Tattoos may seem cool but turning skin into a canvas for artwork, messages and permanent cosmetic designs poses health risks, some of which can prove serious. The tattooing process penetrates the outer and inner layers of skin, paving the way for possible allergic skin reactions, local and systemic infections, rashes, inflammation, scarring and even a potentially heightened risk for some cancers.
The skin is the largest organ in the body, serving as a barrier to the toxins and bacteria surrounding us in our environment. The tattoo artist breaks down part of this barrier by using a machine that creates literally hundreds of needle pricks in order to inject tiny particles of ink into the dermis — the skin’s inner layer.
A new tattoo is literally a traumatic injury to the skin and, as such, activates the body’s immune system, with white blood cells identifying and attacking the ink particles as foreign invaders. This response can lead to temporary pain and heightened sensitivity in the tattooed area, skin inflammation and itching.
Even with proper “aftercare” of the tattoo, keloids — scar tissue — may develop at the tattoo site or granulomas, nodules that form around the ink particles, might appear.
Other possible health complications associated with tattoos include:
• Engorgement of lymph nodes with ink particles;
• Infections that can prove aggressive or dangerous if not promptly treated;
• Allergic reactions, such as swelling and rashes;
• Sarcoidosis, an inflammatory disease affecting primarily the lymph glands and lungs; and
• Lichen planus, a chronic, inflammatory skin disorder. Individuals with pre-existing skin conditions like psoriasis need to be particularly careful before proceeding with a tattoo. In about 25 percent of psoriasis cases, a tattoo may prompt growth of psoriasis-like lesions on or around the tattoo site.
Meanwhile, tattooing has gone from “exceptional” to mainstream, with four in 10 adults between the ages of 18 and 69 in the United States now sporting some type of picture, design or message on their skin, according to a 2017 Statista survey.
The widespread acceptance of tattoos — even in the workplace — leaves scientists feeling increasingly uneasy about tattoos’ potential long-term effects, especially health complications that may be related to contaminants — like titanium dioxide — common to tattoo pigments. Some of these pigments are also used in print toner and car paints, and the toxins in them have proven carcinogenic to animals but not humans — yet.
Authors of a study published in a September 2017 issue of Scientific Reports express concern about how nanoparticles of pigment toxins found in the lymph nodes of tattooed individuals might behave in the body. These particles were less than 1 percent the width of a human hair. Earlier research, described in the British Journal of Dermatology, indicates that pigment nanoparticles travel beyond the immediate tattoo site and may be toxic to nerves and the brain.
Tattoo inks are also unregulated by any government agency. Does that mean tattoos should be avoided? Not necessarily. But people must first carefully weigh the pros and cons of a tattoo and then, perhaps, talk to their physician before proceeding, especially if they have an underlying skin condition or immune system disorder.
Choosing a reputable, licensed tattoo artist and ensuring that inking needles are correctly sterilized are obvious, first-step recommendations. Equal in importance, however, is the follow-up attention a patient should give a new tattoo to minimize complications.
Here are my care tips:
• Keep a new tattoo covered with a sterile gauze or bandage for at least the first day.
• Gently clean the tattoo area daily with plain soap and water. Moisturize it several times a day for a couple of weeks following application.
• Don’t expose a new tattoo to the sun until it is completely healed.
• Avoid swimming or immersion in pools, hot tubs or bodies of water to minimize chances of infecting the wound.
• Don’t scratch an itchy tattoo and let any scabs that form heal on their own.
• Contact a physician if the tattoo site remains red, swelled, itchy or painful after more than a week or 10 days of recovery time.
David Erstein, MD, board-certified in allergy and immunology and internal medicine, is with Advanced Dermatology P.C. For more, visit advanceddermatologypc.com.