Tattoos - skin decorations with side effects

Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.

More posts by Christiane Fux All content is checked by medical journalists.

The tattoo trend is unbroken. Driven by the desire for individuality, 15 percent of the population in this country have had themselves tattooed, and the proportion is even significantly higher among the younger ones.

But complications often follow the joyful pricking: In a British survey, one in four tattooed people reported problems, one in hundred even had to go to hospital because of it. "The list ranges from sun sensitivity to severe skin damage," says Dr. Steffen Schubert in conversation with He works for the information network for dermatological clinics for the registration and scientific evaluation of contact allergies (IVDK) in Göttingen.

Itching, blisters, scarring

The most common are allergic skin reactions, so-called contact eczema. They start out with itching and burning, followed by swelling and redness. Eventually, vesicles, crusts and nodular indurations, so-called papules, and even scars form. Schubert has already come across everything in the specialist literature - from slight courses to severe necrosis in which the skin dies deep into the tissue. "Fortunately, they are very rare," says the biologist.

A third of the color is distributed in the body

However, allergic reactions are not the only serious problem that can arise after a tattoo: "About a third of the color is distributed in the body," says the scientist. The color pigments even color the lymph nodes or the liver.

The invasion of the color pigments calls the immune system on the scene. Persistent exposure to the suspicious substances then weakens the body. Sports physicians estimate that performance losses of up to five percent could be possible for competitive athletes.

Unknown risks

It has not yet been determined whether there are any further dangers: So far, speculations that tattoos could cause liver damage or even cancer have not been confirmed. “We don't have the data for that,” says the researcher. But that cannot be ruled out either: Because what is in the tattoo inks is often unknown and sometimes toxic.

Gray area tattoo parlor

“Tattoo studios are a gray area,” warns Schubert. On the one hand, because only pigments that are also on the index in cosmetics production are prohibited. Manufacturers may use substances that are not listed there, although their compatibility has not been tested. “Most tattooed people don't know that they have components of car paint, plastic or printing ink in their body.” In addition, the ingredients of the colors are often incorrectly declared anyway. Not even an experienced tattoo artist then knows what he is punching in the customer's dermis.

Not all colors are equally risky

"Bright colors from the USA are particularly risky," says Schubert. They contain azo dyes, which have a high luminosity. At the same time, the colored pigments are particularly aggressive. And they break down into fission products that are suspected of causing not only allergies but also cancer.

The researcher also urgently advises against cheap products from Asia. They often contain preservatives and other prohibited substances.

Red color is particularly critical. The pigments it contains provoke allergies particularly often. It is followed by blue and purple, then green, orange and yellow. Black color, on the other hand, is usually better tolerated.

And even henna tattoos are risky - at least the black ones. They seem harmless because they are only applied to the skin and quickly fade again. “They contain the black hair dye p-phenylenediamine. It can cause extreme allergic reactions, ”warns Schubert. Red henna, on the other hand, which is traditionally used in many cultures for decorative skin painting, causes few problems.

Testing in advance is of little use

To protect yourself from contact eczema, a preliminary test at the tattoo artist is unfortunately not enough. On the one hand, the priest can initiate the allergy himself. The reaction only occurs after the tattoo has been in the skin for weeks.

Reactions to existing allergies also only appear after a few days. In order to reliably identify them, you also need expert knowledge as an allergist. A tattoo artist is overwhelmed with it.

Especially those who have known allergies should think twice about risking a tattoo. This applies particularly to allergies to dyes, metals and preservatives. “You should definitely inform the tattoo artist about this,” said Schubert. So he can at least try to avoid these or similar ingredients.

Lasers are not always a solution either

Not only fresh tattoos can cause discomfort, the removal of the images by laser is also tough. “The most severe allergic reactions are not caused by the dyes used, but by their breakdown products,” says Schubert. They are caused by UV rays from the sun - then previously peaceful tattoos can suddenly rebel.

Lasing has the same effect - only it is many times stronger. "Especially if you have an intolerance reaction, you should never have the tattoo removed with a laser!" Warns the researcher. This would release the allergens in a surge and then distribute them throughout the body. The alternative? "All that remains is a surgical removal and a skin transplant for large tattoos."

In the event of complaints, go to the special clinic

So what to do when a tattoo starts to rebel? “Off to the doctor,” advises Schubert. However, 80 percent of those tattooed went to their tattoo parlor instead. Only a doctor can specifically treat the complications and get serious problems under control at an early stage.

It is also important to find out what the patient was allergic to. “An allergy doesn't go away,” says the scientist. The trigger must be avoided for a lifetime in the future.

However, the standard equipment for allergy tests only contains the most common allergens. A large part of the substances made from tattoo inks simply does not appear in it. Clinics that belong to the IVDK are better equipped. A nationwide project is running there to research allergic reactions after tattoos. Therefore, one is also prepared there for the testing of unusual substances.

The patients are not only cared for professionally here. They also provide the experts with new insights into the health risks posed by tattoos. This helps to better illuminate the "gray area tattoo studio". So that other fans of the colorful skin types have to fear fewer complications in the future.

Seek help from the IVDK

Contact points for problems after tattoos are clinics in Germany, Austria and Switzerland that belong to the Information Network for Dermatological Clinics for the Recording and Scientific Evaluation of Contact Allergies (IVDK). You can find out which ones are in your area here: https://www.ivdk.org/de/ueber-den-ivdk/lösungen

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