The main areas of concern when it comes to tattoos related to areas like skin damage, infection and from contaminated tattoo ink. Other concerns include allergic reaction to tattoo dyes, which may develop years later; skin infection; the development of nodules of inflamed tissue called granulomas around the tattoo site; formation of keloids, which are overgrowths of scar tissue; and with blood-borne diseases.
Of course some tattoo parlours are operated to a very high standard and will source their inks from established companies with effective quality control, as well as training their tattoo artists in rudimentary hygiene and aseptic techniques. Other emporia may not be as well managed and there can be an element of risk. Some of the risks are examined below.
Skin damage
The act of having a tattoo can cause skin damage. These include wounds, skin damage, over-exposure of pigment. Sometimes these tattooist-associated tattoo complications arise due to the use of unsanitary equipment or when the tattooist is fatigued.
Research suggests that certain colours that form the pigments used, especially red or similar colours such as purple, pink, and orange (aromatic azo-dye derivatives), cause more problems and damage compared to other colours. There are also concerns about the reaction between red pigmented tattoos, ultraviolet light and the formation of skin cancer (the result of the production of toxins due to photochemical cleavage).
There are also issues with the tattoo removal processes, such as pain, blistering, crusting, skin pigmented changes. The skin of the tattoo remover and the type of laser used are significant in terms of minimizing damage.
Infection
Infections from poor executed tattoo procedures have raised questions about the adequacy of prevention efforts implemented at the tattoo-parlour level. Of concern are pyogenic bacteria that can cause
infections shortly after the tattoo is made. As well as infections associated with wound healing, microorganisms can also find their way into the body during the healing phase of a tattoo, in relation to the way wounds health.
Also, the entry of the needle can cause infection, transferring environmental contamination or organisms from the tattooist – remember, tattoo artists are not healthcare professionals when it comes to aseptic techniques.
Contaminated ink
With contaminated ink this can lead to surface infections of the skin. Microbiological surveys indicate that tattoo inks vary in their quality by manufacturer and region. One review of a range of inks assessed the contamination rate at 10 percent of bottles (plus a typical contamination rate of 17 percent of previously used stock bottles).
Of course, not every infected bottle leads to a person getting an infection. However, based on published surveys, between 0.5 percent and 6 percent of the people with a tattoo experienced infectious complications after being tattooed.
The most common contaminants are species of Bacillus, which represent almost half of the organisms isolated. This organism is associated with the general environment. Among those organisms considered to be clinically relevant are Pseudomonas aeruginosa, Dermacoccus barathri and Roseomonas mucosa. By clinically relevant, this means bacteria that are capable of causing human skin infections.
As to why these issues can occur, this relates to there being very few controls or regulations surrounding tattoo inks. Furthermore, there is not often a high-level of oversight over the hygienic practices of tattoo shops.
