Decorative tattooing has been around for thousands of years; a symbol of distinction and social rank in some cultures. In the last 20 years, tattooing has become more mainstream and people of all ages are getting them in the United States and other western countries. Because of the rise in popularity of tattoos, dermatologists are seeing a growing number of tattoo-associated skin reactions (not to mention, people with “tattoo-regret” requesting laser removal).
Tattoo reactions include various types of allergic reactions to the ink dyes and skin infections caused by staphylococcal bacteria (so-called “staph infections”) or myco-bacteria. Such reactions occur in response to piercing of the skin with needles impregnated with various pigment dyes.
Infections are not very common, especially with western standards of hygiene. It is however, normal to have short-lived redness and swelling of the area after tattooing (usually lasts 1-2 weeks).
Tattoo dyes are made from different materials. For example, the red
color comes from mercury, the green from chromium, the yellow from cadmium, and
the blue from cobalt. The dye is picked up partly by macrophages followed by connective tissue remodeling which traps the pigment from dispersing.
Allergic reactions to red dye occur more often than
allergic reactions to any other color, particularly those made from mercury sulfide (cinnabar). Allergic reactions may cause swelling, itching, weeping, rashes, scaling, or even soreness. In the photo seen below, this patient had an allergic reaction to the red dye in her tattoo. She came to see me in the clinic and was complaining of itching and inflammation at the site of the tattoo. I prescribed her a high potency topical corticosteroid ointment and her symptoms resolved shortly thereafter.
Henna is relatively safe but sometimes it's mixed with paraphenylenediamine. Paraphenylenediamine (PPD) is commonly added to henna to blacken the pigment and speed up drying time. Some people develop allergic contact dermatitis to the PPD in Henna (see images below).
Henna tattoos are temporary tattoos where henna dye is painted onto the skin with a brush (see below).
Henna is relatively safe but sometimes it's mixed with paraphenylenediamine. Paraphenylenediamine (PPD) is commonly added to henna to blacken the pigment and speed up drying time. Some people develop allergic contact dermatitis to the PPD in Henna (see images below).
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