Tattoo Ink Linked to Allergic Reactions Study Finds

Summary
Tattoo ink is known to cause various allergic reactions in skin, leading to such discomforts as itching, swelling, redness, fluid discharge, and peeling. Tattoo inks of various colors contain different chemical compounds. The researchers reviewed various studies which were done to examine the allergic reactions to tattoo pigment. They also studied the allergic reactions of various chemicals used in the tattoo inks.

Introduction
While tattooing, the ink pigments sink from the surface layers into the deeper portions of the skin and get deposited there. These pigments remain there for a long time, and as long as they are within these cells, the pigments are not exposed to allergy producing cells, called eosinophils; hence, no allergic reaction is produced. Many of the conventionally used tattoo pigments such as India ink do not produce any allergic reaction. But tattoo inks are often mixed with some other chemicals, which may cause an allergic reaction in sensitive individuals. The allergic reactions to a particular tattoo pigment can manifest in various forms, including itching and redness. In severe cases of allergic reactions, there can be drainage of serous fluid and peeling of skin forming an ulcer. The authors of the present study not only evaluated various types of allergic reactions produced by tattoo inks, but also reviewed articles on tumors produced by tattoo inks and treatment of the allergic reactions.

Methodology
The authors of the present study intended to review all the articles written on allergic reactions produced by tattoo inks. Hence, they retrieved the articles written on various allergic reactions produced by the tattoo inks. They also studied articles which were written to identify the tattoo pigment causing the allergic reaction. The difference between inks of amateur and professional tattoo workers was also noted. Reports of skin tumors produced by tattoo inks were also reviewed. They also studied the articles written on treatment of allergies produced by the tattoo pigment.

Results

  • Tattoo inks, which contained India ink and azure blue, rarely caused allergic reactions. Red pigment containing cinnabar and yellow pigment containing cadmium yellow produced itching and redness of skin on exposure to sunlight. Henna was found to be a very safe pigment color. But a textile dye, paraphenylene-diamine (PPD), which is added to henna to increase its coloring potential, caused allergic reactions.
  • X-ray microanalysis studies have shown that tattoo pigments that produce allergic reactions contain metals such as aluminum, silicon etc. Professional tattoo workers used inks of different colors; hence, the incidence of allergy was higher with them.
  • Treatment of cutaneous allergic reactions to tattoo ink depended on the extent of damage to the skin. Steroids, oral anti-histamines and protection from direct sunlight are some of the main lines of treatment.
  • Melanomas, keratoacanthomas, and verrucas at the site of the tattoos were also documented.

Next steps/shortcomings
The authors believe that it is essential for physicians to be aware of cutaneous allergic reactions to tattoo ink and the possibility of further reactions occurring through laser treatment. The authors refer to a new technology that is being developed. The new technology captivates tattoo pigments into polymethyl methacrylate (PMMA) polymer beads, which are easy to remove. This prevents the pigments from infiltrating into other portions of the skin and thus helps in treating cutaneous allergic reactions to tattoo ink. The authors suggest that it is really important for tattoo artists to perform a patch test for the commonly occurring allergic reactions before placing a tattoo.

Conclusion
Skin allergic reactions are not uncommon with the use of tattoo pigments in tattoo ink. Sometimes, the reaction can be so severe that there can be complete peeling of skin, resulting in ulcer formation. These reactions are rare with traditionally used inks such as India ink. Therefore, by using these agents one can avoid cutaneous allergic reactions. If tattoo artists want to use additional chemicals, it is better to do a patch allergy test before injecting the tattoo ink. Though this extra step is not always practical, it is an effective way of avoiding severe allergic reactions. It is also important for clinicians to be aware of cutaneous allergic reactions to tattoo pigments, so that they can identify them and start the treatment at the earliest.

For More Information:
Skin Allergic Reactions to Tattoo Ink
Publication Journal: Journal of Cosmetic Dermatology, August 2009
By Ravneet Kaur, MD; William Kirby, DO, FAOCD
From the UCLA-Olive View Medical Center, Sylmar, California; Kirby Dermatology/Dr. Tatoff Inc., Beverly Hills, California

*FYI Living Lab Reports Are Summaries of the Original Research.




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