Brits may face risks getting tattoos and plastic surgery abroad – here’s how to avoid them

More and more Britons are traveling abroad to get tattoos, piercings and cosmetic surgery. Any surgery, no matter where it is performed, carries the risk of injury and infection.

But people traveling abroad for cosmetic surgery may need to be extra cautious – recent reports suggest thousands of UK residents may have unknowingly contracted hepatitis C this way.

It is estimated that more than 170 million people worldwide have hepatitis C. Approximately 1 million people are newly infected every year. By 2022, more than 70,000 people in England will be living with hepatitis C. But many more people may be infected without knowing it, because hepatitis C symptoms can take years to appear.

If left undiagnosed, hepatitis C can develop into a serious and fatal liver disease. But if detected early, treatment is more than 95% effective, underscoring the importance of timely detection.

What is hepatitis C?

Hepatitis C is caused by a virus that infects the liver. The virus is spread through contact with infected blood.

Most transmission occurs through contact with contaminated instruments, such as needles used for recreational drug use. In rare cases, hepatitis C can also be spread through sexual intercourse or from an infected mother to her baby during delivery.

About 80% of people infected with hepatitis C will not show any symptoms. Twenty percent of people do experience a brief flu-like illness, with symptoms that vary and may include fever, headache and muscle aches, fatigue, vomiting, diarrhea, and jaundice.

Symptoms may appear 2 to 12 weeks after infection with the virus. People experiencing symptoms often do not realize the seriousness of their illness.

Some people clear the virus without treatment. But up to 85% of infected people will develop chronic hepatitis, in which the virus remains in the body.

These people may not show any signs of the disease for years and are often unaware of it until more serious damage occurs, which can take decades. Chronic hepatitis C is still treatable, although the sooner you get treatment, the better.

If left untreated for many years, chronic hepatitis C can lead to serious liver disease. This may cause symptoms such as jaundice, swelling of the abdomen and legs, easy bleeding or bruising, severe itching, loss of appetite, and nausea.

Cirrhosis (scarring of the liver) can also cause damage to the brain and nervous system due to the buildup of toxins that the liver normally removes. This can cause concentration and memory problems.

It is estimated that one in five people with chronic hepatitis C will develop a severe form of liver cancer called hepatocellular carcinoma. It is the second most deadly cancer in the world, with a five-year survival rate of only 10%-20%.

Age, excessive alcohol consumption, other infections (such as HIV), and the strain of hepatitis C virus you are infected with all increase your risk of hepatocellular carcinoma.

Risks of medical or cosmetic surgery

With proper sterilization procedures, your chances of contracting any infection are extremely low. But you can get hepatitis C if surgical instruments are used on someone with hepatitis C and are not properly sterilized. Improper sterilization also carries the risk of other diseases, such as HIV and hepatitis B.

Several studies have reported that tattoos performed in nonprofessional settings, such as in prisons, are associated with an increased risk of hepatitis C infection due to improper sterilization. Even tattoos performed in professional tattoo parlors can pose a greater risk if reusable needles are not adequately sterilized between clients.

For perforations, the data are less clear. Many studies have shown that piercings do not increase the risk of hepatitis C, but these studies did not ask participants whether they had their piercings done in a professional clinic or at home. However, there have been reported cases of hepatitis C infection from piercings and exchanging body piercing jewelry with infected people, so caution is important.

Although data are limited, this risk may be the same for cosmetic and dental procedures. Your risk of contracting hepatitis C is very low if proper spaying and neutering is done and you see an accredited surgeon or dentist.

Certain countries have higher rates of hepatitis C, such as Egypt, Mali, Malaysia, Italy, Thailand and Mauritius. Certain strains of hepatitis C may also be more prevalent in certain destinations.

For example, treatment success rates for the major strains of hepatitis C in Nigeria are 94-99%. But in Thailand, the predominant strain is associated with rapid progression of chronic liver disease and poorer treatment outcomes. It’s worth being extra vigilant if you plan to have surgery while visiting these places.

How can you avoid it?

If you are having any type of medical, dental or cosmetic procedure, ask about the decontamination or sterilization process for tools.

In the UK, parliament requires tattoo and piercing shops to use single-use needles or adopt appropriate sterilization methods for reusing equipment (most commonly via an autoclave). If in the UK, ask to see the business’s license to ensure they are registered with your local council.

Other medical procedures, such as Botox or fillers, are less strictly regulated. As with any injection, it should ideally be done by a medical professional, such as a nurse or dentist.

If you are having surgery and are unsure whether the tool is safe, ask to see it before opening the package. Disposable sterile needles are always sealed in the packaging.

Poor hygiene can also spread hepatitis C, so check that these items are changed between clients and that good hygiene practices (such as washing hands and changing gloves between clients) are in place. If in doubt, I recommend not completing the procedure at all.

If you have had surgery abroad (or long ago in the UK) I would recommend ordering a test kit from the NHS. It’s quick, easy and can be done at home. If the result is positive, get treatment as soon as possible because hepatitis C virus is a highly treatable infection.