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Think Before You Ink: Are Tattoos Safe?

December 23, 2007

As the popularity of tattoos continues to grow, so does the 
concern about potential risks. Some risks, such as the 
spread of infections through the use of unsterilized 
needles, have long been known. But what isn't clear is the 
safety of tattoo inks. 
 
Permanent tattoos are made by using needles to inject 
colored ink below the skin's surface. Permanent make-up is 
considered a permanent tattoo that mimics the results of 
cosmetic products such as an eyebrow pencil, lip liner, 
eyeliner, or blush.  
 
While state and local authorities oversee the practice of 
tattooing, ink and ink colorings (pigments) used in tattoos 
are subject to FDA regulation as cosmetics and color 
additives. However, because of other public health 
priorities and a previous lack of evidence of safety 
concerns, FDA has not traditionally regulated tattoo inks 
or the pigments used in them.  
 
FDA has received reports of bad reactions to tattoo inks 
right after tattooing or even years later. Some people 
report itchy or inflamed skin around their tattoos in the 
summer when they've been out in the sun. Recent reports 
associated with permanent make-up inks have prompted FDA to 
study tattoo ink safety.  
 
"Our hope is to get a better understanding of the body's 
response to tattoos and their impact on human health, and 
to identify products at greatest risk," says Linda Katz, 
M.D., M.P.H., Director of FDA's Office of Cosmetics and 
Colors in the Center for Food Safety and Applied Nutrition. 
 
What are the Risks?  
 
• Infection – Dirty needles can pass infections, like 
hepatitis and HIV, from one person to another. 
• Allergies – Allergies to various ink pigments in 
temporary tattoos have been reported and can cause 
problems. 
• Scarring – Unwanted scar tissue may form when getting or 
removing a tattoo. 
• Granulomas – These small knots or bumps may form around 
material that the body perceives as foreign, such as 
particles of tattoo pigment. 
• MRI complications – People may have swelling or burning 
in the tattoo when they have magnetic resonance imaging 
(MRI). This happens rarely and does not last long. 
 
Tattoo Ink Research 
 
In a laboratory within FDA's Arkansas-based National Center 
for Toxicological Research (NCTR), research chemist Paul 
Howard, Ph.D., and his team are investigating tattoo inks 
to find out 
• the chemical composition of the inks and how they break 
down (metabolize) in the body; 
• the short-term and long-term safety of pigments used in 
tattoo inks; 
• how the body responds to the interaction of light with 
the inks. 
"There have been no systematic studies of the safety of 
tattoo inks," says Howard, "so we are trying to ask—and 
answer—some fundamental questions." For example, some 
tattoos fade over time or fade when they are exposed to 
sunlight. And laser light is used to remove tattoos. "We 
want to know what happens to the ink," says Howard. "Where 
does the pigment go?" 
 
NCTR researchers are exploring several possibilities: 
 
• The body cells may digest and destroy the ink, just as 
they rid the body of bacteria and other foreign matter as a 
defense against infection. NCTR studies show that a common 
pigment used in yellow tattoo inks, Pigment Yellow 74, may 
be broken down by enzymes, or metabolized. "Just like the 
body metabolizes and excretes other substances, the body 
may metabolize small amounts of the tattoo pigment to make 
it more water soluble, and out it goes," says Howard.  
• Sunlight may cause the ink to break down so it is less 
visible. NCTR researchers have found that Pigment Yellow 74 
decomposes in sunlight, breaking down into components that 
are colorless. The pigment components may still be there, 
says Howard, and we don't know if these are potentially 
toxic. 
• The skin cells containing the ink may be killed by 
sunlight or laser light and the body may excrete the dead 
cells or may disperse ink breakdown products through the 
body. 
 
Research has also shown that some pigment migrates from the 
tattoo site to the body's lymph nodes, says Howard. Lymph 
nodes are part of the lymphatic system, a collection of 
fluid-carrying vessels in the body that filter out 
disease-causing organisms. Whether the migration of tattoo 
ink has health consequences or not is still unknown. NCTR 
is doing further research to answer this and other 
questions about the safety of tattoo inks. 
 
Tattoo Tips for Consumers 
 
Ink:  
• FDA has not approved any tattoo inks for injection into 
the skin, and many ink pigments used are industrial 
strength colors suitable for printers' ink or automobile 
paint. 
• The use of henna in temporary tattoos has not been 
approved by FDA. Henna is approved only for use as a hair 
dye. Similar to other inks, the use of ultraviolet (UV) ink 
for glow-in-the-dark tattoos also has not been approved by 
FDA.  
 
Permanence:  
• Consider tattoos permanent. Removal is time-consuming, 
costly, and doesn't always work. The most common method of 
tattoo removal is by laser treatment, which delivers short 
flashes of light at very high intensities to the skin to 
break down the tattoo ink. FDA allows several types of 
lasers to be marketed for tattoo removal. Some color inks 
are harder to remove than others. Many repeat visits every 
several weeks may be required to remove a tattoo, and it 
may never be entirely gone. 
• Do not buy or order online do-it-yourself tattoo removal 
products. These acid-based products are not FDA-approved 
and can cause bad skin reactions. 
• Consult your health care provider—not a tattoo parlor—if 
you want a tattoo removed. The American Society for Laser 
Medicine and Surgery can help you find a doctor experienced 
in tattoo removal. 
 
Don't Avoid an MRI: 
• If you need to have an MRI done, don't avoid it. Inform 
the radiologist or technician that you have a tattoo so 
appropriate precautions can be taken. 
 
Source: FDA