Unlicensed Tattoo Artists: Risks and How to Verify

The Underground Tattoo Industry

For every licensed, inspected tattoo shop operating in compliance with health regulations, there are unlicensed operators working out of apartments, garages, basements, hotel rooms, and even the back of cars. Known in the industry as "scratchers," these unlicensed tattoo artists represent a significant and growing public health risk that most people vastly underestimate.

The underground tattoo market has exploded in recent years, fueled by social media. Instagram and TikTok have made it easier than ever for unlicensed operators to build a following, showcase work, and attract clients who are drawn by lower prices, perceived exclusivity, or simply a lack of awareness about the risks involved. A compelling portfolio and a friendly DM exchange are not substitutes for licensing, health department inspections, bloodborne pathogen training, and proper sterilization equipment.

The appeal is understandable from the client's perspective. Licensed tattoo shops charge rates that reflect their overhead: rent on a commercial space, autoclave equipment and maintenance, disposable supplies, insurance, licensing fees, and continuing education. An unlicensed operator working from home has virtually none of these costs and can undercut licensed shops by 50-70%. For a client looking at a $500 tattoo versus a $150 tattoo, the savings are tempting. But what they save in money, they gamble with their health.

This guide explains exactly what those risks are, how tattoo licensing works, and how to verify that the person about to permanently mark your body is qualified and operating legally.

Health Risks of Unlicensed Tattooing

Every tattoo involves thousands of punctures per minute with a needle that penetrates the epidermis into the dermis. This creates an open wound that is simultaneously being filled with ink -- a foreign substance being introduced directly into broken skin. The safety of this process depends entirely on the sterility of the equipment, the quality of the ink, the cleanliness of the environment, and the knowledge and training of the person performing the procedure.

Improper Sterilization

Licensed tattoo shops are required to have autoclaves -- devices that use pressurized steam at 250 degrees Fahrenheit to sterilize reusable equipment. Autoclaves are tested regularly with biological indicators (spore tests) to confirm they are achieving sterilization. The cost of a professional-grade autoclave, regular spore testing, and maintenance runs several thousand dollars per year.

Unlicensed operators rarely have autoclaves. Instead, they may use methods that appear clean but do not achieve sterilization: wiping equipment with alcohol (which does not kill bacterial spores or many viruses), boiling instruments (which does not achieve the temperatures needed for true sterilization), using "clean" but not sterile single-use supplies of questionable origin, or simply reusing equipment between clients with minimal cleaning.

Cross-Contamination

Proper tattoo setup involves an extensive cross-contamination prevention protocol: barrier films on every surface the artist might touch, single-use ink cups, single-use needles and tubes (or autoclaved reusable tubes), disposable gloves changed frequently, and a strict workflow that prevents contaminated items from touching clean supplies. This protocol is taught in bloodborne pathogen training courses required for licensing.

Unlicensed operators who have not received this training often make mistakes that create direct contamination pathways: touching their phone mid-tattoo and then continuing to work, reaching into a supply container with contaminated gloves, using the same ink cup for multiple clients, failing to change gloves when they should, and setting up their workspace in ways that allow aerosolized blood and ink to contaminate clean supplies.

Unregulated Ink

Unlicensed operators often source their ink from the cheapest available supplier, which frequently means unregulated products purchased from online marketplaces. These inks may contain toxic metals, industrial pigments, and bacterial contaminants. See our complete guide on fake tattoo ink health dangers for detailed information on what counterfeit inks contain and the health consequences.

Poor Technique

Beyond hygiene, technique itself matters enormously. An unskilled operator may push the needle too deep, causing blowouts (ink spreading beneath the skin into unintended areas), excessive scarring, and prolonged healing. They may use improper needle configurations that cause unnecessary trauma. They may not recognize signs of allergic reactions or infections developing during the session. And they almost certainly lack the knowledge to provide proper aftercare instructions tailored to the specific work performed.

Bloodborne Pathogen Transmission

The most serious risk of unlicensed tattooing is the transmission of bloodborne pathogens. Tattooing inherently involves contact with blood. Without proper sterilization and single-use protocols, the following diseases can be transmitted from one client to the next through contaminated equipment:

Hepatitis B (HBV). Hepatitis B is extraordinarily resilient. The virus can survive outside the body on contaminated surfaces for up to seven days, remaining capable of causing infection. It is 50 to 100 times more infectious than HIV. A single reused needle or contaminated ink cup can transmit HBV. While a vaccine exists, not everyone is vaccinated, and vaccine-induced immunity can wane over time.

Hepatitis C (HCV). Hepatitis C is the most commonly transmitted bloodborne pathogen through tattooing. Studies have consistently found a statistically significant association between tattooing (particularly in non-professional settings) and hepatitis C infection. HCV can survive on surfaces for up to six weeks. There is no vaccine for hepatitis C. While modern antiviral treatments can cure HCV, treatment is expensive (often exceeding $80,000 for a full course) and requires months of medical monitoring.

HIV. While the risk of HIV transmission through tattooing is lower than hepatitis due to the virus's fragility outside the body, it is not zero. Any procedure that involves blood-to-blood contact creates a potential transmission pathway. Documented cases of HIV transmission through tattooing exist, primarily associated with informal and unlicensed settings.

MRSA and other bacterial infections. Methicillin-resistant Staphylococcus aureus and other antibiotic-resistant bacteria can be transmitted through contaminated equipment or unclean environments. MRSA skin infections can progress to life-threatening systemic infections, particularly in immunocompromised individuals.

How Tattoo Licensing Works in the US

Tattoo regulation in the United States is handled at the state and local level, which means requirements vary significantly by location. However, most jurisdictions require some combination of the following:

Artist-Level Requirements

• Bloodborne Pathogen Training. OSHA-compliant training in bloodborne pathogen safety, typically including certification in the BBP standard. This training covers how bloodborne diseases are transmitted, how to prevent cross-contamination, proper use and disposal of sharps, and emergency protocols for exposure incidents.
• First Aid/CPR Certification. Many jurisdictions require current first aid and CPR certification for tattoo practitioners.
• Apprenticeship or Training Hours. Some states require a documented apprenticeship (typically 1-3 years) under a licensed tattoo artist, or completion of a specific number of training hours.
• Individual Practitioner License. A personal license or permit issued by the health department, often requiring an examination or demonstrated competency.
• Continuing Education. Some jurisdictions require periodic renewal of bloodborne pathogen training and other certifications.

Facility-Level Requirements

• Establishment Permit. The physical location must be permitted by the local health department as a tattoo establishment. This involves meeting specific requirements for layout, ventilation, surfaces, lighting, and sanitation.
• Health Department Inspections. Licensed establishments are subject to regular and unannounced inspections by health department officials who verify compliance with sanitation standards, sterilization protocols, record-keeping, and waste disposal.
• Autoclave and Spore Testing. Facilities must maintain functioning autoclave equipment with documented spore test results demonstrating effective sterilization.
• Insurance. Many jurisdictions require tattoo establishments to carry liability insurance, providing recourse for clients in the event of negligence.

Unlicensed operators bypass all of these requirements. They have no inspections, no sterilization verification, no insurance, and no accountability to any regulatory body. When something goes wrong -- and in the absence of proper safety protocols, things regularly go wrong -- the client has no regulatory body to complain to and limited legal recourse.

How to Verify a Tattoo Artist's Credentials

Step 1: Check the Shop's License

Every licensed tattoo establishment is required to display its health department permit in a visible location, typically in the lobby or reception area. If you do not see a permit displayed, ask. If the artist or shop staff cannot produce it, leave. Contact your local health department to verify that the permit number matches the establishment's name and address.

Step 2: Verify the Artist's Individual License

In states that issue individual practitioner licenses, ask to see the artist's personal license or certification. Many states offer online license verification tools where you can search by name or license number. Check that the license is current and has not been suspended or revoked.

Step 3: Ask About Training

Ask the artist about their bloodborne pathogen training, how recently it was completed, and where they trained. Reputable artists are happy to discuss their qualifications. If the artist is dismissive of these questions or cannot provide specifics, that tells you something important.

Step 4: Review Inspection Records

Many health departments publish inspection results online. Search for the tattoo shop's inspection history. Look for any violations, particularly those related to sterilization, cross-contamination, or sanitation. A clean inspection record is a strong positive indicator. Repeated violations are a clear warning sign.

Step 5: Observe the Environment

During your consultation or appointment, observe the shop's cleanliness and protocols firsthand. The artist should wash hands and put on fresh gloves in front of you. Needles should be opened from sealed sterile packaging. Ink should be poured into single-use cups from sealed bottles. Surfaces should be covered with barrier film. The workspace should be organized with a clear separation between clean and contaminated zones.

Red Flags of Unlicensed Operators

• Operating from a home, apartment, or non-commercial location. While some jurisdictions allow private studio permits, the vast majority of home-based tattoo operations are unlicensed. If the tattoo is being performed in someone's living room, kitchen, or basement, it is almost certainly unlicensed.
• Booking exclusively through social media DMs. Licensed shops have phone numbers, websites, and walk-in availability. Operators who only communicate through Instagram DMs and refuse to provide a physical shop address are likely unlicensed.
• Prices significantly below market rate. If the price quoted is 50% or more below what licensed shops charge for similar work, ask yourself why. The answer is usually that the operator is not paying for the overhead that licensing, inspections, insurance, and proper equipment require.
• No visible health permits or certifications. If you arrive and see no health department permit displayed, no bloodborne pathogen certificate, and no autoclave, you are in an unlicensed operation.
• Reluctance to answer safety questions. A legitimate, licensed artist will welcome questions about their credentials and safety practices. An unlicensed operator may deflect, become defensive, or dismiss your concerns as unnecessary.
• No aftercare documentation. Licensed shops provide written aftercare instructions. Unlicensed operators often give vague verbal instructions or none at all.
• Cash-only, no receipts. While some legitimate businesses prefer cash, an operator who insists on cash and provides no receipt or documentation is creating distance from accountability.
• Tattoo parties or pop-up events. Tattooing at parties, conventions without proper permits, or temporary pop-up locations often involves unlicensed operators working in environments that cannot be properly sanitized.

Legal Consequences and Recourse

For Unlicensed Operators

Operating an unlicensed tattoo business is illegal in virtually every US jurisdiction. Penalties vary by state but can include criminal misdemeanor or felony charges (particularly if a client is harmed), fines ranging from $500 to $10,000+ per violation, seizure of equipment, civil liability for injuries caused to clients, and permanent disqualification from obtaining a legitimate tattoo license. In cases where bloodborne pathogens are transmitted, operators can face additional criminal charges including assault or reckless endangerment.

For Clients Who Have Been Harmed

If you received a tattoo from an unlicensed operator and experienced harm, you have several options: file a complaint with your local health department, report the operator to law enforcement, pursue a civil lawsuit for damages (medical costs, pain and suffering, lost wages), and report to the FDA if contaminated ink was involved. Document everything -- photographs, medical records, communications with the operator, and any witnesses. The lack of licensing actually strengthens a civil case, as the operator was already in violation of the law by performing the procedure.

Frequently Asked Questions