HECKER, Ill. — The first fingernail tattoo started off as a joke.
The client, a man who had lost part of two fingers in a construction accident, wandered into Eternal Ink Tattoo Studio and asked for a fingernail design at the tips of his fingers. It was his way of making light of a bad situation.
The idea amused everyone in the studio. But once Eric Catalano, the owner, had finished the tattoo and put away his needles, “the mood changed in here,” he recalled recently. “Everything turned from funny to wow.”
A photo of the inked fingers went viral, and Mr. Catalano, 39, was thrust into the emerging world of paramedical tattooing. The fingernails looked so realistic that even “Ripley’s Believe It or Not!” tracked him down to feature his work.
“There was a lot of pressure after that,” Mr. Catalano said. “I was so nervous. But it turns out the next one came out amazing. Just like the first one.”
Now people with life-altering scars are coming from as far as Ireland to visit Mr. Catalano’s tattoo shop, some 30 miles outside of St. Louis. They enter Eternal Ink looking for a specific kind of healing: Mr. Catalano’s work makes his clients feel physically whole again, picking up where doctors leave off.
Using tattoos to blend in rather than stand out is a relatively new enterprise. The pigments and techniques of paramedical tattooing aren’t standardized, but paramedical tattoo artists across the country are quickly establishing reputations for using flesh-toned pigments to camouflage imperfections, scars and discolorations.
At the Academy of Advanced Cosmetics in Alpharetta, Ga., Feleshia Sams trains students in paramedical tattoos, showing them how to cover stretch marks, surgery scars and discolored skin. They also learn how to approach paramedical tattoos for people of color; Ms. Sams, 41, created a new line of 30 skin-colored and undertone pigments for trained professionals that she sells online and at her school.
More than 100 aspiring paramedical tattoo artists have completed her course. A tattoo license is required, but separate paramedical tattoo training is not.
Because tattoos are considered cosmetic, the work typically isn’t covered by medical insurance. (Paramedical tattoos remain mostly unregulated, and health care professionals debate the safety of tattoo ink.) Still, many people are willing to pay out of pocket for a service they see as crucial to healing.
Leslie Pollan, 32, a dog breeder in Oxford, Miss., said she sees the service as priceless. After she was bitten on the face by a puppy in 2014, Ms. Pollan scheduled countless corrective surgeries, even journeying into neighboring Tennessee for consultations.
“I went to plastic surgeons that were supposed to be the best in Memphis,” she said. “They gave me no hope, so I started looking for other options.”
She ultimately traveled six hours for a paramedical tattoo session with Mr. Catalano. He used ink and his tattoo needle to camouflage Ms. Pollan’s lip scar, giving her peace of mind and a path to greater confidence.
“You don’t understand until you’ve been through it,” Ms. Pollan said. “It really made me have a different outlook on life.”
Mr. Catalano remains self-taught. And he said he’s still refining the process. For example, he has found that the ink in fingernail tattoos doesn’t always absorb into the scar tissue, so he sometimes has to redo them or touch them up.
He uses techniques he picked up years ago while helping breast cancer survivors who wanted tattoos of areolas — the darkened area around nipples — after having mastectomies. Those tattoos are among the most common paramedical requests.
His grandmother had breast cancer, and her battle with the disease is one reason Mr. Catalano is so dedicated to helping those with the diagnosis.
“Cancer took away a part of my body I can never get back,” said Sarah Penberthy, a breast cancer survivor who traveled from Festus, Mo., to Hecker for Mr. Catalano’s areola tattoos. “I felt like I wasn’t even human.”
Ms. Penberthy, 39, said she was grateful for her life after the ordeal but still felt incomplete. The tattooed nipples and chest plate have helped her feel more comfortable with her experience.
Mr. Catalano doesn’t charge for paramedical tattoos. A GoFundMe page established last year brought in more than $12,000, allowing him to donate his skills — at least for the time being. Each Wednesday (called “Wellness Wednesday”), he does up to eight reconstructive tattoos in his small shop.
“Financially it doesn’t make sense, but it’s just something that I love to do,” Mr. Catalano said. “Every time I see that emotion, I’m 100 percent sure this is something that I can’t stop doing.”
Elsewhere, the business of paramedical tattoos is supported by the plastic surgery industry, said Ms. Sams, the tattoo instructor. Americans spent more than $16.5 billion on cosmetic plastic surgery and minimally invasive procedures in 2018. After tummy tucks, breast augmentations and other procedures, some patients want to cover their scars.
“It’s going to take off even more,” she said, referring to paramedical tattoos. “We’re providing students with a nontraditional way to make a career.”
This article was produced in collaboration with Kaiser Health News, an editorially independent nonprofit news service of the Kaiser Family Foundation. The author is a reporter for Kaiser Health News.
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