Image copyright Getty Images Image caption Procedures which involving piercing the skin are an infection risk

Shops offering tattoos and piercings pose an infection risk, and laws on who works in them should be tightened, say public health experts.

At present, anyone in the UK can set up a parlour and offer procedures without proper training, a report from the Royal Society for Public Health says.

But with one in five adults now having a tattoo, more should be done, it says, to protect the public.

NHS England said higher standards were "long overdue".

"It shouldn't be left to pick up the pieces from dodgy tattoo parlours who don't take infection control seriously," its medical director Prof Stephen Powis said.

The Royal Society's report looks at so-called special procedures - tattooing, cosmetic piercing, acupuncture and electrolysis - which have all grown in popularity in recent years.

The procedures involve piercing the skin and, without good care by the technician and customer, bacteria and other organisms can get into the body, risking infection.

The report describes how a teenager with an infection in an ear-piercing ended up being put on a drip and having the top of her ear removed.

Infections can come from microorganisms living on the skin or those introduced to the body through dirty needles, the report says. These can include hepatitis, tuberculosis, syphilis and HIV.

Outbreaks of infection have been linked to tattooing and piercing in the UK and all four special procedures have caused allergic reactions, it adds.

What are the side effects?

While most people don't experience any negative effects, a survey of nearly 900 people found a small number did (18%) - with the most common issues being burning or swelling afterwards.

Two per cent said they contracted a skin infection while one in 10 of those with side effects said they needed medical treatment.

Image copyright Getty Images Image caption A small minority of people experience negative side-effects from tattoos and piercings

In the same survey, 98% of people said training in infection control should be a legal requirement for anyone carrying out the procedures.

But this does not currently exist anywhere in the UK.

What are the laws on these procedures around the UK?

Different parts of the country have different laws and regulations in place.

Wales is the only part of the UK where a compulsory licensing scheme for tattoo parlours and others offering similar services is being planned.

This means technicians who offer the procedures will need to have an approved infection control qualification, and this information will be put into a national database.

This stops technicians moving counties and setting up new businesses if they have a poor history of infection.

Scotland also has a licensing scheme for business owners but there is no requirement for technicians to have a qualification.

In most areas of England and Northern Ireland, business only have to fill in a registration form to open up a shop. The report says these systems are "outdated and do not provide any reassurance to the public that the business they are visiting is safe".

The Department of Health and Social Care in England said local authorities had the power "to regulate the hygiene and cleanliness of tattoo and piercing providers if they judge there is a risk to health and safety".

A spokesperson said: "We are committed to improving the safety of cosmetic procedures through better training for practitioners and providing clear information so people can make informed decisions."

Ministers recently launched a campaign to make sure people were fully aware of the risks of cosmetic procedures.

Image copyright Getty Images

What else does the report recommend?

The Royal Society for Public Health's report calls for:

non-surgical cosmetic procedures like dermal fillers to be made illegal for under 18s

any infections linked to special procedures to be reported to local councils or health protections teams

tattoo and piercing equipment to only be sold to people with a licence or registration documents

dermal fillers to be included in UK laws around special procedures, eg tattooing, piercing etc

Shirley Cramer, chief executive of RSPH, said: "We would call on the rest of the UK to follow the example set by Wales to ensure infection control and other health risks are minimised, by introducing a mandatory licensing scheme which will require practitioners in place to ensure that the risk of complications is reduced."

Prof Powis said: "Getting a tattoo or piercing might appear cool, but ending up with hepatitis or sepsis certainly isn't.

"All organisations involved need to take their responsibilities seriously, particularly when it comes to young people, and higher standards are long overdue."

NHS England has called for all providers of cosmetic procedures, such as fillers and injections, to be officially registered by the new Joint Council for Cosmetic Practitioners.

Plastic surgeons support the call for non-surgical cosmetic procedures to be restricted to over-18s, unless there is a medical need.

But the British Association of Plastic, Reconstructive and Aesthetic Surgeons said they didn't go far enough.

"The risks associated with cosmetic fillers are far-reaching and, if not administered correctly, the complications can be severe and even life-changing.

"Practitioners must be fully qualified to not only prevent infection, but ensure that only a regulated, high-quality filler product is administered to patients that have been made fully aware of the risks of their procedure."