Collaboration in Civic Spheres

UW study: tattoo snags may mimic diseases, but don’t panic

by Matt Rosenberg November 6th, 2012

In a new study published in a medical journal, a University of Washington dermatologist warns tattoo seekers to beware of possible bacterial complications which can result from variances in types of tattoo inks and practices used, and worrisome-looking symptoms that mimic non-Hodgkins lymphoma, or non-melanoma skin cancer and lupus. But despite these more dire appearances, writes Dr. Michi M. Shinohara, typically the problem is an infection that can be successfully treated with antibiotics. Meanwhile, there are definitely some questions you need to ask your tattoo artist before going under the needle.

The report by Shinohara and a team of four other researchers is focused on what could be found through microscopic analysis of disease on top-surface and below-surface tattooed skin that due to complications has various patterns of rashes and pimples on top, and often the presence beneath the skin of different types of white blood cells which work to attack bacteria and other foreign substances.

The study notes there’s increasing evidence that at least some tattoo inks may contain compounds that can cause allergic reactions, or symptoms mimicking worse conditions, indicating possible cancerous growths.

The inks are suspended pigments made up of metal salts and organic compounds. Depending on color they may include iron oxides and carbons (black tattoo ink); cobalt, copper and chromium salts (blue ink); chromium, copper and yellow cadmium salts (green); and mercury, cadmium and perhaps iron oxides (red).

More intense reds and yellows are being used in tattoo inks now and come from organic azo dyes that the study says were “originally designed for commercial uses such as printing and car paint.”

That might make your skin crawl, but in an email interview Shinohara said she thinks the practice of tattooing today is generally safe.

She added that consumers need to exercise common-sense precautions including careful selection of a provider – meaning in a licensed venue, not a home or jail setting.

Shinohara notes that “although there are more reactions being reported, it’s still a relatively small percent of the overall people being tattooed.” Previous research suggests almost one quarter of U.S. population may have one or more decorative tattoos, and that up to two percent of those may give rise to direct complications, according to the study.

As for the bright colors of azo dyes, Shinohara says we may be at more risk from their inclusion in food such as bright yellow macaroni and cheese products.

What would Shinohara tell a close friend or relative who was planning to get tattooed? She answered, “Being part of the most tattooed generation, I don’t have much of a platform…to tell someone not to get a tattoo ever, but I would encourage them to think long and hard before getting it. Frankly, I would be more worried about the content of the tattoo rather than safety, assuming they go to a licensed tattoo artist who uses sterile/clean equipment. Although you can get tattoo laser removal if you change your mind about a beer brand tattoo on your forearm later, laser isn’t perfect, it’s painful, and can cause scarring. I would definitely be sure that they research the tattoo parlor and artist before – tattoo should be looked at as a permanent body alteration.”

Shinohara said that to thoroughly research the effects of new and changing tattoo inks would be a very big job for the U.S. Food and Drug Administration because of unknowns about quantity limits, impact of sun exposure, and nanoparticles; but increased regulation by local governments around health standards and training of tattoo artists is “a positive.”

An FDA site for consumers on tattoo safety that Shinohara says is “”reliable, accurate and easily understandable” is called, “Think Before You Ink: Are Tattoos Safe?” It provides “Tattoo Tips For Consumers,” plus details on FDA researchers at the National Center For Toxicological Research investigating a series of questions related to whether or not, and how the body might safely process tattoo inks beneath the skin.

Consumers should also familiarize themselves with an FDA update on tattoo-related non-tubercular bacterial infections like those which occurred in a cluster in Washington state (and elsewhere) earlier this year, Shinohara said. It warns of the M. chelonae bacterial strain resulting from contaminated inks; it can cause lung disease, joint infection, eye problems and organ infections. A key precautionary measure is to only use a tattoo artist who insists on inks formulated or processed to ensure freedom from bacteria, and who also avoids use of non-sterile water to dilute inks or wash skin, the FDA alert says.


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