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Abstract This chapter reviews the medical anthropology of tattooing from prehistoric to modern applications. The tattooing found on the 5,300-year-old Tyrolean frozen mummy called the “Iceman” is among the earliest evidence there is that tattooing was used to treat illness—notably, it may have alleviated the pain the Iceman likely suffered from arthrosis, biliary calculi, Lyme disease, or the prolonged use of the bow. Radiological studies have highlighted the direct relationship between lesion and cure, and the multispectral photography technique used to map the Iceman’s tattoos illuminated marks not otherwise visible. The chapter examines the cross-cultural use of tattooing for therapeutic and medical purposes, recent studies of how tattooing may prime the body’s healthy immune and endocrine responses, and dermatological and behavioral risk studies associated with tattooing. Finally, it advocates for newer research perspectives that consider tattooing forms as diverse, prosocial cultural practices with the potential to heal. 

Tattooing is a stressor that could have adaptive benefits. Previous research indicates that endocrine and immune systems adjust to the stress of modern electric tattooing over lifetime experience, but it is unclear how these systems react to traditional hand-tap tattooing. The objective of this study was to explore how the body responds to this intense cultural stressor through examining traditional tattooing in Samoa, where saliva samples were collected throughout the first day from a Samoan man receiving the tattoo. Morning elevations and diurnal profiles of cortisol, C-reactive protein (CRP), secretory immunoglobulin A (sIgA), and bacteria killing activity (BKA) are described, and comparison is made between these data and a previous study including hand-tap and electric tattooing. Peaks in the diurnal cortisol slope correspond with anticipation of beginning an important tattoo, tattooing activity, and evening pain as stress-related analgesia diminishes and inflammation rises. Peaks in CRP levels may reflect normal moment-to-moment changes in salivary excretion. sIgA and BKA fluctuate similarly to one another throughout the day of tattooing. There were no significant differences in average pain ratings or biomarker levels between the two tattooing styles. Exploring tattooing and endocrine function is important to understanding how culture interacts with endocrine and immune function. 

Tattooing has become a prominent form of body modification worldwide since the 20th century, leading to a revival of traditional hand-tap techniques, especially those from Samoa. The Samoan traditional pe’a (male tattoo) and malu (female) are distinctive, as they are administered by hand-tap tools in open-air bungalows and are to be completed in a short period of time, usually 1-2 days for the malu and a week to a month for the pe’a. This study involved systematically collecting saliva samples from participants undergoing traditional Samoan tattooing practices facilitated by Sulu’ape Tatau in Apia, Samoa. The Sulu’ape Tatau lineage is recognized as a prominent representative of the Su’a Guild, which holds significant cultural and historical importance within the realm of Samoan tatau. This study characterizes the physiological responses to tatau by analyzing biomarkers such as cortisol, secretory immunoglobulin A, and C-reactive protein. Given the constraints on healthcare resources in Samoa, understanding these physiological responses provides insight into how cultural practices like tatau may enhance biological resilience against health challenges. 

Abstract Body modification is a blanket term for tattooing, piercing, scarring, cutting, and other forms of bodily alteration generally associated with fashion, identity, or cultural markings. Body modifications like tattooing and piercing have become so common in industrialised regions of the world that what were once viewed as marks of abnormality are now considered normal. However, the psychological motivations for body modification practices are still being investigated regarding deviance or risky behaviours, contributing to a sense in the academic literature that body modifications are both normal and deviant. We explored this inconsistency by conducting a scoping review of the psychological literature on body modifications under the assumption that the psychological and psychiatric disciplines set the standard for related research. We searched for articles in available online databases and retained those published in psychology journals or interdisciplinary journals where at least one author is affiliated with a Psychology or Psychiatry programme ( N  = 94). We coded and tabulated the articles thematically, identifying five categories and ten subcategories. The most common category frames body modifications in general terms of risk, but other categories include health, identity, credibility/employability, and fashion/attractiveness. Trends in psychology studies seem to follow the shifting emphasis in the discipline from a clinical orientation regarding normality and abnormality to more complex social psychological approaches. 

Objectives Tattooing is not an evolved behavior, but it may be a phenotypic gambit to highlight immunological health. Phenotypic gambits are traits or behaviors that appear costly but occur at high rates as a honing process of natural selection not constrained by genetics. Tattooing is an ancient practice that is increasing in popularity worldwide, but it involves wounding the body, which seems counterintuitive because it challenges the immune system and makes one more susceptible to infection. But tattooing may represent a costly honest signal of fitness by “upping the ante” in an era of hygiene or a means to stimulate the immune system in a way that improves and highlights underlying fitness. Materials and Methods We investigated this hypothesis by assessing bacteria killing activity (BKA) in saliva samples collected during two studies of tattooing (N = 40). We compared previous tattoo experience (extent of body tattooed and hours spent being tattooed) to BKA before and after getting a new tattoo. Results Tattoo experience positively predicts post-tattoo BKA (β = 0.48, p = 0.01), suggesting that people with more tattoo experience have a relatively more immediate and active immune response than those with less tattoo experience. Discussion Tattoo experience may elevate innate immunological vigilance, which could aid in protecting against future dermal insults.