being sensitive capturing images

I cannot include faces of service users in my photographs. And I already made a conscious desicison to not use flash in order to remain inconspicuous and capture images which were truly reflective and didn't look staged, however i have noticed even more issues with focusing on hands as many of the women have distinctive tattoos (some are names) I have been where possible avoiding including these in my photographs as these too could contribute to the identity of a service user being revealed.