MONDAY, July 21 (HealthDay News) -- While most Americans who get tattoos are happy with their decision, women are much more likely than men to decide to get their markings removed, new research reveals.

The study authors noted that the gender difference might be attributable to the fact that women appear to face more social stigma and negative comments as a result of having a tattoo.

"We saw that for women there is still some negative societal fallout to having tattoos", said study author Myrna L. Armstrong, a professor in the school of nursing at Texas Tech University's Health Sciences Center, in Lubbock, Texas. "This isn't a problem for men. Society supports men, because tattoos are related to a macho image, so we don't question it. But for women, having a tattoo seems to be a transgression of gender boundaries."

Armstrong and her colleagues outlined their observations in the July issue of the Archives of Dermatology.

The authors pointed out that about one-quarter of Americans between the ages of 18 and 30 have a tattoo, and women constitute between 45 percent and 65 percent of the tattoo market.

Prior studies show that more than 80 percent of the inked crowd are pleased with their decision to get a tattoo. Among the fifth that are not, about 6 percent ultimately remove their marking.

To assess who is seeking removal and why, Armstrong and her team surveyed 196 patients -- with an average age of 30 -- who visited four dermatology clinics for tattoo removal in 2006.

More than half said they had gotten their tattoos between the ages of 16 and 23. Asked about their initial impulse to do so, 44 percent said it was to feel unique, while 33 percent said it made them feel independent, and 28 percent said it made their life experiences stand out.

When asked why they finally chose to remove their tattoo, 57 percent said it had caused them embarrassment; 38 percent said it lowered their body image; 37 percent said it caused problems with clothes; 25 percent said it brought about stigma; and 21 percent said they did so in honor of a particular occasion -- such as a birthday or marriage.

But regardless of motivation, perhaps the most striking statistic was the gender ratio of the patients seeking tattoo removal: 69 percent women versus 31 percent men. The observed gap was a big shift from the breakdown of an earlier study the research team had conducted in 1996, in which more men then women had been seeking tattoo removal.

In the current study, women were also found to be experiencing more negative reactions to their tattoo than men, whether in a public, workplace or school setting -- often forcing them to cover up their tattoo with make-up and bandages.

Armstrong and her team offered women a practical tactic for coping with such stigma.

"I want to stress that we are not being judgmental at all," she noted. "But we recommend that women might think about controlling where the body placement of their tattoo is, so they have control over how it's exposed, and don't have to show it if they don't want to."

Dr. Jeffrey S. Orringer, an associate professor in the department of dermatology at the University of Michigan in Ann Arbor and director of the university's Cosmetic Dermatology & Laser Center, said the findings make "nice sense" and dovetail with his own patient experience.

"And there are a lot of reasons we can speculate as to why," added Orringer. "Women's clothing certainly tends to reveal more of the chest or lower leg area, whereas for men in a business setting, a shirt and tie is covering these areas. And women tend to go through transitions -- both professional and social -- in their 20s, where they might come to feel that what plays on the college campus may not be appropriate in the board room or other settings. So, getting their tattoo removed is a way to move forward into the next phase of their lives."

More information

For additional information on tattoos and tattoo removal, visit the U.S. Food and Drug Administration.