What are the health risks of getting a tattoo?

Under the skin, the tattoo pigments interact with the immune system in ways doctors are only just beginning to understand.
PHOTO: ADOBE STOCK

SINGAPORE - While anyone can sport a new tattoo within hours, the possible biological consequences of getting the body art are less visible.

Under the skin, the tattoo pigments interact with the immune system in ways doctors are only just beginning to understand. So if you are thinking about getting a tattoo, know what is involved and understand the risks.

The tattooing process and the risks

A tattoo is permanent.

The tattoo artist uses a handheld machine with needles to pierce the skin many times, and with every puncture, the needles insert tiny drops of ink into the top layer of the skin. The inks comprise different coloured pigments suspended in a solution.

Tattooing breaks the skin, causing a small amount of bleeding and some pain because the artists usually do not use anaesthesia. Skin infections and other health problems can develop after the tattooing process. These include:

• Allergic reactions, such as an itchy rash at the tattoo site. This can happen even years after getting a tattoo. Red ink tends to trigger allergic reactions more than other colours.
• Skin infections due to contaminated ink or improperly sterilised equipment.
• Granuloma, which is an inflammation formed around tattoo ink.
• Diseases spread through blood: If equipment used to create a tattoo has infected blood on it, the client can develop diseases, including methicillin-resistant Staphylococcus aureus (antibiotic-resistant bacteria), hepatitis B and hepatitis C.

A magnetic resonance imaging (MRI) examination may trigger a burning sensation in tattooed areas with black and brown inks, which supposedly contain more iron oxide, causing the reaction, MRI technicians said. But such an occurrence is rare, said doctors. Sometimes, such black and brown tattoos can lower the quality of an MRI image.

Doctors may restrict procedures on tattooed patients

Doctors rarely refuse to treat patients because they have tattoos, but having extensive tattoos can introduce complications, leading to modified or alternative treatments to ensure patient safety.

In particular, plastic surgeons will not carry out elective procedures on patients with recently acquired tattoos near the surgical site.

Fresh tattoos are open wounds; there is an increased risk of infection and inflammation, affecting healing.

There is also a theoretical risk that inserting a needle through heavily tattooed lower back skin for an epidural or a spinal tap could push tattoo pigment particles into the spinal canal.

Dr He Yingke, a consultant with the Department of Anesthesiology at the Singapore General Hospital, said: “I do not think it is 100 per cent ‘no’. More likely, we will avoid the area with (the) tattoo and try to find a spot that is free of ink. If possible, we avoid directly puncturing into the tattoo.”

For procedures that require intravenous access, doctors may avoid a vein under an extremely dark-coloured tattoo because of poor visibility and choose another site instead.

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