your dermis but is made up of loose connective tissues to underlying structures. Its like the dermis but is like…loose.

Here is a table that breaks down the layers in a more scientific way –

Skin LayerStructureRole in Viscoelasticity
Stratum corneum—outermost layer of epidermisStructure of up to 25–30 rows of corneocytes; includes fibrous keratin; “brick and mortar” arrangement, in conjunction with other stratified layers in the epidermis, increases tensile strength (resistance to longitudinal stress), and resistance to damage ()
Water content is 15–30% ()
Supports pliability (ease in change of shape from baseline)
Promotes strength, elastic behavior, and resistance to loss of skin integrity with movement, stretching, and application of force
Basement membrane zone (BMZ)Collection of three cell layers between the epidermis and the dermis (lamina lucida, lamina densa, and lamina propria; ; ); comprised of proteins (primarily laminins, proteoglycans, and types IV and VII collagens; )
Desmosomes (cells responsible for adhesion) serve as binding cells between basal layer of skin and upper lamina lucida (; )
Anchoring fibrils and a matrix of fibers at varying stages of maturity connect thicker lamina densa layer to upper layer of dermis (; )
BMZ semipermeable to water; limits water passage to maintain skin hydration and support viscoelasticity
Lamina layers extremely flexible due to construction of multiple-microfibrillar subdensa and protein-based supra-lamina desmosomes (; )
Supports epidermis and provides strong adhesion between the epidermal and dermal layers to protect against shearing forces (); when force applied on parallel plane to skin, it has a viscoelastic response of expanding and then contracting fiber matrix and associated fluids
Serves as an anchor to surrounding layers; disruption of BMZ leads to amorphous structure within epidermis and dermis causing skin structure breakage and reduced viscoelastic response
Dermis—layer between the epidermis and subcutaneous tissuesWithin papillary region (uppermost layer of dermis), a networking of thin elastin protein fibers (oxytalan fibers and the elaunin fibers cross-linked via desmosomes) is in loose matrix with procollagen (a precursor to collagen that originates within ground substance) and ground substance (; ; ; )
Reticular region (below papillary region and above hypodermis) is comprised of ground substance and a thicker mesh of collagen fibers wound among thicker elastic fibers assembled from elastin and microfibrils (; ; )
With force, elastin molecules stretch in linear pattern, cross links maintain structure; quick elastic reaction provides immediate response to force, followed by slower viscous response and then full return to baseline
Elastic fibers are thinner in papillary region and used for quick response but break more easily; elastic fibers in reticular region thicker, more bundled with collagen, and provide slower, viscoelastic behavior and greater tensile strength (; )
Hypodermis—innermost and thickest layer of skin; connects dermis to bone or connective tissueAdipose tissue is present in the hypodermis, but thickness of this layer may vary (; ; )Thickness of adipose deposits maintains shape of skin, protects it from underlying (bony) structures, and is positively correlated with skin strength and elasticity (; ); positive and protective effects may negated in obesity ()
Problems with obesity include impaired skin barrier repair, decreased lymphatic flow, decreased strength of collagen structures, impaired circulation, decreased wound healing, and skin disorders that change the structure and impair the function of the skin ()

Borrowed from source: Everett, J. S., & Sommers, M. S. (2013). Skin viscoelasticity: physiologic mechanisms, measurement issues, and application to nursing science. Biological research for nursing15(3), 338–346. doi:10.1177/1099800411434151

Let’s move on with a look at the subcutaneous tissues and why this layer of skin is so thin on your hands.

No fat, What up with dat?

The back of your hands and the tops of the feet are what every 80’s-90’s supermodels hoped their entire body could be like. Nearly fat free! (that was awful)

(I am going to stop putting in a separator and use hands as interchangeable with feet for now. That repetitive explanation is getting tiring)

The back of your hands look like crêpe paper stretched over a turkey skeleton. There is little to no fat on the hands of most people and, as anyone who has had their hands tattooed, the shock and vibrations you get from a tattoo make the hands hurt a lot. They tend to blow out, heal hard and take more of a beating through your normal day, in comparison with other parts of the body.

All over your body, the fatty layer (also known as the hypodermis or subcutaneous layer) exists to absorb blows and gives easy-access pathways for blood vessels to connect through your body. It also stores/releases energy, insulates your body and connects the tissue (skin) to underlying fascia which connects the skin to muscles, tendon and other stuffs.

One additional part of this amazing part of the skin is that it contains fibroblasts and macrophages, which if you had read the skin article (out soon), are key in getting the pigment to become “permanent” .

Fancy scientific mechanisms aside, the fatty tissue (in tattooing) keeps the skin supple and helps absorb some of the force that is emitted by the tattoo machine (via a needle). It also helps smooth out the dermis when you pull a stretch, making the layers under the epidermis more consistent thickness wise.

Imagination time!

Place a dish outside on a concrete slab and hit it with a hammer… what happens? It explodes!

Now take another plate and place it on a pillow and smack it with a hammer… what happens? …It still blows up, but the shock you feel from swinging a hammer is greatly decreased.

Hand and foot tattoos for thick skin – Yes everyone has thick skin

This may seem like a weird idea that we all have thick skin but, in essence, we do. That thick skin is on the palms of our hands and soles of our feet. Its there because we need additional protection from our environment with the feelers that we utilize to interact with our world.

Our hands and feet are what we use to interact with our environment. It is what gets us to work and allows us to do the jobs we choose to do. Our feet go through an immense amount of stress every day. Each step you take is an opera of stress distribution and pressure. Your weight, with what speed you are going, is absorbed by a complex network of bones, muscles, connective tissues… and a bunch of magic! (not really) Those stressors increase the pressures to a value that can be multiple factors higher than what your physical weight is. 

nasty feet

Why are the fatty parts so important for tattooing?

The fat helps create a less volatile surface for you to tattoo. The needles that are being driven by a tattoo machine will have a little cushion when they strike the bottom of the machine stroke. This is supremely important as the cushion not only helps the client feel less pain (initially) but also enables the skin to settle evenly when stretched.

What’s that you say? Stretching is influenced by the amount of fatty tissue underlying the skin?!

skin layers

It’s super important to get the stretch down right!

(Upcoming article on stretching will be linked HERE when it is completed)

SubQ – Skin on the hands and feet

The subcutaneous layer (SubQ or fatty layer, like stated before) that all but missing in the hands and feet make things difficult to tattoo but serve a function that is unique to these parts of the body.

Due to the lack of fatty tissue, there is less connection to the underlying structures in the hands and feet. This makes it easy for the fingers and feet to bend and move with less restriction but it also has an effect when getting the hands and feet tattooed.

Yes, your magnificent biceps can take a tattoo and look amazing when oiled up! But, could you imagine how it would feel if the skin on your hands were attached to the muscles the same way your arms or thighs? That would be weird and restrictive.

Walking or grasping something would become very difficult, in the beginning, but as your muscles developed those movements would be even further restricted. Larger muscles needed to move the resticed joints would cramp the area that they occupy and the idea of dexterity would be absent from the species.

Next up on the block for tattooing hands and feet is the uppermost layer of your skin, the horny layer.

The Horny Layer – Not what you think

Image result for stretched skin diagram hand and foot tattoos - Austin powers style. oh behave!

Another aspect that is unique to the hands and feet on a body is the excessively developed horny layer of skin. No, your hands don’t want to get down ya dirty, or maybe they do? The horney layer is another name for the uppermost layer of your epidermis, the stratum corneum.

The stratum corneum (which will be called the horney layer from here out because…I am like a teenager at heart) is made up of all those dead skin cells that are slowly sloughing off when new ones are made. The skin all over your body is always dying but there is a greater sloughing that happens on your hands and feet because they are constantly in use.

One other aspect of these areas on your body is an additional layer of skin called the stratum lucidum.

Ahhhh, the circle of life!

The upper most layer of skin is comprised of mostly dead cells, they had to get there somehow. These dying or dead cells are migrated up through the skin by newly formed cells further down and once they reach the top, they fall off.

Working our way into the skin, and looking at something that is totally unique to these body parts we end up at the stratum lucidum. It is located between your epidermis and dermis on the hands and feet. It’s a collection of specialized cells that give your hands and feet a waterproof, protective layer. Much like a rain slicker in inclimate weather, this layer adds additional protection to these parts of your body and help to keep pathogens out of the parts of your body that interact with your world.

You may have noticed this specialized layer of skin if, like myself, you have gone for a long walk and come home to some swollen, soaked socks. You can also see this layer in action when you take a nice hot bath and get all pruney!

The keratin cells in your hands absorb water and swell, but only the dead/dying layers on your hands above the stratum lucidum! neat eh! This specialized layer is great at protecting your most precious digits and, to be honest, aren’t we glad that our backs don’t wrinkle like that in the tub!

Next, onto the dermis!

The dermis. The real target of hand and foot tattoos

Ok. This article has become more about the skin rather than focusing on tattooing. I understand if you need to go but, I promise, after this section we will move onto the real meat and potatoes you came for!

The dermis is what lies between the epidermis and the subcutaneous tissues of the skin. It is made up mostly of collagen and elastin. These two proteins are what gives your skin it’s bouncy resilience. Your nerves, blood vessels, lymph vessels and sweat glands are also crammed into this space!

We are not ignoring the blood and lymph vessels, which help with thermoregulation and supply oxygen and nutrients to surrounding cells. We are moving past them quickly to talk about more specialized cells.

Another type of cell that makes up the dermis is a mast cell. These specialized cells are a part of the inflammatory response that helps the body deal with intruders (infectious materials like viruses or other things that shouldn’t be there). I’ll leave you a link that explains it all in a much better fashion than I can.

Dermis Explained

Why is the dermis important?

The dermis is where the pigment stays and becomes “permanent”. Your epidermis is constantly sloughing off and is composed of dead/dying cells (mostly keratinocytes). These cells that are being pushed out are not capable of “holding” pigment. The pigment holding cells are the macrophages that are summoned up from the lower layers of the dermis.

These specialized cells deal with infections and foreign particles (like ink). The macrophages consume/engulf the pigment particles that have been injected into the skin and hold it in place. These cells, like all others in our bodies, slowly die off and dump their contents (tattoo pigment) back into the skin before being transferred up to be sloughed off.

What happens to the pigment when that occurs, you ask?

ink life cycle after tattooing

The body sends more macrophages in response the the released foreign particle. The newly formed macrophages come forth, engulf the pigment and lay in wait until they meet their inevitable end.

This process continues during your livable existence and ensure that your tattoo is going to last a lifetime. (for now… mwahahahaha SCIENCE! – more on this later)

What’s up with hand and foot tattoos?

How about you, dear reader take this one. I know you can probably answer this question pretty well after all that typing that occurred above! (at least I hope so…)

hand structure
  • With a layer of subcutaneous tissue that is less evident, the body can experience greater trauma when being tattooed. Higher degree of trauma = lower chance of healing cleanly.
  • Lower levels of subcutaneous tissue create a more difficult stretch which creates a more uneven dermal layer. This makes it nearly impossible to place the pigment consistent into the skin so it shows an even tone and doesn’t “blow out”.

(A blow out is where the pigment is placed in a way that causes it to spread in an unpredictable way under the skin. The pigment placed into the body can roll along the capillary pathways, along soft spots of less dense skin or be carried into less dense areas by the inflammatory/immune response that occurs during a tattoo.)

  • Higher levels of stress from normal daily use increase the amount of shedding that needs to occur as more cells are destroyed from use.
  • Being constantly in use, the environmental stresses are greater than other parts of the body so an increase in healing time may occur.
  • The thicker horny layer creates a longer pathway for ink and needles to travel. this travel will dislodge pigment at different depths that can create an illusion of a well done tattoo. When the tattoo heals, and the misplaced pigment is shed (not absorbed) the finished product could be much lighter than anticipated.

So this list is going to left and added to at another time. I have shit to do and I am running out of time!

How can we tell who would be a better candidate for a hand or foot tattoo

This one is simple. You do a consult and touch their hands/feet after washing your hands and putting on a set of gloves.

Look at the skin. Is it very thin looking? If so, you will need to adjust your machine speed to ensure quality injection of pigment.

Give the skin a little push and pull. Does it feel tight or strongly attached to the underlying structure? If it does, there is a better chance that the SubQ layer is thicker than average and should be easier to tattoo. If the skin is very loose, there is a better chance that the tattoo will fall out or blow out if your needle depth is not set shallow and run on a slower machine setting.

WHen doing a consultation, ask the person who wants the tattoo what they do for a living. If you are going to tattoo a bakers hand, or a mechanics hand, there is a greater than average chance the tattoo will heal like total crap. Why you ask? BECAUSE THEY WORK WITH THEIR HANDS!

The type of work and what the skin is introduced to in a daily grind are what we consider environmental stresses. If you were to apply those same stresses to any other part of the body, what would you expect? (This wasn’t rhetorical)

How evident is the vascularization of the hand? If it seems very prominent, located near the surface, the epidermis will be thinner than normal (maybe they don’t use their hands for work or have a light duty job). If this is the case, you will have to adjust your hand and machine speed to ensure good saturation and less trauma.

In closing for now…

There is more information that needs to be added to this so let’s leave this article as a primer for those of you who need more.

Thanks for reading.

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