Thinking of getting a tattoo?
Thursday, July 19, 2018
One of my earliest memories is sitting at the kitchen table with my grandpa. Not one to engage a child in conversation, my grandfather ate his dinner in silence and I simply observed. He would slurp his soup and always dribble a bit on his chin. This was particularly entertaining for a 4-year old especially since grandpa never wore his dentures. What caught my eye the most, however, was the tattoo on his forearm. As a young man, my grandfather sailed the seas as a merchant marine. Like so many sailors, he had a tattoo. If he were alive today, I would ask him the significance of the tattoo. Perhaps it simply commemorated that stage of his life or was a good luck talisman. Either way, I thought it was rather exotic, as I knew no one else with a tattoo. Nowadays, tattoos are mainstream, no longer relegated to sailors and rock stars. It is estimated that four in ten Americans have tattoos. Some sources report that nearly 50% of millennials have tattoos. With over $3 billion in revenue, the tattoo industry is going strong. Exponential growth, however, raises questions regarding tattoo safety and potential health risks. Concerns arise in three main categories, infection and skin issues, ink contaminants, and removal. Long-term consequences are not clear at this point and studies are just beginning.
Infection and Skin Issues
· Unsterile tattooing equipment and needles can transmit infectious diseases such as HIV, hepatitis, and skin infections caused by Staphylococcus aureus (“staph”) and other bacteria.
· Medicaldaily.com reports three percent of tattoos become infected, and almost four percent of people who get tattoos recount pain lasting more than a month. (Tulane University study) About 22 percent of participants with new tattoos reported persistent itching that lasted more than a month.
· The most common skin reactions to tattoo include superficial and deep local infections, systemic infections, allergic contact dermatitis, photodermatitis (rash when exposed to sun), granulomatous and lichenoid reactions (small knots or bumps that can form around particles of tattoo pigment) and skin diseases localized on tattooed area (eczema, psoriasis, lichen, and morphea). Tattooing also can lead to keloids — raised areas caused by an overgrowth of scar tissue.
· Some people with tattoos also experience complications when undergoing a MRI. Reactions include swelling or burning. People with iron-based tattoo pigment may be more susceptible to this magnetic-based reaction.
· The FDA considers tattoo ink to be a cosmetic. Although a number of color additives are approved for use in cosmetics, none is approved for injection into the skin. Many pigments used in tattoo inks are not approved for skin contact at all. Some are industrial grade colors that are suitable for printers’ ink or automobile paint. The FDA has traditionally refrained from regulating tattoo inks or pigments (due to other health priorities and previous lack of evidence). Recent scientific studies, however, have raised concerns. The FDA is now researching tattoo ink and pigments.
· In 2016, Europe released a 118-page analysis of tattoo inks and pigments. The top chemicals of concern are polycyclic aromatic hydrocarbons (PAHs) including benzopyrene, a known carcinogen. Benzopyrene is found in many black inks. In addition, a Bradford University study found that tattoo inks, especially black pigments contain the smallest nanoparticles (ultramicroscopic particles). Nanoparticles readily penetrate the skin and travel to underlying blood vessels and your bloodstream. These could potentially build up in the spleen and kidneys.
· Red inks may contain mercury, while others contain cadmium or iron oxide. Based on current findings, red inks seem to cause more skin irritation than other colors. Other color inks may be derived from heavy metals including lead, antimony beryllium, chromium, cobalt nickel, and arsenic.
· The tattoo removal industry is booming. The experts estimate the worldwide tattoo removal market to increase at a compound annual growth rate of almost 16% between 2017 and 2021. Annual revenue is upwards of $80 million.
· Laser removal has improved but still has limitations in erasing vibrant tattoo colors. The word “removal” is misleading. The ink is not sucked out of the body. Lasers blast apart pigments, sending the degraded particles into the body. It is not clear how the ink is flushed from the body. Further research is needed to determine possible side effects of these particles. Case studies have found ink particles in the lymph nodes. Long-term effects are not known at this time.
· Short-term laser complications include pain, blistering, scarring and lightening or darkening of the skin. While the scarring may persist, most of the other symptoms disappear with time.
· Infections and long-term skin ailments are possible when getting a tattoo.
· Tattoo inks are not regulated and may contain cancer-causing agents.
· Ink particles can travel throughout the body. However, long-term effects remain unknown.
· Before getting or removing a tattoo, do your research.
Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville, NY. To discuss this or other topics, contact Lorraine at firstname.lastname@example.org or (585) 335-4327.