• Almost one in five (18%) people who have had a tattoo, cosmetic piercing, acupuncture or electrolysis in the last five years experienced negative effects, with the most common side effects including burning or swelling.
  • Nine in ten (90%) of the UK public believe that people who carry out such special procedures should be legally required to hold an infection control qualification – there is currently no such requirement.
  • RSPH is also calling for age-limits on cosmetic fillers - the majority (87%) of the public believe dermal fillers should be made illegal for under-18s. 

RSPH has published its latest report, Skins and Needles, which takes a look at health risks associated with the increasing number of people in the UK having tattoos, piercings and other treatments that compromise the skin barrier. Between 2004-2014 there was a 173% increase in the number of tattoo parlours in the UK, and now one in five of us have a tattoo.

Currently there is no standard legal requirement across the UK in infection control for anyone offering special procedures, such as tattoos or piercings. This means that currently anyone can set up shop without appropriate training and could ultimately put people at risk of infection. In UK legislation, the term ‘special procedures’ refers to tattoos, cosmetic piercings, acupuncture and electrolysis. There is also no specific legislation covering other equally invasive treatments, such as dermal fillers.

Based on a national survey of people who had at least one special procedure in the previous five years, of those who reported having had a negative side effect, one in ten required medical treatment. 

The RSPH research also found: 

  • Anyone can purchase specialist equipment online to carry out tattooing or piercings without the necessary training or qualifications in how to use them;
  • Two fifths of people who had a special procedure did not check whether the person carrying it out was registered or licenced to carry it out; 
  • The most important factor that influenced where they had their special procedure was the skill of the technician, followed by the cleanliness of the premises and recommendations by previous clients.

RSPH is now calling for: 

  • All UK governments to make non-surgical cosmetic procedures illegal for under 18s. 
  • Businesses to only sell tattoo and piercing equipment to individuals who can provide documentation evidencing their registration or licensing with their local authority.
  • All UK health systems to bring in a requirement for an infection control qualification as part of licensing and to review the procedures included within special procedures legislation.  
  • Infections linked to special procedures to be included in the list of notifiable diseases that must be reported to local councils or local health protection teams. 
  • All UK governments to review their special procedures legislation to include non-surgical cosmetic procedures such as dermal fillers


Shirley Cramer CBE, Chief Executive of RSPH, said: “The growing popularity of tattoos, piercings and cosmetic procedures is all part and parcel of people choosing to express themselves and their individual identity. However, the legislation and regulation of providers of these services, which ultimately protects the public, is markedly different across the UK and in some areas is not fit for purpose. This matters because one in five people are still at very real risk of sepsis and other complications. 

With the surge in demand for tattoos, piercings and a growing variety of cosmetic procedures, such as fillers, we hope this report sparks a wider discussion about the need to provide safeguards and reassure those who seek to undertake body modification in all forms in the UK today. 

We would call on the rest of the UK to follow the example set by Wales to ensure infection control and other health risks are minimised, by introducing a mandatory licensing scheme which will require practitioners in place to ensure that the risk of complications is reduced.”

Nicole Holmes, President of the UK Association of Professional Piercers (UKAPP), says: “People should have the freedom to express themselves through piercings, but they should also have the right to do so safely and without harm to their health. When someone approaches a piercer, they embark on an exciting new creative project, but one that comes with some health risks that must be managed.

Piercers should embrace the mandatory licensing scheme called for in this new report. It will enhance our craft, ensuring everyone in the industry is qualified and working at the highest hygiene and safety standards. This will minimise risks and, in the end, lead to higher rates of client satisfaction.”