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One early study among high school students from 8 states found that 10% had tattoos, and 55% expressed interest in tattooing.Of students with current piercings, high-ear cartilage (53%) was the most common visible piercing, followed by navel (38%), tongue (13%), and nipple and genital (9%) piercings.Estimated prevalence rates for NSSI in 2008 for adolescents were between 14% and 24%.It can include cutting, scratching, burning, and hitting oneself.Individuals who hurt themselves report injuries to many different body parts.Importantly, NSSI is clinically concerning because of an association with mental health disorders, whereas body modification such as tattooing, piercing, and/or scarification does not have these associations and is more socially acceptable.Tattoos, piercing, and scarification are now commonplace among adolescents and young adults.This first clinical report from the American Academy of Pediatrics on voluntary body modification will review the methods used to perform the modifications.

Tattooing and piercing of various body parts no longer is a high-risk–population phenomenon, as evidenced by growing numbers of adults and adolescents not considered at risk who have tattoos and multiple ear and body piercings.

Other feelings attributed to having a tattoo included feeling rebellious (25%), attractive or strong (21%), spiritual (16%), healthier (9%), more intelligent (8%), and athletic (5%).

Estimates of tattooing and piercing among adolescents range by data source and age group.

Although interest in body modification has increased recently, history teaches us that body modifications are not new.

Archeologists have found evidence of tattoos, piercings, and scarification as far back as 2000 BC, when they were largely used as a form of art or to identify group membership, such as a religious group or tribe.

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