Skin Reactions linked to Tattoos

Centuries Old Practice

For eons the human race in many parts of the world has practiced the art of embellishing the body with tattoos. The primitive civilizations used body art for decorative purposes while yet other populations used tattooing as a symbol of distinction or social rank. In the modern day world and in the past 20 years, tattooing has become a trend in many western countries.

Tattoo parlors have been increasing in numbers everywhere. Though, not all of them follow good hygienic practices. Consequently the number of tattoo related skin infections have been on the rise. Types of reactions that have been known to occur after acquiring a tattoo or several tattoos are:

1.  Acute Inflammatory Allergic Reaction

The main cause of an acute inflammatory allergic reaction of the skin to tattoos is determined to be the pigment in the inks used to affix the tattoo. More specifically the red pigment (composition - Mercury sulfide (cinnabar), Ferric hydrate (sienna), Sandalwood and Brazilwood) used in tattoos has been identified to cause allergic reactions. There are two types of allergic reactions:

  • Dermatitis – occurs on contact when the needle pierces the skin
  • Photoallergic Dermatitis – occurs when the area where the tattoo resides is exposed to the sun

2.  Eczematous Hypersensitivity

Eczematous hypersensitivity reaction is a type of allergic skin issue that occurs from tattooing. Some reactions will appear as a rash that may or may not be at the actual site of the tattoo. Eczematous Hypersensitivity reactions occur when a person is allergic to the pigments in the tattoo ink. The general allergic reaction is to mercury that is present in the red pigment. The good news is that these reactions are temporary in nature and can be treated with topical steroids.

3.  Photo-aggravated Reactions

Happen when the tattoo site is exposed to the sun and UV rays. The yellow and red pigments in the tattoo ink react when exposed to the sun, as the yellow pigment is created from cadmium sulfide. The red pigment also contains traces of cadmium and hence the allergic reaction. A red rash together with swelling can be seen around the tattoo.

4. Granulomatous Reactions

This type of reaction typically occurs in one specific pigment in the tattoo ink, which is the red pigment. There will either be one firm localized swelling at the tattoo site or multiple tiny granulomas within the color region of the tattoo. This type of reaction is always very difficult to treat. A topical injection of steroids may be tried but if this fails then the solution is to remove the tattoo, for aesthetic reasons.

5.  Lichenoid reactions

Once again it is the red pigment in the tattoo ink that produces this reaction. The signs and symptoms resemble:
  • Small, flat- topped, polygonal bumps
  • The bumps grow together into rough, scaly plaques
  • In appearance the reaction resembles lichen which is found on plants

6.  Pseudolymphonmatous Reactions
  • It is normally a delayed hypersensitivity reaction to the red tattoo pigment
  • This reaction has been found to occur when green or blue tattoo inks have been used in the tattoo, too
  • This reaction commonly ranges from plum to red colored nodules and plaques

7.  UV Black Light Reactions
  • Similar to the red pigment in the tattoo ink, some UV black light tattoo inks are also likely to cause allergic reactions
  • Inks containing phosphorous create skin rashes and leave brown scars