Thirty years ago, a good girl didn't walk into an establishment plastered with images of dragons and flames, hike her shirt up over one shoulder and let her body be injected with ink. Especially not if she was, like Darlene Nash, a 57-year-old grandmother.

But America has changed since then, and so has Nash. "When I was young, I worried about what other people thought, but as I got older I didn't care," said the Catonsville, Maryland, retiree. "I think with maturity comes a certain level of confidence."

She flashed a smile, then braced herself as the tattoo machine began etching a pattern across her right shoulder blade. On her other shoulder blade was Nash's first tattoo from seven years ago — a rose to commemorate a sister who died young and a heart for her first granddaughter. This month, she was adding a bouquet of forget-me-nots for her mother, who died of Alzheimer's, a ribbon for friends who died of cancer and an additional heart marking the birth of another granddaughter.