Medical complications of tattoos: A comprehensive review

Parvez S. Islam, Christopher Chang, Carlo Selmi, Elena Generali, Arthur Huntley, Suzanne S Teuber, M. Eric Gershwin

Research output: Contribution to journalReview article

37 Citations (Scopus)

Abstract

Tattoos are defined as the introduction of exogenous pigments into the dermis in order to produce a permanent design. This process may occur unintentional or may be deliberately administered for cosmetic or medical reasons. Tattoos have been around for over 5000 years and over time have evolved to represent a common cosmetic practice worldwide. Currently, adverse reactions are relatively rare and generally unpredictable and predominantly include immunemediated reactions and skin infections. Along with better healthcare standards and more stringent public health mandates such as the provision of disposable needles, major infectious complications related to hepatitis and human retroviral infections have decreased significantly. When they do occur, skin infections are most frequently associated with Staphylococcus aureus or Streptococcus pyogenes. The aim of this study is to review the types and rates of medical complications of permanent tattoos. PubMed search and search dates were open ended. Acute local inflammation is the most common complication, but infections, allergic contact dermatitis, and other inflammatory or immune responses that are not well-characterized may occur. As many patients with immune reactions to tattoos do not react on skin or patch testing, it is postulated that the antigens contained in dyes or pigments are such small molecules that they need to be haptenized in order to become immunogenic. Red ink is associated more frequently with long-term reactions, including granulomatous and pseudolymphomatous phenomena or morphea-like lesions and vasculitis. Exacerbation of preexisting psoriasis, atopic dermatitis, and pyoderma gangrenosum may occur after tattooing. There is no well-defined association between cancer and tattoos. The treatment of tattoo-related complications may include local destructive measures (cryotherapy, electro-surgery, dermabrasion, chemical destruction, ablative laser destruction), surgical excision, and thermolysis of the pigment using Q-switched laser therapy.

Original languageEnglish (US)
Pages (from-to)273-286
Number of pages14
JournalClinical Reviews in Allergy and Immunology
Volume50
Issue number2
DOIs
StatePublished - Mar 3 2016

Fingerprint

Infection
Cosmetics
Skin
Lasers
Dermabrasion
Tattooing
Localized Scleroderma
Pyoderma Gangrenosum
Ink
Cryotherapy
Allergic Contact Dermatitis
Streptococcus pyogenes
Laser Therapy
Atopic Dermatitis
Dermis
Vasculitis
Psoriasis
PubMed
Hepatitis
Needles

Keywords

  • Cancer
  • Delayed type hypersensitivity reaction
  • Dermatitis
  • Dye
  • Granulomatous reactions
  • Ink
  • Laser
  • Patch testing
  • Pigment
  • Skin infection
  • Skin prick testing
  • Tattoo
  • Type IV hypersensitivity reaction

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

Medical complications of tattoos : A comprehensive review. / Islam, Parvez S.; Chang, Christopher; Selmi, Carlo; Generali, Elena; Huntley, Arthur; Teuber, Suzanne S; Gershwin, M. Eric.

In: Clinical Reviews in Allergy and Immunology, Vol. 50, No. 2, 03.03.2016, p. 273-286.

Research output: Contribution to journalReview article

Islam, Parvez S. ; Chang, Christopher ; Selmi, Carlo ; Generali, Elena ; Huntley, Arthur ; Teuber, Suzanne S ; Gershwin, M. Eric. / Medical complications of tattoos : A comprehensive review. In: Clinical Reviews in Allergy and Immunology. 2016 ; Vol. 50, No. 2. pp. 273-286.
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