From the Guidelines
If an older tattoo becomes raised and irritated, it likely indicates an allergic reaction, infection, or skin condition that requires attention. This reaction can occur years after getting a tattoo because the body may develop a delayed hypersensitivity to tattoo pigments, particularly red ink which contains mercury sulfide that commonly triggers reactions 1. Some key considerations for managing this condition include:
- Applying a cold compress to reduce swelling
- Using over-the-counter hydrocortisone cream (0.5-1%) twice daily for up to a week to relieve itching and inflammation
- Keeping the area clean by washing with mild soap and water, then pat dry gently
- Avoiding scratching or applying harsh products to the irritated tattoo Environmental factors like sun exposure can also break down tattoo pigments into substances that trigger immune responses. It is essential to consider alternative or concomitant causes of dermatitis, such as allergic contact dermatitis or irritant contact dermatitis, and evaluate them via comprehensive history taking and physical exam 1.
If symptoms persist beyond a week, worsen, include fever, or if the area becomes increasingly painful or starts oozing, consulting a dermatologist promptly is crucial as you may need prescription-strength treatments or further evaluation, including patch testing to evaluate for a clinically relevant causal allergen 1. A dermatologist may recommend a stronger topical steroid, phototherapy, systemic therapy, or occupational modification for recalcitrant cases 1.
From the Research
Tattoo Irritation
- There are no research papers to assist in answering this question, as the provided studies focus on the effects of hydrocortisone and other treatments on patients with severe COVID-19, sepsis, and cardiac surgery, rather than tattoo irritation.
- The studies 2, 3, 4, 5 discuss the use of hydrocortisone in various medical contexts, but do not address the topic of tattoos or skin irritation.
- Study 6 mentions biopsy and musculoskeletal lesions, but is not relevant to the question of tattoo irritation.
- Without relevant research papers, it is not possible to provide a definitive answer to the question of what it means if an older tattoo becomes raised and irritated.