Tattoo Pain Chart

How to read this chart honestly. It tells you which placements experienced artists plan differently for. It does not tell you what you will feel. The single largest study of tattoo pain could not show that body area predicts pain intensity at all, and it is the study most likely to have found the effect if one exists at the scale people imagine. Treat the chart as a planning tool, not a prediction.

Witkoś and Hartman-Petrycka, 2020

Witkoś J and Hartman-Petrycka M, “Gender Differences in Subjective Pain Perception during and after Tattooing,” International Journal of Environmental Research and Public Health 2020;17(24):9466 (PMID 33348763). A survey of 1,092 tattooed adults in Poland — 863 women and 229 men — using the Numerical Rating Scale, on which 0 is no pain and 10 is the worst pain the respondent has ever felt. Multiple regression tested gender, age, BMI, education, body area, session duration, bleeding, stress level and painkillers taken beforehand.

Read the limitations before you quote it

Four of them matter, and none of them are hidden — the authors state them.

The method note behind “no study found”

Searching Europe PMC for tattoo and pain in title and abstract returns six records. They are: a study of musculoskeletal pain in tattoo artists; a case report of dermatitis after a henna tattoo; two papers on reducing pain during laser tattoo removal; a case report of complex regional pain syndrome after a wrist tattoo; and a patent application. None of them ranks body sites by tattooing pain. That is the entire published field. When a tattoo pain chart gives you a number for the ribs, it is not reporting research, because there is none to report.

That drop is the most useful thing in the data and it is rarely reported: pain roughly halves the moment the machine stops. What happens over the following days has not been studied. There is no published curve, no average number of hours, and no measured comparison between placements for how long soreness persists.

Practitioner observation, not data: at Apollo, clients most often describe the first 24 to 48 hours as a sunburn-like soreness that fades over the following days, with bony placements and larger pieces staying tender longer. That is what the bench sees. It is not a measurement, and anyone presenting a healing-pain timeline as clinical fact is inventing it. Anything hot, spreading, or genuinely worsening after the first couple of days is a doctor question rather than a tattoo question — see the tattoo aftercare guide and tattoo healing for the rest of the recovery picture.

The controlled evidence, stated exactly

Keating SC, Thomas AA, Flecknell PA and Leach MC, “Evaluation of EMLA cream for preventing pain during tattooing of rabbits,” PLoS ONE 2012;7(9):e44437. Eight New Zealand White rabbits, crossover design, ear tattoos with and without prior lidocaine-prilocaine cream. Tattooing without the cream produced significantly more struggling and vocalisation, higher grimace scores, higher peak heart rate and higher blood pressure. With the cream, the responses were indistinguishable from sham tattoos. The authors’ conclusion is that ear tattooing causes transient and potentially severe pain in rabbits, “which is almost completely prevented by prior application of local anaesthetic cream.”

That is a genuine result and it is also eight rabbits and a rabbit ear. It is not a human tattoo, not a human dose, and not evidence about the products sold to tattoo clients.

What the FDA has actually said

In a warning letter dated 25 March 2024 (MARCS-CMS 666693) to a company selling tattoo numbing cream and spray, the FDA set out the regulatory position plainly. Over-the-counter external analgesics marketed without an approved application must conform to monograph order M017, which permits lidocaine only in the range 0.5% to 4%. The products in question were labelled lidocaine 5%, combined with prilocaine and epinephrine, neither of which M017 permits at all.

The safety reasoning in the letter is the part worth reading before you buy anything online. FDA states that it has warned in multiple public health advisories about lidocaine and other “-caine” products “when applied over large areas of skin, particularly on irritated or broken skin, for prolonged periods of time, and when the skin is covered after application,” because those uses “increase the amount of active ingredient that passes into the bloodstream and, if used improperly, may cause serious injury.” A tattoo appointment is exactly that scenario: a large area, broken skin, hours of exposure, often under wrap, and typically applied by someone who is not a clinician. The letter also records that FDA “is not aware of any adequate and well-controlled clinical studies in the published literature” supporting those products for that use.

What this means in practice

A piercing is a single needle pass measured in seconds. A tattoo is a sustained procedure measured in hours. The strongest measured predictor of tattoo pain intensity in Witkoś 2020 was session duration, which is the one variable on which the two procedures differ most. On that evidence, the reasonable expectation is that a piercing is sharper and far shorter, while a tattoo is lower-intensity and cumulative — but that is inference from one study’s regression, not a measured comparison, and it should not be quoted as one.

Practitioner observation, not data: clients at Apollo who have had both very often describe the piercing as the more intense single moment and the tattoo as the harder overall experience, mostly because of how long it lasts. Cartilage piercings are the ones most often described as sharper than expected. If you are weighing the two, the piercings section covers what each placement involves.

Two of the three strongest measured predictors are things a first-timer can influence. Stress level was a significant predictor of pain during tattooing (B = 0.45, p = 0.001), which means the standard advice to manage anticipation has actual evidence behind it rather than just being reassurance. Session duration was the other (B = 0.35, p = 0.001), which is a direct argument for starting with a piece that finishes in one comfortable sitting rather than an ambitious first commitment.

The consensus tiers above still have a use here: a first tattoo on the outer forearm, outer thigh, outer calf or upper arm is the standard recommendation, and the reason is that these placements rarely surprise anyone. For the rest of the planning — how a placement ages, how visible it is, and whether your design fits the canvas — see the tattoo placement guide, and for the full pre-appointment walkthrough the first tattoo guide.

Be careful about how much weight that carries. The study is a retrospective survey, so it establishes that higher stress and longer sessions went with higher pain scores — not that lowering either one lowers pain. No trial has tested any pain-management technique during tattooing. The rest of this section is what artists at Apollo do at the bench because it appears to help clients get through a session, and it is offered on that basis rather than as evidence.

Before the session

During the session

What is sourced here and what is not. The stress, duration, bleeding and painkiller figures are from Witkoś 2020 and appear with their coefficients in the evidence section. Everything else in this section is labelled practitioner observation, because that is what it is: what artists at Apollo see across many sessions, not a measurement. For what to do after the session, see the tattoo aftercare guide.

These are the placements artists steer nervous first-timers toward, and the reasoning is consistent across shops. They are also, usefully, among the placements that age best, so the low-pain recommendation and the good-aging recommendation point the same way. What they are not is a guarantee. Individual variation in the one study large enough to show it was wide — a standard deviation of 2.60 on a 10-point scale means people getting comparable work reported anything from barely noticeable to severe.

One further claim was softened rather than cut. The page previously asserted that rested clients rate the same session one to two points lower than unrested clients. Sleep deprivation increasing pain sensitivity is well established in the general pain literature, but the specific one-to-two-point figure for tattooing has no source and is no longer stated.

Merged in on 1 September 2026. A separate article, Tattoo Pain Management: A Guide To A Comfortable Ink Experience, covered the same ground with none of the sourcing and now redirects here. Its preparation and in-session material was carried across and labelled as practitioner observation. Three things were not carried across: its lists of lower-pain and higher-pain body areas, superseded by the chart above; its description of box breathing as a “proven” technique, since no trial of it during tattooing was located and the word was doing work the evidence does not support; and a client testimonial about a navel piercing, which had nothing to do with tattoo pain.

• Witkoś J, Hartman-Petrycka M. Gender Differences in Subjective Pain Perception during and after Tattooing. International Journal of Environmental Research and Public Health. 2020;17(24):9466. doi:10.3390/ijerph17249466. PMID 33348763. Open access.
• Corniani G, Saal HP. Tactile innervation densities across the whole body. Journal of Neurophysiology. 2020;124(4):1229–1240. doi:10.1152/jn.00313.2020. PMID 32965159.
• Keating SC, Thomas AA, Flecknell PA, Leach MC. Evaluation of EMLA cream for preventing pain during tattooing of rabbits: changes in physiological, behavioural and facial expression responses. PLoS ONE. 2012;7(9):e44437. doi:10.1371/journal.pone.0044437. PMID 22970216. Open access.
• US Food and Drug Administration. Warning Letter to Sky Bank Media, LLC dba Painless Tattoo Cream Co., MARCS-CMS 666693, 25 March 2024. Center for Drug Evaluation and Research. fda.gov.
• US Food and Drug Administration. Over-the-Counter Monograph M017: External Analgesic Drug Products for Over-the-Counter Human Use (Order ID OTC000033), cited within the warning letter above.
• Europe PMC literature searches on tattoo and pain, run against title and abstract fields, used to establish the absence of body-site pain rankings in the published literature.

Statements labelled practitioner observation come from artists and piercers at The Apollo Tattoo & Piercing Studio in Santa Monica. They describe what the bench sees across many clients. They are not measurements, they were not collected systematically, and they are marked so you can weigh them accordingly. For the wider evidence picture on tattooing — ink composition, the cancer studies, the healing evidence gap — see tattoo facts.