Tattooing is a process of putting various pigments into the skin.1 Despite being done for cultural, cosmetic, or medical reasons, it can have complications such as allergic reactions and infections, as well as additional short-term and long-term complications.

 

1. You May Get an Infection

Tattooing involves using needles to place pigments into the skin. Tattoo needles pierce the skin, which can allow bacteria to enter the body.2 Infections most commonly occur because of inadequate skin preparation and poor hygiene during the tattooing or the healing process.1

Infections can occur immediately after receiving a tattoo or in the days and weeks after while the tattooed skin heals. Signs of an infected tattoo include:3

• Redness
• Pain, particularly worsening pain
• Itchy, red bumps developing within the tattoo area
• A temperature of 100.4 F or higher
• Chills or shivering
• Pus-like area within the tattoo area
• Sores developing within the tattoo

When getting a tattoo, ensure the tattoo shop properly cleanses and prepares the area being tattooed and follows required hygiene standards. If signs of infection develop, see a qualified healthcare provider, such as your primary care provider or a dermatologist.3

 

2. You May Have Prolonged Wound Healing

During tattooing, needles pierce the skin’s various layers. Whenever the skin’s integrity is breached, the body’s internal healing process begins. Because wound healing is complex, the pigments used in tattooing can negatively affect it.4 Common wound healing concerns include:

• Itching
• Development of scabs or crusts
• Impaired skin healing

To protect the skin and support healing, the American Academy of Dermatology recommends using a water-based lotion or cream to keep the skin from drying out and protecting tattoos with SPF30 or higher sunscreen.5

 

3. You Could Have an Allergic or Non-Allergic Reactions

Identified as one of the most common complications of tattooing, both non-allergic and allergic reactions have been documented.4 The literature identifies red ink as most implicated in allergic reactions.6

Non-allergic reactions can occur during or even after wound healing begins. Non-allergic reactions include:4

• Cutaneous granuloma. This condition causes skin bumps or skin plaques due to the immune system treating the tattoo ink as a foreign body and trying to isolate the ink.7
• Pseudolymphoma. This condition occurs when the body’s immune system mimics a type of lymphoma but is actually a benign condition related to the tattoo.8

The main allergic reaction is hypersensitivity. Hypersensitivity can occur anytime from a month to several years after tattooing. Hypersensitivity reactions might include:9

• Itchy skin (pruritus)
• Erythema (redness or discoloration due to dilated blood vessels)
• Swelling (edema)

If signs of a non-allergic or allergic reaction become evident, contact a qualified healthcare professional, such as a primary care provider or dermatologist.

 

4. You May Have Short-Term Immune Responses

Tattooing creates tiny wounds, and the wound-healing process begins immediately. Wound healing generates an inflammatory response by the immune system. The inflammatory response has been linked to exacerbating, or even initiating, various short-term immune responses:10

• Sarcoid granulomas, which can cause systemic reactions such as pulmonary sarcoidosis or uveitis
• Psoriasis flare3
• Lichen planus
• Eczema
• Keloid
• Vitiligo
• Alteration to the body’s typical response to vaccination11

Research indicates that signs of short-term immune responses occur within the first few weeks of getting a tattoo, although they can appear years later. If any of these skin conditions occur, a qualified healthcare provider, such as a primary care provider or dermatologist, can assess and develop an individualized treatment plan.

 

5. You Could Have Long-Term Health Concerns

Few studies link tattooing to long-term health concerns. The pigments used in tattooing contain components such as heavy metals and polycyclic aromatic hydrocarbons, which the International Agency for Research on Cancer has classified as cancer-causing or potentially cancer-causing.12 Other health concerns identified in the literature include:13

• Cardiovascular disease
• Liver toxicity
• Increased risk for malignant lymphoma14
• Increased risk for skin cancers15