Researchers at NYU Langone Medical Center in New York find that as many as 6% of New Yorkers who get a tattoo have experienced tattoo-related rash, severe itching or swelling that has lasted more than 4 months and for some, many years.
According to Dr. Marie Leger, senior study investigator and NYU Langone dermatologist, an estimated one in five adults in the US has at least one tattoo.
"Given the growing popularity of tattoos," says Leger, "physicians, public health officials and consumers need to be aware of the risks involved."
Leger, an assistant professor in NYU Langone's Ronald O. Perelman Department of Dermatology, and team's findings appear online in the journal Contact Dermatitis on May 27.
The study findings resulted from survey interviews with some 300 adults in New York's Central Park in June 2013. The findings reflect those discovered in studies conducted by European countries - which have only recently begun to monitor medical complications associated with tattoos.
Survey participants ranged in age from 18-69 years, with a majority claiming to have no more than five tattoos (one having 53), with the arm being the most popular tattoo site, at 67%.
"We were rather alarmed at the high rate of reported chronic complications tied to getting a tattoo," comments Leger. She adds that while some adverse skin reactions can be treated with anti-inflammatory steroid drugs, others may require laser surgery.
Surgery is sometimes necessary in extreme cases to remove the tattooed areas of the skin or built-up scar tissue and granular skin lesions, which can rise several millimeters on the skin and cause considerable itching and emotional distress.
The study revealed that areas of skin injected with two of the most common tattoo ink colors, red and black, experienced the most long-lasting complications.
Chemical composition of colored tattoo inks is "poorly understood and not standardized"
Almost half (44%) of chronic reactions were due to red ink, even though only slightly more than a third (36%) had tattoos with red ink. One third of chronic cases involved black ink, while over 90% of the participant's tattoos used black coloring.
"It is not yet known if the reactions being observed are due to chemicals in the ink itself or to other chemicals, such as preservatives or brighteners, added to them or to the chemicals' breakdown over time. The lack of a national database or reporting requirements also hinders reliable monitoring."
Leger indicates that the reality of complications tied to tattooing are partly due to lack of regulatory oversight, and also the fact that the chemical composition of colored inks used in the process is poorly understood and not standardized among dye manufacturers.
"The skin is a highly immune-sensitive organ, and the long-term consequences of repeatedly testing the body's immune system with injected dyes and colored inks are poorly understood," says Leger. She adds:
"Some of the reactions appear to be an immune response, yet we do not know who is most likely to have an immune reaction to a tattoo."
Another key finding from the study indicates that similar types of short-term complications, including delayed healing, pain, swelling and infection within weeks of getting tattooed, occur in 10% of individuals.
Additionally, the data showed that only a third of those who experienced a reaction sought medical advice or assistance. Many instead, revisited the tattoo parlor for guidance.
Leger and team have future plans to conduct a larger survey to determine specifically what color inks and dye components are most closely linked to adverse reactions. They anticipate that their investigations might reveal other factors that may put people at a greater risk of suffering chronic complications from getting "inked."
Back in 2012, Medical News Today reported that some tattoo inks are tainted with nontuberculous Mycobacteria, which can cause serious infections, including lung diseases, eye problems, several organ infections and infection of the joints.