Health Risks of Tattoos and Piercings

Medical issues and health risks associated with tattooing and piercing are serious and should not be underestimated. If proper precautions are not exercised, repercussions can be risky and dangerous.

Breaking of the skin barrier is required while tattooing and piercing therefore infection and allergic reactions are very likely to occur. There are universal precautions that must be followed by all licensed tattoo artists and piercers.

Some of these precautions include sterilization of equipment and using single-use needles and ink. Tattooists are also required to have bloodborne disease training.

According to dermatologists, medical complication due to tattoo pigments in body is rare, but severe, and majority of people do not assess health risks involved before getting a tattoo or piercing. The different types of pigments used in tattoo inks should also be regulated, so as to ensure that the chemicals used in these pigments are not hazardous.

Some of the most common health-risks involved in these practices are discussed below:

  • Infection
  • Ink reaction
  • MRI complications
  • Formation of Keloids
  • Development of Granulomas
  • Haematoma
  • Lymphatic Inflammation
  • Melanoma
  • Blood thinners


Instruments used in tattooing and piercing may come in direct contact with bodily fluids as well as blood. Diseases will be transmitted if the instruments used on a person have also been used on another person without sterilization.

However, due to the universal precautions being enforced, necessary sterilization of equipment and single use needles and ink in modern tattoo parlors, the chances of infection spreading is very rare.

The chances of infection spreading are more common in prisons where amateur tattoo artists and piercers work without any sterilization units. A program was introduced in Canada in 2005 to provide legal tattooing and piercing to prisoners to avoid risk of infections. Inmates were also trained to staff these parlors and operate them.

Donation of blood is prohibited by Red Cross in the US for at least 12 months if a person has received a tattoo. However, if the procedure is done in a licensed parlor using sterile equipment, donation of blood can be made.

Those states which do not have a licensing program for tattoo artists are subjected to the 12 month prohibition, regardless of the standards of the parlor. In UK, this prohibition is for four months.

HIV, hepatitis B, hepatitis C, tuberculosis and skin infections are some of the diseases that can be transmitted if equipment used for tattooing or piercing is not sterilized properly. Risk of tetanus is also reduced by having a tetanus booster which should be up to date, prior to tattooing.

Ink reaction

Studies have described tattoo inks to be histologically nonreactive i.e. they do not react with skin on a cellular level. This is possibly because of the skin’s immune system which encapsulates pigments inside the fibrous tissue.

Allergic reactions to tattoo ink have been documented throughout the world. However, there is no overall estimate of the number of incidents of allergic reactions.

Allergic reactions to latex are much more common than reactions to tattoo ink. Artists and piercers can be requested for the use of non-latex gloves, but rare as these allergic reactions may be, they occur the most with red and yellow pigments used in tattoo inks.

Exposure to sunlight can also trigger a reaction. If a person is allergic to metals, they might react to pigments in tattoo ink with swelling of skin or itching. Pigments in red ink are more allergenic than others, therefore allergic reactions are mostly observed in red tattoos.

According to a survey, 40% of organic tattoo pigments used in Europe are not approved for any type of cosmetic use.

MRI complications

In a few cases, MRI scans on tattoos have been documented to cause burns.

This is more common in designs with large areas of black color, since black pigment contains iron-oxide. Heat up can occur if the scanner induces current in the iron present. Pigments not containing iron are also known to cause burns during MRI scans. However, these burns are very rare.

MRI complications also occur due to metal jewelry worn in piercings.

Formation of Keloids

Keloid is a thick, over-developed scar. Keloids are firm and fibrous nodules varying in color. They are benign and not at all contagious. Severe itch and pain occurs in many cases.

Development of Granulomas

Inflamed tissue in the form of nodules is called granuloma. It occurs when immune system attempts to block any substance which it sees as foreign but cannot eliminate. Both tattoo ink and jewelry worn in piercings can cause this.


It occurs due to puncturing of blood vessels during tattooing. A bruise appears which might heal within one week. Bruises can appear all around the tattoo or together as one large bruise. It’s mostly blue or black in color. Discoloration can occur if the ink spreads into the tissue layer underneath the dermal layer of skin.

Lymphatic Inflammation

When pigments move from tattoos towards lymph nodes, larger particles accumulate there causing inflammation. This occurs due to the burden on lymphatic system of the body.


Discoloration or inflammation can also visually indicate melanoma. It is a common type of skin cancer. Therefore the chances of misdiagnosis of melanoma in patients with tattoos are high so care must be exercised.

Blood thinners

Excessive bleeding can be caused by blood thinners, affecting the tattooing process. Aftercare healing can also take longer while the process of getting ink into the skin is also slowed down by increased bleeding.

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