One in four people in the US has a tattoo, and if you’re part of this statistic you know how painful getting one can be. The problem is that, like the tattoo itself, that pain lasts and in some cases the adverse reactions caused by the foreign body, i.e. the dye, can endure for months and months at a time. This isn’t something new per se, but what’s surprising is how frequent this happens. Researchers at New York University asked 300 or so people in Central Park if they had a tattoo and whether they experienced anything out of the ordinary following the procedure, like redness and scarring. Almost 10% confirmed they had developed abnormal reactions. Of these 6% had  itching, scaly skin and swelling , and 4% claimed they went through pain, itching and infection and these didn’t stop for at least four months.

Image: TQN

“I’m not anti-tattoo at all; I happen to think tattoos are beautiful,” said study co-author Dr. Marie Leger, a dermatologist at the New York University Langone Medical Center in New York City. But people should know that “there are certain risks,” Leger added.

Leger regularly receives patients who report itching and raised, scaly skin around their tattoos. One patient in particular who showed adverse reactions around the red parts of her tattoo only prompted Leger to investigate, so she and colleagues embarked on this study. Though not the best sample size, the study did uncover some interesting facts (of course, replication with a larger base sample is warranted).  Allergic reactions to the dyes, especially red dye, are responsible for some of the nasty chronic pain and skin perturbances that can last for months at a time. The more varied the colouring of the tattoos, the more trouble the people surveyed seemed to report. Again, especially the reds.

Leger recons that these painful reactions aren’t due to the artist’s touch or any germs around the parlor. Instead, it seems to be an one on one thing between the tattoo dyes and the body. In those cases where  warmth, swelling and drainage appears at the tattoo, people should go to an urgent care clinic or get some other medical help immediately, Leger said. Things like these seem to happen.

The findings, however, raise an important issue surrounding materials for tattoos and their regulation, or lack thereof.

“Tattoo inks aren’t very closely regulated in the United States,” Leger told ZME Science.

“Some of the skin reactions may be very subtle and require a dermatologist to diagnose exactly what it is,” said Dr. Jared Jagdeo, assistant professor of dermatology at UC Davis, who was not involved in the current research.

“The findings [of the current study] highlight the importance of educating the general public prior to tattooing,” Jagdeo said. “Anytime you introduce a foreign substance into the body, in this case the skin, there is the potential for adverse events [such as] infection or something more serious like an allergic reaction,” he said.

So, according to the paper published in Contact Dermatitis if you’re pain adverse, you might consider having a black-inked tattoo, or keep that red to a minimum if you really have to. Of note is that this isn’t something confined to permanent tattoos. In 2013, the FDA issued a a warning that temporary tattoos,  popular and commonly applied by small retail outlets, may be putting customers as risk of serious dermatological complications. Serious and long-lasting reactions were reported that consumers had not bargained for after getting temporary tattoos. Reported problems include redness, blisters, raised red weeping lesions, loss of pigmentation, increased sensitivity to sunlight, and even permanent scarring.

While we’re at it, check out this previous post I wrote about what makes tattoos permanent (hint: it’s not the ink itself). And if you really want to get rid of that embarrassing 9th grade tattoo, you’ll be happy to hear some scientists are working on a tattoo removal cream which doesn’t leave any scars  (better than blasting lasers on your dermis right?).