In all my 82 years, the thought of getting a tattoo has never crossed my mind! It’s not that I’m worried about it hurting, although some recipients have said it hurt like crazy; it’s that I think they don’t really enhance a person’s appearance. If anything, depending on where they are located, a tattoo can appear very unsightly, if not altogether sinister. The idea of having a tattoo on your face, in my mind is the ultimate expression of a low self image, and is a means self-mutilation and an attempt to change your image supposedly for the better. But in reality, it has the opposite effect. I also think some tattoos are a vain attempt to draw attention to one’s self, which they certainly do, but not always with kindness and respect.
Then the idea came to me: I should search the medical literature for a scientific article on the adverse effects of getting and having a tattoo. I found a few articles, the results of which are the basis of the essay that follows. Before I start, I must admit a bias against tattoos that will influence the tone of what I say, so be aware of that now so you’re not angry later.
Tattoos have been around for centuries. Only in the last twenty years have we seen a massive increase in the number of men and women sporting everything from a butterfly tattoo on the low back to the complete chest, back, and neck tattoo’s that are elaborate works of art.
Fortunately, state and local health departments and government agencies have had their eye on tattoo parlors and artists, and are diligent in their efforts to maintain a sanitary environment and prevent blood-borne transmission of disease. Artists and parlors are required to be licensed and trained in how to handle needles and properly dispose of them. Parlors are subject to inspections now and then and must follow OSHA (Occupational Safety and Health Administration) guidelines and use sterile equipment. Clients are not tested for disease beforehand, but great care is taken not to spread disease if the client does have an issue.
The major diagnoses people worry about acquiring from getting a tattoo are cancer, hepatitis B or C, and AIDS, or HIV. The risk of getting one of these is very small as long as the artist uses new gloves for each person, practices proper technique, and does not re-use needles. The chances of getting HIV are low to negligible, as they are with hepatitis B and C. Cancer has been studied extensively, and there is no well-defined association between cancer and tattoos.
Well, if not hepatitis, HIV, or cancer, what adverse reactions do occur? Though they are relatively rare, most are either immune-mediated (local allergic reactions) or skin infections. Local reactions include allergic contact dermatitis or a local inflammatory response. Reactions can be immediate, delayed, or long-term. Antigens in the dyes or pigments used are culprits in local inflammatory reactions that are sometimes severe. Red dyes have been associated with long-term reactions. Skin infections, when they occur, are most often caused by Staphylococcus aureus or Streptococcus pyogenes, two common skin pathogens that appear when sterile technique is ignored.
Tattoo inks may contain heavy metals, aromatic hydrocarbons, and aromatic amines which are toxic if the amount in the ink exceeds permissible limits. After injection into the skin, these pigments are absorbed by cells in the skin layers, but most of it (60%-90%) is later taken away by the lymphatic system. About one-third of tattoo ink remains in the epidermis (the surface layer), one-fourth is absorbed by the lymphatics, the rest stays in the dermis, the layer below the surface layer. These dermal pigments are absorbed by cells in the dermis and remain there as the tattoo.
Now, we know tattoos are not the source of serious diseases. At worst, they might get infected with bacteria if they are not done properly using good hygienic technique, or they might develop a local allergic reaction from the ink, the usual cause.
Knowing that getting a tattoo is safe and doesn’t cause cancer, hepatitis, or HIV does NOT change my mind about ever getting one!
References: Islam PS, et al. Medical complications of Tattoos: A Comprehensive Review Clin Rev Allergy Immunol 2016 Apr;50(2):273-286.
Sindoni A, et al. Adverse effects related to tattoos in the community setting: a systematic review. J Epidemiol Community Health 202@ Oct;75(10):1023-1028.
Dodig S, Cepelek-Dodig D, Gretic D, Cepelek I. Tattooing: immediate and long-term adverse reactions and complications Arh Hig Rada Toksikol 2024;75:219-227.
Hepatitis C and getting tattoos. Publication by Hepatitis Infoline.
www.google.com/do-tattoo-parlors-test-for-disease.
www.google.com/are-tattoo-artists-licensed
