INTRODUCTION

A tattoo is a non verbal form of expression that has been in use since antiquity, the oldest
preserved evidence dating back to 6000 BC. But tattoos were absent from the European culture
for more than a millennium unless their reentry in Europe from Polynesian countries by Thomas
Cook and his fellow sailors in late eighteenth century. The word tattoo is a modification of
Polynesian word tattaw or tatau which means to mark.

Tattooing refers to marking of the skin by puncturing and introducing pigmented material.
Although it derives from a Polynesian word, tautau, decorative tattooing has been found in most
societies over many centuries.

The ultimate purpose of tattooing has always been identification. Undoubtedly, tattoos function
to draw distinctions between people who have them and those who do not and thus can be seen
as physical markers indicating belonging to or separation from certain social or cultural groups.

In modern society tattoo has some additional meanings. For example, tattoos may express
individualism, defiance, affection, risk-taking, alliance, sexual preference, beauty, fantasies,
freedom, etc. It wasnt long when tattooing was associated with sailors, prostitutes, slaves and
lower class labourers.

However during the last three decades the tattooing has undergone dramatic redefinition and has
shifted from a form of deviance or stigma to an acceptable form of expression. The idea of
popularity of tattooing in current generation can be assessed by the fact that 10% percent to 16%
of adolescents age 12 to 18 and 3% to 9% percent of the general population in US are reported to
have permanent tattoos. Though the popularity of tattooing for body modification has increased,
the psychosocial data about tattooing behaviour are few and controversial.

However the studies are limited but almost all of them are of view that there might be a possible
relationship between the tattooing and high risk behaviours which very often lead to criminal
behaviours.

In fact the tattoos are classified as criminal tattoos and non criminal tattoos based on the
content of the tattoo if it reflects some conflict with law or not respectively. These behavioural
correlates of tattooing have led to a suggestion by some physicians that finding a tattoo during
physical examination should alert to the possibility of an underlying wide range of
psychopathological conditions.
 History
Tattooing has been practiced for thousands of years with evidence of it occurring in the upper
Paleolithic era (38,00010,000 BC) and from the 11th dynasty of ancient Egypt in the second
millennium BC1.

Mummified and preserved remains from the Bronze Age have been found to have tattoos; an
example of which was the body of a man (O tzi) whose tattooed remains were found in 1991
in the Tyrolean Alps2.

The possibility of a therapeutic/magical purpose for some of these tattoos was considered, given
that several dark blue tattoos were found overlying arthritic areas of the lumbar spine and ankle3.

In mummified remains the viewing of such tattoos may be enhanced by using infra-red
light4Tattooing continued into the Iron Age with complex designs being found in skin retrieved
from two Siberian graves dated between the sixth and second centuries BC.

The presence of elaborate goods in both of these graves suggested that such tattooing was
associated with high social rank. Tattoos in Greek and Roman times, however, indicated the
opposite, with tattoos being a marker for barbarian tribes such as the Celts and Scythians, and
also for slaves and criminals.

Although early Christians used tattoos as a secret way of recognizing each other, a later edict by
Pope Hadrian in the eighth century forbade the practice5. This did not stop medieval European
crusaders and pilgrims to the Holy Land from getting tattoos of Christian symbols such as the
Cross of Jerusalem.

Later still, tattooing replaced branding in eighteenth century Britain to mark military deserters,
and in nineteenth century France for convicts sentenced to forced labour . While earlier tattoos
had quite thick outlines, in recent times in Western cultures the development of the fine line
style has resulted in much more complex and intricate designs (Figs. 1, 2).

1
Sperry K. Tattoos and tattooing. Part I: history and methodology.Am J Forensic Med Path. 1991;12:3139.
2
Murphy WA Jr, zur Nedden D, Gostner P, Knapp R, Recheis W, Seidler H. The Iceman: discovery and imaging.
Radiology. 2003; 226:61429.
3
http://www.archaeologiemuseum.it/en/node/262. Accessed 2 July 2013.
4
Hansen JPH, Melgaard J, Nordqvist J. The mummies of Qilakitsoq. National Geographic. 1985;167:191207.
5
Ibid.
 Fig. 1 A recent monochromatic fine-line tattoo of a face

Fig.2 A recent fine-line tattoo of a rhinoceros in a decedents flank with

surrounding bright blue coloration

Non-European cultures also have long traditions of tattooing. Although tattooing in Japan dates
back to the fifth century BC, it was often found only in those considered to be outside normal
society. This persists today with members of criminal organizations such as the Yakuza
sometimes having full body tattoos .Tattooing has long been a part of traditional South Pacific
societies and was originally reserved for the upper classes of warriors and chieftains. Early
Pacific explorers such as Cook and Bougainville brought back tattooed individuals to exhibit in
Europe.6

Methods of producing a Tattoo

Traditionally tattoos were produced by either cutting the skin and rubbing in soot or other
pigments, or by using sticks or bones dipped in pigment.

Heavy metal tipped awls were used by the Shan tribes in Myanmar (Burma) that relied on the
weight of the instrument to pierce the skin

6
Caplan J. Speaking scars: the tattoo in popular practice and medico-legal debate in nineteenth-century Europe.
Hist Workshop J. 1997;44:10742.
 Fig. 3 Four traditional Shan tribal tattoo awls from Myanmar

This contrasted with Dyak tribes in Kalimantan where sharp needles were attached to light
wooden handles that were tapped over a design (Fig. 4).

Fig. 4 Two wooden Dyak tattoo awls from Kalimantan.

Today tattoos are usually produced by using electric machines with multiple needles that pick up
ink and inject it into the dermis. Dyes include India ink, cadmium, chromium, cobalt salts and
mercuric sulfide7. Tattoos acquired in prisons may be associated with less sophisticated methods
and unsanitary practices and are associated with higher rates of infection.

Accidental tattoos

Occasionally pigmented material may be introduced into the skin inadvertently as with coal
miners who may contaminate superficial lacerations and abrasions with coal dust. Staining of the
gums may also occur from dental amalgam and tattooing with gunshot residue may occur with
close range discharges.8

7
Ibid.
8
Swift B. Body art and modification. In: Rutty GN, editor. Essentials of autopsy practice: recent advances, topics,
and developments. London: Springer; 2004. p. 15986.
 Tattoo marks

Tattoo marks are designs made in the skin by multiple small puncture wounds with needles or an
electric vibrator dipped in coloring matter. The dyes commonly used are Indian ink, carbon
(black), cinnabar or vermilion (mercuric sulphide) red, chromic acid (green), indigo, cobalt,
prussian blue (ferric ferrocyanide), ultramarine (blue). Techniques and dyes vary from country to
country.

The most permanent pictures are made when the dye penetrates the dermis. If the dye is
deposited into deeper layers of dermis, it will be removed by phagocytes. Most of the tattoo
marks are found on the arms, forearms and chest, but may be present on any part of the body.

If the pigment has been deposited below the epidermis, it will very slowly become fainter and
certain pigments, such as vermilion, and ultramarine may disappear after about ten years.

The rate of fading depends not only on the composition of the pigment, but also on the depth to
which it penetrates the skin, and the site which is tattooed.

Parts protected by clothing retain the design for longer period than the exposed parts of the body.
Tattoos on the hands disappear early due to constant friction.9

Tattoo styles

A range of tattoo styles may now be encountered in most morgues. Older styles of tattoos in the
West usually depict hearts, scrolls with the names of family members, daggers, animals, sailing
ships and roses and were most often found amongst sailors or ex-navy personnel. Sometimes the
designs signified a particular event, such as a swallow on the chest of a sailor indicating that he
had travelled 5,000 miles.

More recent styles using fine line and detailed photorealistic work may be in either grayscale
(where the designs are produced using shades of grey) or color, with advances in shading
techniques and with new colors such as vibrant greens and orange. Tribal designs that are
usually monochromatic and often based on Celtic designs are now also popular 10(Fig. 5).

9
http://healthdrip.com/tattoo-marks/Healthdrip May 26, 2012Forensic Medicine, General Health, Uncategorized
10
Green T. The Tattoo Encyclopedia: a guide to choosing your tattoo. New York: Simon & Schuster; 2003.
 Fig.5 A Western tribal design

Gang and prison tattoos are often crude with antisocial messages and an emphasis on death and
violence such as images of skulls, snakes, the grim reaper and tombstones. In certain groups such
as Russian prisoners an inmates life history of incarceration may be documented in his or her
tattoos11.

More traditional styles may be found in tribal people from areas such as Africa, South-East Asia
and Polynesia. Designs are specific for different groups and regions and so may be useful in
disaster victim identification exercises or in helping to identify unknown individuals. The
monochromatic designs are usually in black ink. Eastern tattoos, as may be found in members of
the Yakuza, are often quite elaborate with the use of multiple colors and pigments.12

The significance of tattoos

Many individuals in Western countries choose tattoos for purely decorative purposes that may
have humorous or sexual connotations. Customized tattoos may be used to record relationships,
the birth of children or the death of a friend or family member.

So-called commemorative tattoos may involve the latter, with cremated ash from the person
being memorialized mixed in with the pigment. Information in customized tattoos may be
particularly useful for identification purposes.

Inmates of Nazi concentration camps in the Second World War had identification numbers
tattooed on their arms, which was a practice similar to that used by the Romans to identifying
slaves and criminals.13

11
Baldaev D, Vasiliev S, Sidorov A. Russian criminal tattoo encyclopaedia, vol. 3. London: Fuel Publishers; 2008.
12
http://www.dailymail.co.uk/news/article-1382041/Ashes-ashesdust- tattoos-Memorial-body-ink-using-cremated-
remains-lovedones- grows-popularity.html. Accessed 5 October 2017. at 11:35 am IST
13
Cains G, Byard RW. The forensic and cultural implications of tattooing. In: Tsokos M, editor. Forensic pathology
reviews, vol. 5. Totowa: Humana Press; 2008. p. 197220.
In certain religious groups, such as among Hindus, tattoos may be used to ward off the evil eye
or to ensure fertility, and are seen as a normal expression of faith. This contrasts with
Christianity and Islam where tattooing is forbidden

e. g.: Ye shall not make any cuttings in your flesh for the dead, nor imprint any marks upon
you; I am the Lord. Leviticus 19:28.

A number of studies in the literature have linked tattoos to high-risk behavior and psychological
illnesses including schizophrenia, anti-social and borderline personality disorders, fetishism and
paraphilias, and substance abuse.14

This has been a long-held opinion, with Lombroso in the nineteenth century stating that the
convicts with numerous tattoos are natural and dangerous criminals, and that the worst and most
bestial types are distinguished by their obscene and cynical designs.15

Identification of a Living Person16

A) In civil cases:

Identification of a living person is very important in cases such as: marriage, inheritance, or
in case of people impersonating somebody else to obtain unlawful property.

Identification of living body follows all the points mentioned for the dead with the addition
of certain features as:

1. Character of voice, the expression, hand writing (right or left handed).

2. Standard of education, the intellect and the accent.
3. Any mannerism in speech and movements of the hands during talking and any tics.
4. Any peculiarities in the gait during walking.
5. Photographs: side view and face view, but they can often be misleading by accidental
reversing of a negative to find that wounds which were on the left side of the face appear
to be on the right side.

14
Raspa RF, Cusack J. Psychiatric implications of tattoos. Am Fam Physician. 1990;41:14816.
15
Ibid.
16
http://medstudynotes.pgpreparation.in/2008/01/medico-legal-importance-of-tattoo-marks.html?m=1accessed on 5
october 2017 at 11:45 am IST
B) In criminal cases:

Personal identification of living persons in criminal cases is essentially the work of the police,
depending on:

Anthropometry:
Bertillon system Anthropology:
(Anthropos = man and metron = measurement)
It deals with the measurement of various parts of the human body. The system is
applicable to adults only because the human body does not alter after about the age of 21
years and that no two persons show the same measurements in all respects.
Finger Prints (Dactylography).
Foot prints, palm prints, lip prints, iris prints, and voice prints
DNA fingerprints

Cases on Identification of persons

There are certain features of the body that help in the identification of it. Some of these features
such as age sex, occupational marks, wars and tattoo- marks, fingerprints and teeth assume quiet
and importance when dealing with the case of dead body whose identity is untraceable they may
even give a definite clue to the identity of the dead.

The case of R versus Ross CCC December, 1831, as given in Taylor, gives an interesting
reading. This was the case of close identity between two women, one supposed to be
murdered, and the other found in a hopelessly exhausted condition in immediate
neighborhood of the place where the first woman was supposed to be done to death.

The Prisoner when questioned had replied that the woman supposed to be murdered was the
same as was found in the immediate neighborhood. The most interesting thing was that there was
a similarly of names and both the women were the natives of Ireland, their ages and occupation
even coincided.

The identification rested on two factors, first the relatives of the murdered woman had sworn that
the body found in the exhausted condition was not that of the deceased, and secondly, the
presence incisor teeth in the woman supposed to be murdered, while the medical evidence
deposed that the other woman whose body was found in an exhausted condition must have lost
her incisor teeth long before death.
Taylor relates another Case of Identity from teeth. A man was charged with the murder of a
woman with whom he has cohabited 14 years earlier and who had disappeared. A dentist stated
that a fortnight before the woman was missing he extracted the first molar tooth on the left side
from the lower jaw.

When the exfiumeecy was shown to him, the tooth was absent, and he affirmed that was the
place where he had extracted the tooth. He was thus able to clearly to identify the skeleton as that
of the missing women.

In one more case tattoo marks were resorted to by Amritsar Police. Four women of Bagaria
village were tattooed with the words Jeb Katri (pick-pocket) on their foreheads. The Punjab
and Haryana High Court ordered surgical removal of the same in Rajindra Hospital and then buy
a private hospital in Patiala. However the scar remained after surgery.

Sydney Shark Case

James Smith disappeared on April 8, 1935. A shark was caught alive 14 days later, which
vomited a human arm at the aquarium where it was kept. Medical examination revealed that the
arm was severed from a dead body by a sharp weapon. Smiths wife and brother identified the
arm from the marks of two men boxing. The identity was also confirmed by fingerprints. Later,
Patric, Brady was tried for his murder at Sydney.17

G Webster reports of 50 year old man of Ratnapur District of Ceylon, whose body was
exhumed from 3 feet deep pit, 5 weeks after his disappearance. The features were
unrecognizable and the epidermis putrefied, discolored and sodden, but the tattoo-marks
of Saint Michael were clearly visible on the dermis of the right upper arm. In the tropical
climate of Ceylon, putrefaction of dead bodies begins in about 30 hours after death. The
features may be unrecognizable in 2 or 4 days and the epidermis peels off in about 7 to 10
case days depending on the mode of burial.18

Cases occur where only fragments of the body are found or bones are produced by the
prosecution alleging them to be of the victim of the crime. In such cases the first point in
identification must be to determine that the fragments of the bones are of human origin, having
determined that they must be carefully inspected to ascertain whether they all belong to one body
or whether there are any in Congress or duplicate parts.

17
Taylors Medical Jurisprudence, 11th edn.p.19.
18
Fingerprint and Identification Magazine, Chicago, March 1968.
 Taylor defines that when fragments are found the sex, age, structure and general development of
the body should be investigated and careful search made for marks of identification as from scars
tattoos fractures hair etc.

The means employed to separate the fragments (saw, knife, etc.) should be elucidated, and
whether they have been carefully this articulated or roughly hacked apart the line of in season
should be the subject of special study, for it may prove definitely that certain parts belong to the
same body.

The parts found should be fitted together at times so they should be carefully preserved.
Information it should be further ascertained as to what treatment the parts have been subjected.
For example whether they have been boiled, burnt or treated with chemicals.

If vital organs or large vessel are available, it should be noted whether injuries have been
inflected which might have caused death, and whether any injuries found were infected before or
after death. If the head is available, the teeth would be of most valuable assistance in
identification.

Pathological features
Once foreign material is injected into the skin a series of coordinated inflammatory and
reparative processes occur that may be used to give a very approximate age to the tattoo 19,
although this generally only applies in the very early stages.

The initial response to a tattoo is erythema and swelling, followed by sloughing of the epidermis
without blistering. Indurations occurs after 57 days, with crusting of the surface followed by
healing after about 2 weeks 20.

In a tattoo that has been present for some time the pigment appears histologically as aggregated
black material within the interstitium and inside macrophages in the dermis, usually without a
significant inflammatory reaction. This material may also be found in adjacent and regional
lymph nodes21 and may be misinterpreted if the macroscopic details and history were not
known22

19
ONeil M, Dubrey SW, Grocott-Mason R. An unusual tattoo.Heart. 2003;89:474.
20
ibid
21
Casper JL.A handbook of the practice of forensic medicine, vol. 1.London: New Sydenham Society; 1861. p. 109.
22
Friedman T, Westreich M, Mozes SN, Dorenbaum A, Herman O. Tattoo pigment in lymph nodes mimicking
metastatic malignant melanoma. Plast Reconstr Surg. 2003;111:21202.
 Complications

=Septic inflammation =Erysipelas =Abscess =Gangrene

= Syphilis = AIDS =Leprosy =Tuberculosis

Complications of tattooing are reduced if sterile equipment is used under aseptic conditions,
however amateur tattoos produced at home or in prisons may be associated with transmission of
blood borne diseases such as hepatitis C and localized tissue reactions or bacterial infections23.

Other diseases that have been transmitted by the use of unclean equipment are leprosy and
syphilis. The latter may have occurred when tattoo artists moistened needles with their own
saliva24.

A variety of skin conditions have been associated with tattoos that may be classified as
allergic/granulomatous/ lichenoid reactions, inoculation/infection and coincidental 25. Allergic
reactions occur most often to red mercuric- based inks and cause swelling, erythema and pruritis.

The use of alternative pigments such as ferric hydrate, cadmium selenide and organic vegetable
dyes such as Brazil and Sandalwood have reduced the incidence of these types of reactions .

Removal / Erasure of Tattoo-Marks

1. SURGICAL METHODS:

(a) Complete excision and skin grafting,

(b) Production of burn by means of red hot iron,

(c) Scarification, and

(d) Carbon Dioxide Snow.

23
Long GE, Rickman LS. Infectious complications of tattoos. Clin Infect Dis. 1994;18:6109.
24
Ghorpade A. Inoculation (tattoo) leprosy: a report of 31 cases. J Eur Acad Dermatol Venereol. 2002;16:4949.
25
Leggiadro RJ, Boscamp JR, Sapadin AN. Temporary tattoo dermatitis. J Pediatr. 2003;142:586.
 The earliest surgical method employed was the production of a burn by the application of a red
hot iron into the design. When the dead tissue sloughed off, it took the tattoo- marks with it but
usually left behind a bad scar in its place.

The use of carbon dioxide snow produces similar results. A complete excision of the tattoo
marks followed either by sliding slabs or skin grafting is often a satisfactory method. A reduction
of the intensity of color of the tattoo marks is possible by over-tattooing in the titanium oxide a
white pigment.

Lacassagne and J Rousel recommended the scarification of the tattooed spots and then sprinkling
them over with finely powdered potassium permagneta. After few days, the scab falls off, and
smooth, colorless, almost unscarred skin appears. Scarification by sand paper or wire brush
technique or dom abrasion is not so satisfactory26.

2. ELECTROLYSIS

Miller suggests electrolysis for the removal of tattoo marks by means of a needle attached to the
negative pole of a battery in order to get the softening action of the alkali from there27. Once the
pigment is laid bare by the needle, it is scrabed and picked away from the tissues in which the
pigment is deposited.

Another method is to insert the needle into the tattoo mark a certain number of times; using a
current of 5 to 2 milliamperes. This forms a superficial eschar, which drops off in the course of a
week or so, taking the pigment with it, and leaving a white superficial scar.

3. CAUSTIC SUBSTANCES remove pigment by producing inflammatory reaction and a

superficial scar, e.g., mixture of papain in glycerine, zinc chloride and tannic acid. Caustic
substances applied to the mark remove the pigment by producing an inflammatory reaction and
a superficial eschar. For instance, a mixture of papain in glycerineoften removes a tatoo mark.

Tardieu reports the case of a criminal who successfully removed the tattoo-mark made of Indian
ink in 6 days, by first macerating the skin in a paste of lard and acetic acid, and then thoroughly
rubbing it with the solution of caustic Potash or soda and lastly with dilute hydrochloric acid 28.

Case law in Shankar Mahto vs State of Bihar29, it was held that according to medical evidence,
the dead body was found badly decomposed and no tattoo marks were found. The High Court

26
JS Pegum, PRSM, 1957, 50, 607.
27
Electrolysis for the Removal of Tattoo-marks, Medical Council, Philadelphia, 13, 3724, 1908,JAMA, 14 January
1928, 94.
28
Peterson, Haines and Webster, Legal Medicine and Toxicology, second edn. Vol 1,160.
29
[2002] 3LRI 787: AIR 2002 SC 2857: 920020 6 SCC 431: 2002 SCC (Cri) 1346.
held that the post mortem report did not suggest that when the body was recovered, it was so
badly decomposed that the same could not have been identified by daughter of the deceased.

Hence, the High court opined that the identification of dead body by means of tattoo marks
present on the arms of the deceased, which were visible at that time, was not unusual. Apart from
tattoo marks, dead body was identified by face, ears and teeth as well. In view of the said facts,
plea raised to make the identification of dead body doubtful was rejected.

(4) LASER BEAM: By exposure to laser beams, the particles of the dye get vaporized and
expelled from the tissues in gaseous form.

(5) CONFLUENT SMALLPOX AND CHRONIC EZEMA: Confluent smallpox has been known to obliterate
tattoo marks in children, and chronic Eczema because the disappearance of tattoo marks.
Sometimes, a new tattoo marks maybe superimposed on the old one with a view to enter the
pattern and does obscure identity.

Disappearance of tattoo-marks
Tattoo-marks may disappear during the lifetime without leaving any trace on the body after
period of at least 10 years, provided the pigment used as vermilion or ultramarine, and if the
mark has not penetrated deep into the skin.

Even in these cases the pigment may be seen deposited in the neighboring have lymphatic
glands, if examined and after that whoever the marks are indelible if pigments such as Indian ink,
soot, gunpowder, or powdered charcoal have been used and have penetrated deep into the fiber-
elastic tissue of the skin.

These marks are so permanent that they may be recognized even in decomposed bodies after the
skin has peeled off. In the one case, the letters PL tattooed on the left forearm were evident in
a badly decomposed body examined a fortnight after death.

A faded tattoo mark maybe revealed by the use of the ultraviolet lamp or may be rendered visible
by rubbing the path and examining it with a magnifying lens in strong light. Infrared
photography may also be useful.

Medico-legal importance of tattoo marks

1. Identity. If there are large numbers of tattoos, positive identification can be made by them
alone. Initials and dates, regimental or nautical details, identity numerals, ones own
name, etc., provide more scientific basis for identification.
2. Religion.
3. God of worship.
 4. Indicate culture or life-style. The distribution of tattooing and the nature of designs and
figures.
5. May indicate a particular country or region.
6. The presence of indecent figures points to definite perversion in the individual.
7. They reflect travel, history, war, occupation, sex interest, etc.
8. Gang members may wear tattoo marks of allegiance and symbolism to indicate status or
other aspects relevant to their particular group
9. Illicit drug users may have them that identify them as belonging to a particular group or
to obscure injection sites.
10. Indicating the name, address, religion, birth date and place of the person.
11. Giving an idea about the environmental and social background of the person e.g. tattoo
marks is generally practiced in lower class of society. In addict persons, they are
practiced to conceal the injection sites.
12. In certain tribal groups tattooing and scarification are a part of traditional healing
practices. For example in parts of West Africa healers will draw a thin line on the
forehead to treat epilepsy or draw tattoos on the hands and legs for the treatment of
peripheral neuropathy.

Forensic issues
As dermal pigments in tattoos remain in situ for years, the identification of the type, pattern and
number of tattoos may be an extremely useful adjunct to identifying an unknown decedent30.
This can occur even with quite pronounced putrefactive changes and loss of superficial skin
layers.

Although dental and DNA matches are sought during disaster victim identification/management
operations31 tattoos were useful identifiers in some of the badly decomposed bodies in Thailand
following the 2004 Tsunami.

There are also a number of other pieces of information that may be derived from tattoos that
include possible previous occupation and club/gang affiliations, previous military service, names
of family members, medical conditions, previous travel destinations, drug taking habits, prison
history, and religious and cultural background.

30
Prahlow J, Byard RW. An atlas of forensic pathology. New York: Springer Publishers; 2012.
31
Byard RW, Winskog C. Potential problems arising during international disaster victim identification exercises.
Forensic Sci Med Pathol. 2010;6:12.
 Some Key Points
1. The characteristics of tattoos that are encountered during a forensic autopsy should be
clearly documented to include their location, style and major features.
2. Attempts should be made to decipher any text that is present as this may include names
and dates that were significant to the decedent.
3. Appropriate photographs should be taken, particularly if identification is in question.

CONCLUSION

Up until a few years ago tattoos were studied for their historical and cultural aspects and to some
extant for the medical complications arising after getting a tattoo. But during the recent years
tattoos and tattooed persons are being studied and assessed for psychoanalysis in forensic
backdrop.

As per literature survey, the permanent tattoos are strongly associated with high-risk behaviors
such as substance abuse, violent nature, sexual abuse and anti-social personality disorders.
Although a single tattoo may be no more than body ornamentation, with little psychopathologic
significance, it may also be an indication of underlying psychiatric problems.

It seems that no matter where one goes today, it is impossible to escape the reality that body art
in the form of tattooing has become an integral part of culture and society. Although tattoos once
had a reputation as part of the undesirable class, as they were typically associated with the
criminal milieu, but now tattoos have experienced resurgence in the past decades.

Given these strong links between tattooing and high risk behaviors, the tattooing can serve as a
useful, easily visible and clinical marker that may identify people who are at a higher risk for
engaging in illegal deeds. That is why; the presence of a tattoo noted during any sort of
examination of associated persons should prompt an in-depth assessment by a psychiatrist or
forensic psychologist.