Once the preserve of servicemen, truck drivers and bikers, the tattoo has become an international fashion statement that adorns the limbs and nether regions of the rich and famous, and their fans.

Pop star Christina Aguilera has “Xtina” on her neck, Hollywood icon Nicholas Cage has a lizard with a top hat on his back, actress Angelina Jolie had the name of her former husband Billy Bob Thronton etched on her arm, English football star David Beckham had the name of his wife, Victoria, tattooed in Hindi on his arm — along with the names of his children on his back.

And those are just some that have been snapped in public. Gossip magazines are left to speculate about what is hidden down under.

The tattoo has come out of the boiler room to join the mainstream, from the fashion runways of Paris and Milan to the MTV generation of the new rich in Asian countries like Vietnam.

But few countries have adopted this form of body art like Americans.

Sixteen per cent of US adults, 45 million people, have a tattoo, according to a recent Harris Interactive poll. Thirty-six per cent of people aged between 25 and 29 said they had at least one.

Bob Wilson has had a tattoo studio in the small Maryland town of Brunswick for 16 years. “The area we are in is kind of rural. But in a radius of 10 miles there are five tattoo shops, with five or six people tattooing,” he said. In the Arizona city of Tucson, with 750,000 people, there are 32 salons registered with the Alliance of Professional Tattooists, which said there may be twice that figure really operating.

The tattoo is a way of expressing one’s love — like Beckham — or patriotism or attachment to a make of motorbike. But the popularity has also spread because of improved hygiene, with standards now laid down by the American Red Cross, and the modern palette of 80 colours now available.

New York State only ended a 36-year ban on tattoo parlours in 1997. The practice was made illegal following an outbreak of hepatitis in the 1960s, said Mike Bakaty, who has been in the industry for 27 years.

According to Bakaty, who used to work out of his apartment, celebrity exposure of tattoos has been a boon to artists like himself.

In the US, sports stars such as basketball’s Michael Jordan alongside pop stars such as Aguilera and Britney Spears and actors like Ben Affleck, Whoopi Goldberg and Jennifer Aniston have all boosted the tattoo’s popularity.

And where the young set the trend, older Americans who were too scared in the past are following. “More and more people who get their first tattoo are older; 40, 55, 60, that’s something new,” said Wilson. “Often they have had a major change in their lives, a loss, a divorce.”

Wilson said he was just working on covering the back of a man who had never previously had a tattoo. “He just got divorced, his oldest child just moved to college.”

According to the Harris poll, 34 per cent of those with tattoos felt more sexy, 29 per cent more rebellious and 5 per cent “more intelligent”.

“The tattoo has a meaning for the person who has it. The fact that it’s becoming mainstream doesn’t affect that,” said Wilson.