You May Want to Think Before You Ink

Tattoos may result in long-term skin conditions

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Tattoos have really gone mainstream in the last decade or so, but for some, tattoos can leave a long-lasting mark — in more ways than one.

A new study found that tattoos had a relatively high rate of complications — such as itching, skin rashes, swelling and infections. These reactions may last for months and, in some cases, for years after getting inked.

"We were rather alarmed at the high rate of reported chronic complications tied to getting a tattoo," said lead study author Marie C. Leger, MD, PhD, of New York University's Ronald O. Perelman Department of Dermatology, in a press release. "Given the growing popularity of tattoos, physicians, public health officials, and consumers need to be aware of the risks involved."

Coyle S. Connolly, DO, a board-certified dermatologist and president of Connolly Dermatology, told dailyRx News that patients thinking about getting a tattoo should be aware of all the possible complications, "including, but not limited to, infection, pain, swelling, itch, scarring, allergic reactions, sun sensitivity, etc. In my practice, I have seen more reactions to red dye in the form of itchy raised bumps or granulomas. One should consider the, as yet to be completely understood, consequences of the ink, preservatives, and brightening chemicals that break down over time and have the potential for eliciting unwanted immune reactions."

Dr. Leger and team said that this is the first study of its kind in the US. The researchers estimated that 1 in 5 Americans has a tattoo, which includes decorative body art as well as cosmetic tattooing — such as permanent eyeliner.

“The skin is a highly immune-sensitive organ, and the long-term consequences of repeatedly testing the body's immune system with injected dyes and colored inks are poorly understood," Dr. Leger said. "Some of the reactions appear to be an immune response, yet we do not know who is most likely to have an immune reaction to a tattoo."

Dr. Leger and team interviewed about 300 adults in New York City's Central Park in June 2013.

Around 6 percent of the patients reported complications — such as rash, severe itching or swelling — that lasted more than four months. These patients also reported delayed healing, pain and infections within a few weeks of getting a tattoo.

Dr. Leger and team found that red and black ink — the two most common colors — were linked to the majority of skin reactions. Almost half of these were related to red ink, even though that color accounted for only one-third of the tattoos.

Patients typically had fewer than five tattoos, although one patient had 53. Patients ranged in age from 18 to 69.

Although some skin reactions can be treated easily with anti-inflammatory or steroid medications, others may require laser surgery.

Dr. Leger and team found that many of those interviewed opted to go back to the tattoo parlor for assistance with their complications rather than seeking medical care.

"Patients may not seek medical attention because they may be under the false impression that the adverse reaction they are experiencing is a normal component of the tattoo process," Dr. Connolly said. "Some patients may also feel the tattoo artist and not a physician is best equipped to handle any negative reaction."

According to Dr. Leger and colleagues, a lack of tattoo regulation and of standardization in ink manufacturing may be the root of this problem.

"It is not yet known if the reactions being observed are due to chemicals in the ink itself or to other chemicals, such as preservatives or brighteners, added to them, or to the chemicals' breakdown over time," Dr. Leger said. "The lack of a national database or reporting requirements also hinders reliable monitoring."

This study was published in the May issue of the journal Contact Dermatitis.

New York University's Langone Medical Center funded this research. No conflicts of interest were disclosed.

Review Date: 
May 27, 2015
Last Updated:
May 28, 2015