Psoriasis is an inflammatory condition that affects the skin. It occurs when a problem with the immune system causes skin cells to grow too quickly. This can pose challenges for a person who wishes to have a tattoo.
Tattoos are a popular form of body art. Self-expression and decoration are some reasons a person might choose to get a tattoo. For people with psoriasis, there may be extra factors to consider when deciding whether to get a tattoo and where to have it.
First of all, the presence of psoriasis on the skin can make deciding where on the body to get a tattoo more difficult.
Also, those with psoriasis have a higher risk of experiencing a reaction called the Koebner phenomenon, which can lead to tattoo-induced psoriasis.
The Koebner phenomenon commonly occurs with psoriasis. It causes psoriasis plaques to form at sites on the skin where damage or trauma has occurred. This is what can happen when someone gets a tattoo.
Psoriasis affects everyone differently, so a doctor will not be able to predict who is at risk of tattoo-related complications.
In the sections below, we discuss what a person with psoriasis may wish to consider before getting a tattoo.
A person with psoriasis who wishes to get a tattoo will need to consider several factors:
A person with psoriasis may have scale-like patches or plaques on the skin. Where these are may vary from person to person and will depend to some extent on the type of psoriasis they have.
Inverse psoriasis is most likely to occur in the folds of the skin, but plaque psoriasis — which is the most common form of psoriasis — can occur almost anywhere on the body.
When deciding where to put a tattoo, people should try to find a place where skin changes do not usually occur. However, a flare may occur when a person gets the tattoo, as an injury — such as that which the tattoo needle causes — can also trigger a new flare. How the skin will react to the tattoo is difficult to predict.
It is not possible to effectively apply a tattoo in an area that currently has scales due to the buildup of skin cells there. If a flare occurs after getting the tattoo, it may spoil the effect.
Getting a tattoo in a place where skin changes frequently occur may lead to disappointment, as the plaques may make it hard to see the tattoo.
Infection and allergy
When a person gets a tattoo, there is also a risk of infection and allergic reaction.
Tattoo needles break the skin to apply the dye. Therefore, they can introduce bacteria and other harmful germs into the skin, potentially causing a serious infection.
Also, the dyes that manufacturers use in tattoo inks can sometimes cause allergic reactions. For some people, these reactions are so severe that they have to remove the tattoo.
Possibility of refusal
Since psoriasis is an inflammatory skin process, some tattoo artists may not agree to tattoo a person with the condition.
Some artists will not apply a tattoo even if the psoriasis is not currently active. In fact, in some states, laws prohibit tattoo artists from tattooing a person with active eczema or psoriasis.
If the artist agrees to do the tattoo when symptoms are absent, the person may have to wait for some time before getting the tattoo; but for some individuals, the skin never fully clears.
Learn more about the triggers of psoriasis and some home remedies.
The Koebner phenomenon refers to the development of skin lesions following an injury to healthy skin.
It can result from a simple scratch, but it can also be a response to tattooing, especially in people with psoriasis.
For example, a person with psoriasis may choose a location for a tattoo where they have never experienced skin changes.
After having the tattoo, however, a psoriasis-like flare might occur. This typically occurs weeks later, though some people have reported reactions occurring later still.
A 2013 paper in the journal CMAJ cites figures suggesting that around 25% of people with psoriasis will experience the Koebner phenomenon after sustaining a skin injury such as a tattoo.
In the Koebner phenomenon, symptoms usually only affect the area where skin damage has occurred. It is not an infection, and it is not contagious.
Doctors do not fully understand why the Koebner phenomenon occurs. They know that it is common in people with psoriasis, but they cannot predict who will experience it after getting a tattoo and who will not.
A person with psoriasis should be aware of the risk of experiencing lesions on the tattooed area, even if psoriasis plaques have never occurred in that area before.
The Koebner phenomenon is a temporary change. Treatments that are suitable for other types of psoriasis can usually help resolve it.
Skin trauma is a common trigger for psoriasis. Other triggers include stress, excess sun exposure, and smoking.
A person with psoriasis should remember that they have a higher risk of experiencing a flare after having a tattoo.
They also need to consider the same risks that a person without psoriasis does when getting a tattoo. For example:
Cross-contamination: There are strict rules for sanitizing tools and needles, but there is no guarantee that every tattoo artist will follow them. If a tattoo artist reuses a needle or does not keep needles in a sterile condition, a person can contract a serious illness, such as HIV, hepatitis B or C, or tetanus.
Ink contamination: In the past, companies have recalled some products due to bacterial contamination.
Anyone who gets a tattoo should follow the aftercare instructions from their tattoo artist and know how to identify symptoms that need follow-up care.
Some signs of an infection include:
- fever and chills
Skin symptoms from a tattoo should improve with time, not worsen. If symptoms worsen, it is important to see a doctor or dermatologist.
Learn more about tattoo aftercare here.
Questions to ask before getting a tattoo
Before getting a tattoo, a person should ask the tattoo artist about their sanitation techniques and how they keep their equipment clean.
For example, every tattoo parlor should have a machine called an autoclave that sterilizes instruments at ultra-high heats. Staff should always wear gloves during this procedure.
Also, the artist should place tattoo inks in a single-use cup and throw them away after completing a tattoo.
A person may also wish to ask to observe how the tattoo artist prepares the instruments before getting a tattoo. They do not have to agree to this step, but if they do, it can provide peace of mind for some people.
It may also be worth asking which brand and colors of ink the tattoo artist will be using. Then, a person can check whether there are any active recalls on the product.
Getting advice on safety and healing
A person should also ask and follow the tattoo artist's advice on how to prevent infection and promote healing after getting the tattoo.
A person with psoriasis may wish to ask their doctor or dermatologist about getting a tattoo before going ahead. They will be able to take the individual's symptoms into consideration and offer specialist advice on safety precautions, warning signs, and aftercare.
People with psoriasis have to take a few things into consideration before getting a tattoo. For example, they should carefully consider the location of the tattoo and be prepared to experience a temporary psoriasis-like flare called the Koebner phenomenon.
Many people with psoriasis have tattoos. The National Psoriasis Foundation feature a gallery of tattoos for people with psoriasis on their website.
The participants share their stories about how they decided to get their tattoo, including the process of deciding where to put the tattoo and the impact, if any, it had on their psoriasis.