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Lower-back tattoos (often referred to as tramp stamps) are a form of body art that became popular among women in the 2000s and gained a reputation as a feminine type of tattoo. They are sometimes accentuated by low-rise jeans and crop tops, and are considered erotic by some. Concerns have been raised about the use of epidural catheters for women with lower-back tattoos.
Although historically men comprised the majority of tattoo recipients, in the early 1990s, the practice gained popularity among women. In the early to mid-20th century, women with tattoos were heavily stigmatized, and were rarely found in middle-class society. Lower-back tattoos were popularized in the early 2000s, in part owing to the influence of female celebrities, including Britney Spears, Christina Ricci, and Pamela Anderson. The popularity of low-rise jeans and crop tops may have also spurred the increase in lower-back tattoos. Another appeal of tattooing the lower back is that there is little fat there, lessening the chance that images will become misshapen over time. Also, the lower back is often concealed, providing women the choice of when to reveal their tattoo. Although some male celebrities have back tattoos, they are generally not worn by men.
Women's lower backs are often viewed by people as an erotic body part, leading to the association of lower-back tattoos with sexuality. Lower-back tattoos are also perceived as an indication of promiscuity by some, possibly owing to media portrayals of women with tattoos. In a 2011 study of media stereotypes, Chema Salinas criticized media portrayals of lower-back tattoos, arguing that they are unfairly cast as a symbol of promiscuity. There are a number of pejorative nicknames for lower-back tattoos, including "tramp stamp", "bulls-eye", and "target". A Saturday Night Live sketch satirized the practice, describing a "rub-on" tattoo remover marketed at middle-age women who received lower-back tattoos while young.
Medical practitioners who administer anesthesia have questioned whether epidural analgesia should be provided to women with lower-back tattoos. Concerns have emerged that epidural catheters may cause tattoo pigment to enter interspinous ligaments and other areas, potentially leading to health problems. There is general consensus that epidural catheters should not be placed through irritated or infected tattoos. However, harm has not been clearly documented when placing epidural catheters through healthy tattooed skin; a review in the American Association of Nurse Anesthetists Journal concluded that "epidural catheter placement through lumbar tattoos is a practitioner's decision based on clinical judgment". In Current Opinion in Anaesthesiology, Frédéric J. Mercier and Marie-Pierre Bonnet state that the evidence for complications when placing epidural catheters is unconvincing, but advocate avoiding the practice owing to the lack of long-term evidence.
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