Pages

10/26/11

PLEASE READ—Teen Drivers: Fact Sheet (from the CDC website)

Motor vehicle crashes are the leading cause of death for U.S. teens, accounting for more than one in three deaths in this age group.1 In 2009, eight teens ages 16 to 19 died every day from motor vehicle injuries. Per mile driven, teen drivers ages 16 to 19 are four times more likely than older drivers to crash. Fortunately, teen motor vehicle crashes are preventable, and proven strategies can improve the safety of young drivers on the road.

How big is the problem?
In 2009, about 3,000 teens in the United States aged 15–19 were killed and more than 350,000 were treated in emergency departments for injuries suffered in motor-vehicle crashes.1,2  

Young people ages 15-24 represent only 14% of the U.S. population. However, they account for 30% ($19 billion) of the total costs of motor vehicle injuries among males and 28% ($7 billion) of the total costs of motor vehicle injuries among females.3

In 2006, the motor vehicle death rate for male drivers and passengers ages 15 to 19 was almost two times that of their female counterparts.

Who is most at risk?
The risk of motor vehicle crashes is higher among 16- to 19-year-olds than among any other age group. In fact, per mile driven, teen drivers ages 16 to 19 are four times more likely than older drivers to crash.4

Among teen drivers, those at especially high risk for motor vehicle crashes are:
Males: In 2006, the motor vehicle death rate for male drivers and passengers ages 15 to 19 was  almost two times that of their female counterparts.1

Teens driving with teen passengers: The presence of teen passengers increases the crash risk of unsupervised teen drivers. This risk increases with the number of teen passengers.5

Newly licensed teens: Crash risk is particularly high during the first year that teenagers are eligible to drive.4

What factors put teen drivers at risk?
Teens are more likely than older drivers to underestimate dangerous situations or not be able to recognize hazardous situations.6

Teens are more likely than older drivers to speed and allow shorter headways (the distance from the front of one vehicle to the front of the next). The presence of male teenage passengers increases the likelihood of this risky driving behavior.7

Among male drivers between 15 and 20 years of age who were involved in fatal crashes in 2005, 37% were speeding at the time of the crash and 26% had been drinking.8,9

Compared with other age groups, teens have the lowest rate of seat belt use. In 2005, 10% of high school students reported they rarely or never wear seat belts when riding with someone else.10

Male high school students (12.5%) were more likely than female students (7.8%) to rarely or never wear seat belts.10

Compared with other age groups, teens have the lowest rate of seat belt use.
African-American students (12%) and Hispanic students (13%) were more likely than white students (10.1%) to rarely or never wear seat belts.10

At all levels of blood alcohol concentration (BAC), the risk of involvement in a motor vehicle crash is greater for teens than for older drivers.10

In 2008, 25% of drivers ages 15 to 20 who died in motor vehicle crashes had a BAC of 0.08 g/dl or higher.10

In a national survey conducted in 2007, nearly three out of ten teens reported that, within the previous month, they had ridden with a driver who had been drinking alcohol. One in ten reported having driven after drinking alcohol within the same one-month period.10n 2008, nearly three out of every four teen drivers killed in motor vehicle crashes after drinking and driving were not wearing a seat belt.10

In 2008, half of teen deaths from motor vehicle crashes occurred between 3 p.m. and midnight and 56% occurred on Friday, Saturday, or Sunday.10

How can deaths and injuries resulting from crashes involving teen drivers be prevented?

There are proven methods to helping teens become safer drivers. Research suggests that the most comprehensive graduated drivers licensing (GDL) programs are associated with reductions of 38% and 40% in fatal and injury crashes, respectively, among 16-year-old drivers.1

Graduated driver licensing (GDL) systems are designed to delay full licensure while allowing teens to get their initial driving experience under low-risk conditions. For more information about GDL systems, see Teens Behind the Wheel: Graduated Drivers Licensing.

When parents know their state’s GDL laws, they can help enforce the laws and, in effect, help keep their teen drivers safe.

Resources

Graduated Drivers Licensing Toolkit  (order a copy online)
In this Healthy States tool kit, users can find out more about GDL systems, why GDL laws are needed, and what state legislators can do to improve state GDL laws.

Graduated Drivers Licensing Fact Sheets (from the 2007 International Symposium on Novice Teen Driving: GDL and Beyond)

The National Safety Council, with sponsorship from the CDC, the National Highway Traffic Safety Administration (NHTSA), the GEICO Foundation, Nationwide Insurance, General Motors Corporation, and State Farm Insurance, held the second International Symposium on Novice Teen Driving in February 2007. These fact sheets summarize the current scientific findings on Graduated Driver Licensing that were presented at the Symposium in February. Information in the fact sheets is based on papers written by Symposium presenters and published in the April 2007 GDL Special Issue of the Journal of Safety Research.

The Guide to Community Preventive Services
This online guide offers recommendations about motor vehicle injury prevention issued by the Task Force on Community Preventive Services.

References
1.   Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS) [Online]. (2010). National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (producer). [Cited 2010 Oct 18].
2.   NHTSA[2009]. Fatality Analysis Reporting System (FARS), 2009. Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration, National Center for Statistics and Analysis.
3.   Finkelstein EA, Corso PS, Miller TR, Associates. Incidence and Economic Burden of Injuries in the United States. New York: Oxford University Press; 2006.
4.   Insurance Institute for Highway Safety (IIHS). Fatality facts: teenagers 2008. Arlington (VA): The Institute; 2009 [cited 2009 Nov 3]. 
5.   Chen L, Baker SP, Braver ER, Li G. Carrying passengers as a risk factor for crashes fatal to 16- and 17-year old drivers. JAMA 2000;283(12):1578–82.
6.   Jonah BA, Dawson NE. Youth and risk: age differences in risky driving, risk perception, and risk utility. Alcohol, Drugs and Driving 1987;3:13–29.
7.   Simons-Morton B, Lerner N, Singer J. The observed effects of teenage passengers on the risky driving behavior of teenage drivers. Accident Analysis and Prevention
8.   National Highway Traffic Safety Administration (NHTSA), Dept. of Transportation (US). Traffic safety facts 2008: Speeding . Washington (DC): NHTSA; 2000a [cited 2009 Nov 6].  
9.   National Highway Traffic Safety Administration (NHTSA), Dept. of Transportation (US). Traffic safety facts 2008: Young Drivers . Washington (DC): NHTSA; 2008b [cited 2009 Nov 6 ].
10. Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance—United States, 2007 [Online]. (2009). National Center for Chronic Disease Prevention and Health Promotion (producer). [Cited 2009 Nov 6 ].


Accident Number Four: The Details

Just when I thought it was going to be smooth sailing, the water got rough and salty again.
I had my mom over to help me put up curtains, and before we could get open the package to the double rod set, troubled daughter called me—totally hysterical.
She had been in another accident.
She was on her way somewhere on the freeway, and the driver in front of her slammed on her brakes causing my daughter to slam on hers. Of course, she crashed into that car and wrecked her car. My mom and I got to the scene, which was about 15 minutes away, about 30 minutes before the highway patrol did. Luckily for my daughter, an off-duty federal agent happened to be driving by and stopped so he could flash his lights and divert traffic around her car. The other driver had moved their car about half a mile up the road for some reason—not sure, maybe to get out of the way of moving cars, maybe because they started to flee the scene and their car died.
While we waited, I gave my daughter a few bags—one for garbage, one for stuff to take home. She was crouching and throwing certain things in her purse, too. While she HAD recently cleaned her car, there were obviously some untoward things in there that perhaps she didn’t want any offer—or my mother or me to see. My mother made the mistake of trying to help her clean the car. Bad idea. I once had a two-day fight with my daughter because I did that and found a 12-pack of Miller Lite (that of course was NOT hers).
Finally, an officer showed up and had to make sense of the whole thing. He took statements, moved my daughter’s car out of the way, and assessed the situation. Meaning: my daughter got cited, which we expected since she was the slammer, not the slammee. Thank heavens she was not: high, drunk, tired, in gangster attire, pissed off, texting, doing her makeup, or flirting with the person in the next car. It was just a cut-and-dry accident that my insurance will cover (with a $500 deductible, of course).
As we waited, my daughter complained of a sore knee, and I did notice that she was limping and it was swelling up. The officer called the fire department to send out a unit to look at her. They came almost immediately—a wonderful and kind crew of people—and checked her out. To be on the safe side, they decided to take her to a nearby hospital, and proceeded to strap her to a spine board with a neck brace and restraints from head to toe. It was surreal to see her like that—nightmarish, actually. Not how you want to see your child.
My mom and I met her at the hospital, and when we got to her room, she had been in the restrained position for almost 20 minutes and was coming unglued. As soon as she saw me, she started to panic and cry. I ran to the desk of nurses and doctors and asked if I could please loosen the thing, but they said she had to stay put. She really started to panic so I asked again and a really nice younger nurse, “Nurse Nicole” came to the rescue and was able to calm her until the physician’s assistant came in and cut off the Velcro straps. She told her the story of her accident a year ago that resulted in her breaking her neck but not even being aware of it until a year late. I gratefully saw my daughter’s blood pressure and pulse return to normal on the monitor.
After some snacks, an X-ray of her knee, and some Vicodin, we were free to go home. My daughter was asleep by the time we left the parking lot. She’s facing a couple of days of great soreness and we’re facing her grumpiness, but she’s okay, alive, not broken and nothing else matters. Not the car, not the money, not even the whys, hows, and whatnots.

10/21/11

Hey Guys! Watch This! For Teens, Friends Make Risk More Fun

Brain scans show risk is more fun when friends watch

Published on October 16, 2011 by Nancy Darling, Ph.D.

I love Car Talk, NPR's car centered talk show starring Tom and Ray Maggliozi. 
The Car Guys claim that many of the dumbest things ever done are preceded by the immortal words Hey guys! Watch this!
I think they call them “famous last words.”
They must know a lot about teenagers. 
Adolescents and Risk
Adolescents are known for taking risks. Although generally healthy, they spend a lot of time in hospitals - mostly because they do dumb things. They crash cars. They drink too much. They skateboard while texting. They have unprotected sex with condoms in their pockets and drink too much with people they barely know. 
Contrary to stereotypes about teenagers, though, this is NOT because they don't know better. They do. If anything, adolescents over-estimate the risks of things like drunk driving. They should - adults warn them about risks all the time. And it's not that they think they're invulnerable. Teens don't think they're any more immortal than adults do.
Kids take risks because risky behavior is FUN. It feels good.  And, as I said in my last piece, Teens Respond To Pleasure, Not Pain, that's important in understanding adolescent behavior.
The Dual Systems Model of Risk
Recent work by developmental psychologist Laurence Steinberg suggests that adolescents' willingness to take risks is due to the mismatch in the growth rate of three areas of the brain associated with risk taking: the ventral striatum, the orbitofrontal cortex, and the lateral prefrontal cortex.
His work suggests that the timing of growth in this areas puts kids in the position of a car with too much accelerator and not enough brake.
Risk seeking is based on two primary processes: sensation seeking and impulse control.  Sensation seeking—taking pleasure in strong positive experiences—is situated in the ventral striatum and the orbitofrontal cortex, both of which process incentives. Impulse control—what keeps us from acting prematurely—is situated in the lateral prefrontal cortex.
The two systems are related, but different. and grow at different rates:
  • The incentive processing centers become sensitized right after puberty, making adolescents take much more pleasure out of rewards. This leads them to experience risk as relatively more pleasurable. 
  • The impulse control centers of the brain develop more slowly over time, and are still developing in early adulthood. This is the part of the brain that keeps you from doing risky things before you think through the consequences.
Because of the difference in the timing of their development, for much of middle adolescence, kids are very sensitive to rewards but have not yet fully developed strong impulse control. Thus Steinberg's analogy of the accelerator without a brake.
Sensitive to Pleasure?  Now Bring in Friends
A recent piece by Chein and colleagues, Peers increase adolescent risk taking by enhancing activity in the brain's reward circuitry, provides compelling evidence that when teens are with friends,
  • they take more risks
  • the areas of their brain associated with incentive processes are activated
Importantly, this does NOT happen in adults as young as their 20's. 
In Chein's study, high school students, college students, and young adults come into the lab with friends and play a video game. The goal is simple: and frighteningly similar to real-life. 
You're a driver in a hurry. You need to get from Point A to Point B as quickly as possible. There are stop lights. When the light turns yellow, you can hit the brake and wait or you can try your luck. If you're lucky, you get through quickly. If you don't, you crash.
They got great results. When high school students knew friends were watching them, they took significantly more risks than when driving alone. And they also crashed more.
Neither college students nor adults behaved that way. Their behavior was  similar in both conditions. In fact, they crashed less when friends were watching (although this difference was non-significant).
The higher crash rates in the peer conditions was NOT because teens were distracted by noisy friends. That's important. Often, we attributed to poor driving performance in cars crowded with teens to the noise and distraction. And that may well be a factor.
But not in this study. Here, drivers were told that friends were watching them. But the friends were in the other room, watching on a monitor. So it couldn't be that the friends were distracting. The participants just knew they were there.
Peeking into Kid's Brains
But why the difference? 
Chein and colleagues performed MRI scans of their participants while they were doing the driving task. Again, they had the participants do it alone and then knowing that friends were watching them.
Two things about these findings are interesting and—frankly—scary.
First, high school students, but not college students or young adults, showed activation of the ventral striatum and frontal cortex in the presence of peers. What do these brain areas do?  Activation suggests that they are primed to experience and evaluate pleasure (incentive processing). In other words, these findings indicate that in the presence of peers, teens experience things as more pleasurable.
Second,  college students and adults show evidence of left lateral pre-frontal cortex activation when doing the task. High school students don't. What does this area of the brain do?  Puts on the brakes and controls impulses. In other words, the area of the brain associated with judgment doesn't come on-line during the driving task at all until college. That's scary.
Hey Guy! Watch This!
Alone, high school students, college students, and young adults all perform similarly on this simulated driving task.
But put them with friends, and younger kids take way more risks. 
Why?  Because it just feels good. Everything is more exciting. The risks are more pleasurable. And the rewards of taking risks are just that much more salient. 
Although speculative, you can think about the implications of these findings . . .
  • for driving
  • for gambling
  • for sex
And also for positive outcomes
  • for taking a hard class
  • for learning something new
  • for trying a new job or career
  • for studying abroad
Even for watching movies.
One of the strengths and charms of teenagers is that they are ready and willing to try new things.
That's also what puts them at risk.
The better we understand this, the more effectively we can use this knowledge to help teens explore and try new things and stretch themselves. Even change the world.
And the better we can help them protect themselves from these very same impulses when they put themselves in danger.

Teens Respond to Pleasure, Not Pain: Parent Accordingly


Published on October 12, 2011 by Nancy Darling, Ph.D.

It's not often that I read a scientific paper and immediately change how I parent my child.
But I did last week.
I was reading a series of pieces by developmental psychologist, Laurence Steinberg, first recipient of the Klaus Jacobs award for "groundbreaking contributions to the improvement of the living conditions of young people." Steinberg has spent his career studying adolescents. His early work focused on the family—how teens renegotiate family relations during the pubertal transition (kids win, moms lose) and then on parents' continuing role in adolescents' lives. His textbook, Adolescence, was the first in the field. It continues to educate generations of students who will go on to become healthcare workers, lawyers, and educators so that their work will be based on facts, not stereotypes.
More recently, Steinberg has focused his attention on adolescent risk-taking, integrating his training in human development and family studies with neuroscience and new brain imagining techniques. He was lead scientist of the amicus brief  filed by the American Psychological Association in the U.S. Supreme Court case (Roper v. Simmons) that abolished the juvenile death penalty.
Last week, I read what Steinberg had to say about teenagers and risk.
Teenagers aren't stupid. Really.
Although teens are typically healthier than either children or adults, they wind up in the hospital a lot. Why? Risk. They crash cars because they're drunk or driving too fast. They shoot each other. They take foolish risks texting and riding bicycles. They get pregnant because they have unprotected sex with condoms in their pockets.
Teens do dumb things.
But they're not stupid. Study after study has shown that adolescents are AWARE of risks. If anything they are more aware of risk than adults are (probably because we keep warning them about danger) and overestimate the negative consequences of their actions. 
Why then do they make foolish decisions?
It's all in their brains.
In Age Differences in Sensation Seeking and Impulsivity as Indexed by Behavior and Self-Report: Evidence for a Dual Systems Model, Steinberg and colleagues argue that the different growth speed of two areas of the brain create a perfect storm for risky behavior.
Their argument is straightforward. Sensation seeking—taking pleasure in strong positive experiences —is situated in two brain areas: the ventral striatum and the orbitofrontal cortex, both of which process incentives. Impulse control—what keeps us from acting prematurely—is situated in the lateral prefrontal cortex. Although both are involved in risk-taking, they aren't the same. Steinberg's analogy: people waiting in a long line at Disney World to take a roller coaster are high in sensation seeking (leading them to seek out risk) but also high in impulse control (which should help them avoid risk).
Although both areas of the brain change from childhood to adulthood, they don't change at the same speed. 
  • The incentive processing centers become sensitized right after puberty, making adolescents take much more pleasure out of rewards. This leads them to experience risk as relatively more pleasurable.
  • The impulse control centers of the brain develop more slowly over time, and are still developing in early adulthood. This is the part of the brain that keeps you from doing risky things before you think through the consequences.
Too much accelerator, not enough brake
During most of the teen years, this creates a problem. Risky behaviors feel great and are experienced as more rewarding. Impulse control hasn't yet caught up—nor have knowledge and judgment. Thus emotion says go, but wisdom hasn't yet said stop.
How science changed my parenting
There are important take-home messages here for risk taking, social policy, and our understanding of teens that I will discuss in my next post.
But the first thing I took home from this reading had to do with my parenting. TEENS ARE MOTIVATED BY PLEASURE, NOT BY PAIN.
Thus telling a 13-year-old that he will fail a test tomorrow if he doesn't study isn't that effective in inducing willing compliance. He knows that. But risk avoidance is not emotionally motivating. And that video game sure is.
Reminding a 13-year-old how good it feels to accomplish something, how happy he'll be when he does well, and how much more time he will have to play if he studies efficiently works a lot better. Those POSITIVE emotions activate their incentive-processing center. And teens are VERY sensitive to pleasure.
So I tried it. 
I stopped reminding my son of all the negative consequences of not doing what he was supposed to.
I consistently pointed out how good it felt to do the right thing. Every positive I could think of.
A week later, things are going great.
He's less anxious. His work has improved. We've gotten along better. And he's taking more responsibility for making good choices. Even choices he doesn't like (like practicing his violin tonight because he wants a whole day of uninterrupted time on Saturday). 
And you know what? I feel better too. I can be motivated by reward as well.

Match your parenting to how teens' brains work.

I Talked to My Teen about Her Tattoo

I agonized a bit over how to broach the subject of the tattoo with “troubled teen.” At first I was angry and wanted to lecture and yell like the old me. Then after a day went by (we sometimes go two or three days without crossing paths, so this was normal), I was calmer. I talked to my boyfriend who’s had his share of experiences in this regard, and he shed some light on the subject. Our discussion, if you translated it to paper, would look like a spreadsheet with columns for the approach I COULD take and the consequences next to the approach I SHOULD take and the consequences.
He helped me decide to discuss it with her like an adult and perhaps ask WHY. Why did she feel compelled to sneak a tattoo illegally, knowing my feelings and my parameters? Why did she lie when asked directly if she had a tattoo? What brought her to the conclusion that getting a tattoo near her groin by someone willing to do it illegally was a good idea? What was going through her mind at the time? I told her in advance that we were going to talk about this issue so we could both be mentally prepared.
I never got the opportunity to talk to her during my angry phase; instead, the opportunity arose when I was level-headed and we were on the phone going in opposite directions. The conversation went well. I sort of talked to her like she was someone else’s kid—it probably sounded to her like I had no emotion about it at all and she was most certainly caught off guard. I’d bet she practiced what she was going to say to me when I finally confronted her.
I simply asked her if she could explain, and she was ready with her story. She told me that she got it during the time she went to live with the white trash people when she was 16. She didn’t know what she was thinking and was impulsive and stupid, and has spent the last two years hiding it from me. It didn’t come out the way she wanted, and it’s actually unfinished. She said she feels embarrassed and guilty and didn’t want me to find out because she didn’t want me to be upset, knowing how much I object to tattoos. My daughter said, “I’m sorry, Mama” many, many times—and she might actually be sorry, who knows? I’ve become a pretty good cynic, as you can imagine
I didn’t exactly lecture, but I explained to her my concerns about her being rebellious for no apparent reason, the dangers of tattooing in general, the issue with illegal/unlicensed/underage tattooing, the cost of this mistake, the regrets she’ll have, my feelings about her being tattooed…all the ideas I’ve discussed ad nauseum with my girls and in this blog. She just said, “I know, and I’m so sorry.”
OK, so now what? Nothing. There’s nothing I can do. It’s on her body, it’s gross, I’m appalled…and I have to live with it. I asked her, since she’ll be 18 in about 7 weeks, if she planned to ink up at that time. She has every right to do it, but if that’s her decision, she’ll have to live elsewhere. She said that she knows that, and will hold off until she can afford to manage on her own—she can live without tattoos for a little longer without dying. HOWEVER, she does plan on not only getting more tattoos, but fixing the one she already has.
My hope is that she will realize how costly/dangerous they are to get vs. how costly/painful they are to remove and change her mind. I have a lot of hopes, for that matter—that she’ll get all new friends, be a straight-A student in college, and become an attorney. **Sigh**

10/18/11

Quotes about Tattoos

The world is divided into two kinds of people:  those who have tattoos, and those who are afraid of people with tattoos. –Author Unknown

Louie brought his new girlfriend over, and the nicest thing I can say about her is all her tattoos are spelled correctly. –Robert Harling, Steel Magnolias

Tattoos to me are are like the Walmart of rebellion. I think I was looking for some kind of outward display of anguish that I was a serious person. – Actor Ryan Reynolds

I got my first tattoo, a Playboy Bunny, because I was young, dumb and drunk... – Anna Nicole Smith

I always look for a woman who has a tattoo. I see a woman with a tattoo, and I'm thinking, okay, here's a gal who's capable of making a decision she'll regret in the future. – Comedian Richard Jeni

Tattoo on the lower back. Might as well be a bulls-eye.–Vince Vaughn in the film The Wedding Crashers

White folks are not going to come to see a bunch of guys with tattoos, with cornrows. I'm sorry, but anyone who thinks different, they're stupid." –Charles Barkley

Women, don't get a tattoo. That butterfly looks great on your breast when you're twenty or thirty, but when you get to seventy, it stretches into a condor. –Billy Elmer

Beauty is skin deep, unless you have really bad tattoos. –Jacob Calle

Getting tattoo is easy. Undoing it is no pretty picture.

Getting tattoo is easy. Undoing it is no pretty picture.

The Rise of Tattoo Remorse: Heavy Cost to Erase What’s Often an Impulse Decision

By Brad TuttleSeptember 8, 2011 

Most fads are relatively harmless, inexpensive, and, by their very nature, short-lived. Tattoos, however, have become remarkably trendy at the same time they’re as long-lasting as purchases get. If and when you have that sweet $80 tattoo you got on a whim in college removed because it now looks silly, the procedure will wind up being far more painful (“like getting burnt with hot baking grease”) and way more expensive ($3,600!) than when you got tattooed in the first place.

The Boston Globe recently profiled a few of the many tattooed Americans who regret their decisions to go under the needle and now just wish their skin was ink-free. According to a 2008 poll, 16% of the inked suffer from “tattoo remorse,” and the number of people electing to have tattoos removed—like the number of people choosing to get tattoos, by no coincidence—has been on the rise in recent years. In 2009, there were 61,535 surgical procedures performed to remove tattoos.

That doesn’t necessarily mean 61,535 tattoos were actually removed that year. In some cases, it takes 15 or more sessions to remove a single tattoo. Each of these sessions can be an ordeal. In order to scare his kids away from getting tattoos, actor Mark Wahlberg had them observe when a few of his tattoos were removed. This is how Wahlberg described the experience:

“It’s like getting burnt with hot baking grease,” he told Jay Leno on “The Tonight Show” in February. “There’s blood coming up, it looks like somebody welded your skin. Hopefully that will deter them.”

Of all the tattoos that can be later regretted, perhaps none is worse than the name of one’s ex. One 25-year-old student told the Globe that, naturally, he wished he didn’t have the name of his now ex-girlfriend (Kate) tattooed on his buttocks:

“I was in love,” he explained, a warm smile spreading across his face as he recalled how he felt when he impulsively went to the tattoo parlor. Now? The smile disappeared. “It reminds me of her.”

And obviously not in a good way. Talk about a pain in the butt.

Some tattoos don’t age well for other reasons. The 31-year-old marketing director described in the story’s introduction got her ankle tattoo—a Chinese symbol supposed to symbolize a warrior and scholar—when it seemed like the cool thing to do in college. Later, she found out the mark translated as something like “mud pie.” Embarrassed—because the mark was basically meaningless, and because the tattoo was a mismatch for the professional world she now worked in—she wound up spending $3,600 to have the tattoo removed over the course of two years. She too is spoken of as a cautionary tale:

“At work, I’m the poster child for not getting a tattoo,” she said. “One of my colleagues has told her children all about me.”

Where some see fads and regret, others sense opportunity. This month’s Money magazine profiles Marci Zimmerman, who had an idea while scanning a crowd of tattooed fans at a 2003 baseball game:

Surrounded by sweaty fans shedding their shirts, and “looking around at all the bad tattoos, I thought, ‘Someday, tattoo removal is going to be a huge business,’” she says.

After researching tattoo removal as a business, she leased space in downtown Phoenix, purchased a $100,000 laser, contracted with a doctor to operate that laser, and opened up Delete—Tattoo Removal & Laser Studio last year. This year, the salon expects revenues of $400,000, and Zimmerman plans on one day running some 50 tattoo-removal studios.

Brad Tuttle is a reporter at TIME. Find him on Twitter at @bradrtuttle. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.

Credit: http://moneyland.time.com/2011/09/08/the-rise-of-tattoo-remorse-heavy-cost-to-erase-whats-often-an-impulse-decision/