Psoriasis is an inflammatory skin condition that causes itchy, dry, and sometimes painful plaques on the surface of the skin. This can pose challenges for a person who wishes to have a tattoo.

Approximately 10–30% of people in Western countries have at least one tattoo.

People with psoriasis may have to consider extra factors when deciding whether to get a tattoo, such as its location on the body.

Psoriasis causes scaly plaques or lesions to develop on the skin’s surface. The severity and location will vary for each person and may depend on the type of psoriasis they have.

For example, inverse psoriasis typically appears in the folds of the skin, while plaque psoriasis — which accounts for 80–90% of psoriasis cases — may appear anywhere.

It is advisable to get a tattoo in a place where skin lesions do not usually occur. However, this does not prevent a symptom flare-up from happening when people get a tattoo — it only reduces the risk.

This article discusses the risks and complications of getting a tattoo with psoriasis, as well as what people may wish to consider beforehand.

Psoriasis resources

Visit our dedicated hub for more research-backed information and in-depth resources on psoriasis.

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Around 10% of people who get a tattoo experience a complication. However, several risk factors may have a greater affect on those with psoriasis.

Infection

Tattoo needles repeatedly puncture the skin to apply ink. During this process, they may introduce bacteria and other germs into the skin, potentially causing an infection.

A person may contract a serious illness from inadequately sanitized tools and needles or cross-contamination, such as:

People undergoing treatment for psoriasis have a higher risk of infection.

For example, systemic therapies may cause skin dryness and thinning, which could prolong the healing process and promote infection. Immunosuppressant therapy may also increase the risk of infection.

It is also worth noting that companies have previously recalled some products due to bacterial contamination.

Scarring

It is common for people to experience scarring during the tattoo healing process.

Areas of the body that are more susceptible to atypical scarring include the chest, shoulders, and upper arms.

For people with psoriasis, skin trauma from the needle may trigger a symptom flare-up or new psoriasis plaques in the area of the tattoo.

Allergies

A 2019 study found that certain dyes in tattoo inks may cause allergic reactions. This is most common with red inks, as well as green, blue, and violent inks.

The researchers also found that 32% of people reported worsening allergy symptoms due to sunlight exposure. However, nearly 1 in 5 people who get tattoos report sunlight sensitivity.

Inflammation

Inflammation in the area of the tattoo is a common reaction due to repetitive skin trauma.

For some people, the whole tattoo may seem elevated, swollen, and have the texture of sandpaper. For others, inflammation may only occur in specific places where the artist inserts certain colors.

However, people with psoriasis are 25% more likely to experience a reaction called the Koebner phenomenon. This refers to the development of skin lesions following an injury to healthy skin.

Possibility of refusal

Some tattoo artists may refuse to tattoo someone with psoriasis, even if the condition is not currently active.

In other cases, the artist may ask a person with psoriasis to consult their doctor and get medical approval.

If the artist agrees to do the tattoo when symptoms are absent, the individual may have to wait for some time before getting the tattoo. However, for some people, the skin may never be fully clear.

In some states, laws prohibit artists from tattooing a person with active eczema or psoriasis. It is important to research state laws before an individual with psoriasis gets a tattoo.

The Koebner phenomenon refers to any new skin lesion that develops in previously healthy skin after experiencing skin trauma.

A person with psoriasis may choose a location for a tattoo where they have never experienced skin plaques.

However, after having the tattoo, a psoriasis-like flare might occur within the new tattoo lines. This typically occurs 10–20 days later, though it may take up to 2 years for symptoms to show.

Nearly 1 in 4 people with psoriasis who get a tattoo develop Koebner phenomenon.

A person with psoriasis should be aware of the risk of experiencing lesions on the tattooed area, even if psoriasis plaques have never previously occurred in that area.

Other triggers of skin trauma include sunburns, scratches, and insect bites.

There are safety measures that a person with psoriasis can take before, during, and after their tattoo to avoid any complications.

Questions to ask before getting a tattoo

Individuals may consider asking the tattoo artist the following questions:

  • What are your sanitation techniques?
  • How do you keep your equipment clean?
  • Are there any active recalls on the inks you use?
  • Do you have experience tattooing people with psoriasis?

Other questions people may ask themselves before getting a tattoo are:

  • Do they have an autoclave machine that sterilizes instruments at ultrahigh heat?
  • Are the staff wearing gloves while sterilizing equipment?
  • Are the artists wearing gloves while tattooing?
  • Are the tattoo inks being placed in a single-use cup and being thrown away after a tattoo is complete?
  • Am I comfortable getting a tattoo with this person and at this place?

The answer to the second set of questions should all be “yes.”

A person with psoriasis may also speak with a doctor about getting a tattoo. The doctor will consider the individual’s symptoms and can offer specialist advice on safety precautions, warning signs, and aftercare.

Aftercare

Anyone who gets a tattoo should follow the aftercare instructions from their tattoo artist to prevent infection and promote healing.

Symptoms of an infection that need follow-up care include:

  • redness, which may only be visible on lighter skin
  • swelling
  • pain
  • new rashes or lesions
  • fever and chills

The healing process will depend on several factors, such as the size, location, and duration of the tattoo. However, people can generally expect at least 2 weeks before their tattoo fully heals.

If skin symptoms do not improve, it is important to contact a doctor.

Do tattoos make psoriasis worse?

People with psoriasis who are undergoing treatment — systemic therapy, phototherapy, immunosuppressant therapy — are at an increased risk of developing infections and more severe plaques, scars, and inflammation.

How likely am I to have tattoo-related complications?

Approximately 25% of people with psoriasis are at risk of the Koebner phenomenon after getting a tattoo. This happens when new skin plaques or lesions develop in places previously unaffected by psoriasis.

Can a tattoo trigger autoimmune disease?

Getting a tattoo may worsen a person’s psoriasis symptoms and increase their chances of developing:

  • infections
  • allergic reactions
  • symptom flare-ups
  • plaques in areas previously unaffected — Koebner phenomenon

People with psoriasis require extra considerations before getting a tattoo, such as the location of the tattoo. They should also be aware they may experience a psoriasis flare-up, such as the Koebner phenomenon.

The National Psoriasis Foundation features a gallery of tattoos for people with psoriasis on its website.

The participants share their stories about how they decided to get their tattoo, including the process of choosing where to put the tattoo and the effect, if any, it had on their psoriasis.

A person with psoriasis may wish to speak with a doctor before getting a tattoo. They will consider individual symptoms and may offer specialist advice on safety, warning signs, and aftercare.