Are tattoos beneficial or harmful to health?

From the Guidelines

Tattoos can be considered safe when done in regulated establishments with proper hygiene protocols, but they carry risks including allergic reactions, skin infections, and bloodborne diseases. When considering getting a tattoo, it's essential to weigh the potential benefits of self-expression and aesthetic appeal against the potential health risks. According to a study published in Pediatrics 1, the rate of complications from having tattoos placed is likely low, but reported complications include inflammation, infections, neoplasms, and rare reports of vasculitis. Some key points to consider when getting a tattoo include:

• Researching tattoo artists thoroughly to ensure they follow proper hygiene protocols
• Considering potential professional implications as some workplaces still maintain policies against visible tattoos
• Following aftercare instructions to prevent infection, such as keeping the area clean, applying recommended ointments, avoiding sun exposure, and not swimming until healing is complete
• Being aware of the potential risks of bloodborne diseases, such as hepatitis C, although the risk is likely low if the procedure is done in a licensed establishment 1. Overall, the decision to get a tattoo should be made after careful consideration of these factors, and it is crucial to prioritize proper hygiene and aftercare to minimize the risk of complications.

From the Research

Risks Associated with Tattoos

• Tattooing is a tremendous exposure of the human body to needle operation, particles, and chemicals, which can lead to various complications 2
• The risk of complications is related to a person's health condition, level of insight, decision-making, and to the operation of tattooing, tattoo inks and utensils, tattoo parlour, and the aftercare 2
• Chronic complications with allergy in red tattoos and nodules due to pigment agglomeration and foreign body formation in black tattoos are less common but certainly at the level of cumbersome skin disease 2
• Reactions to black tattoos are strongly associated with sarcoidosis 2

Contraindications for Tattooing

• Certain medical conditions, such as chronic skin diseases, pigmented lesions of the skin, (congenital) heart disease, immunosuppressive diseases and treatments, blood clotting disorders, and pregnancy/breastfeeding, may be contraindications for tattooing 3
• Patients with chronic skin disorders, such as psoriasis or atopic dermatitis, should be advised on the risks and recommendations of tattooing 4
• Dermatologists should be aware of the main risks associated with tattooing and provide adequate counselling to patients considering getting a tattoo 4

Medical Complications of Tattoos

• Adverse reactions to tattoos are relatively rare and generally unpredictable, but can include immune-mediated reactions and skin infections 5
• Skin infections are most frequently associated with Staphylococcus aureus or Streptococcus pyogenes 5
• Red ink is associated more frequently with long-term reactions, including granulomatous and pseudolymphomatous phenomena or morphea-like lesions and vasculitis 5
• Exacerbation of preexisting psoriasis, atopic dermatitis, and pyoderma gangrenosum may occur after tattooing 5

Advice for Patients Considering a Tattoo

• Patients should be aware of the risks associated with tattooing and take necessary precautions to reduce the risk of complications 2, 6
• Physicians should provide adequate counselling to patients considering getting a tattoo, including information on the risks and recommendations for tattooing 6, 4
• A campaign called 'Tattoo - know your risk' can provide detailed fact sheets about tattoos, tattoo problems, how to reduce risk, and a checklist for the tattoo customer before decision-making 2