By Melissa Smith

Fads come and go as frequently as Jennifer Lopez gets a new boyfriend. And often to be considered "cool," one must keep up with the latest trend. Back in the seventies, there were platform shoes. Then in the eighties, big bangs were in. Lately the craze has included tattoos and piercings. According to the Mayo Clinic, about 20 million Americans now have tattoos.

There are many reasons why people get a tattoo or piercing. Some do it simply because they are 18 and can, others say it's a statement about who they are. Like one girl who got a tattoo of a Scottish thistle on her ankle because she's, well, Scottish. An adult woman said her numerous tattoos all have meaning, like one on her arm has each of her kid's names on it.

As for piercings, one student in high school said her parents offered to get her a belly button ring as an incentive for good grades. Chad Frichtel, a high school senior, has six piercings and says he found it to be addicting.

"I wanted to get just my ears pierced, originally. And then, I started to want to get my tongue pierced. So once I turned 18, I went and got my tongue pierced and then it just really changed my perspective on piercings and the way they look and the way people view people with piercings." Frichtel said. "And so then, I started to get more and after I got my ears and tongue, I got three more piercings. It like really changed my view; it opened up a different world to different kinds of people and stuff. I usually thought that they are all freaks until I got mine and then I was like, 'they're not freaks, they just have cool interests too.'"

The biggest cost to this hip fashion accessory is the money. At the Hole Look in Anchorage, a body piercing costs $30 without jewelry and a tattoo goes for $100 per hour. But the other, less obvious cost of these procedures can be your health. And it's more than just pain and bleeding. It's possible to contract blood-borne diseases such as HIV and certain types of Hepatitis from piercing or tattooing. Heart complications can also occur. According to one Mayo Clinic study of patients with congenital heart disease, after getting a piercing, one of four patients go endocarditis, which is an inflammation of the heart lining and valves.

Are you still thinking about getting a cool piercing? You're not alone. In 2001, the University in New York conducted a survey that showed 51 percent of its students had piercings. Some negative results of piercings, specifically tongue piercings, are chipped or broken teeth, blood poisoning, breathing problems, cysts and nerve damage. Don't forget that along with getting an oral piercing, you are also putting yourself at risk of contracting herpes or other oral infections, and toxic shock syndrome, too.

Tattoos have their problems as well. They increase your odds of contracting bacterial skin infections, and you won't be allowed to donate blood for a year.

Some of these health side effects result from re-using needles and other equipment form previous customers. Non-sterile environments also allow bacteria to get into the flesh wounds. The good news is, if the establishment where you get your tattoo or piercing is clean and sanitary, you should be safe. Mickey Neely from The Hole Look, says the store takes extra precautions to ensure the safety of their clients.

"Needles, the stuff we actually use to poke are single use only. And then are put into a sharps container when the procedure is done with," Neely said. "The clamps and such are multiuse. They get used one time and then we run them through an ultrasonic cleaner at the end of the night, leave them to dry over night and then come in the morning and bag and sterilize them."

While there are risks involved, your chances of having complications are low. But knowing about the potential problems can help you if you are considering joining the next generation of fashion by getting a tattoo or piercing.