How safe is your tattoo ink?

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August 26, 2016 – Before you get that dolphin tattoo on your ankle or “Mom” on your bicep, be warned: the ink used in tattoos can be harmful, even years later.

A new report has raised questions about the safety of tattoo inks used in Europe, most of which are imported from the United States. Inks contain dangerous chemicals, including carcinogens.

The report, from the European Commission’s Joint Research Centre, also identified heavy metals such as arsenic, lead and nickel, preservatives, organic compounds, bacteria and other potentially harmful substances in the inks. .

It calls for a thorough review of tattoo inks used across the EU and stresses the need for strict regulation of inks, which are also used for permanent make-up.

After the report was published, the organization asked the European Chemicals Agency (ECHA) to look further into the safety of tattoo inks.

“Tattoo inks and permanent makeup (PMU) may contain hazardous substances – for example, substances that cause cancer, genetic mutations, reproductive toxicity, allergies or other adverse health effects “, says a statement from ECHA.

Concerns accompany a rapid increase in the number of people getting tattoos. Nearly one in three American adults has a tattoo, according to a Harris poll. Four years ago, only 1 in 5 adults were inked. Two tattoo industry trade groups, the National Tattoo Association and the Alliance of Professional Tattooists, did not respond to requests for comment.

In this country, the FDA has also raised concerns about tattoo ink.

Last August, the FDA announced a voluntary recall of A Thousand Virgins inks, which were found to be contaminated with bacteria. The previous year, another company, White and Blue Lion, recalled its inks and other tattoo equipment due to contamination that could have caused sepsis, a life-threatening complication of infections. Other recalls have taken place in previous years, here and in Europe.

Other concerns the FDA raises on its website include:

  • Allergic reactions
  • Itching and inflammation when exposed to the summer sun
  • Granulomas, or small knots or bumps that form around areas where the body detects foreign material, such as pigment from tattoo ink
  • The spread of tattoo ink in the lymphatic system of the body. It is not known whether this has any health consequences.

But the FDA says it knows little about the tattoo inks used today. Tattoo inks are considered cosmetics and their color additives are subject to regulatory authority. But the agency says it did not use that authority “due to other public health priorities and a prior lack of evidence of safety concerns,” spokeswoman Lauren Sucher wrote.

“The FDA cannot identify specific components of concern at this time,” writes Sucher. “The FDA is doing research to improve our knowledge about tattoo inks and the ingredients they contain.”

Sucher declined to say whether the FDA will test color additives in the future.

“There are no color additives approved for injection as decorative tattoos,” Sucher says. “When we become aware of a safety issue associated with any cosmetic, including tattoo ink, we investigate and take appropriate action.”

For some experts, this is not enough. “The bottom line is that they’re not doing their job,” says Charles Zwerling, MD, president of the American Academy of Micropigmentation. “Tattoo ink has very, very minimal regulation. You don’t even know if the bottle is sterile. In the European study, they found 5-10% were infected with bacteria. That’s a bit frightening.

Zwerling, a North Carolina eye doctor who has studied and written about permanent makeup and tattoos for many years, says, “These new pigments coming out have never been tested and, because they’re organic, have a much higher risk of complications. .. organic pigments can cause horrible allergic reactions. We know that in medicine. It’s not new.

Arisa Ortiz, MD, director of laser and cosmetic dermatology and assistant clinical professor of dermatology at the University of California, San Diego, says red inks are particularly problematic. They can cause allergic and inflammatory reactions. “It can happen with any color, but red is the most common culprit of allergic reactions,” she says.

In one case, a patient of hers developed significant swelling and fatigue after having a lip liner tattoo, a cosmetic procedure. His condition did not improve until the tattoo was laser removed.

“The inks can cause systemic reactions when patients are allergic to whatever is in the tattoo, but there is no way to test if you are allergic to any tattoo dye because allergic reactions can occur many years later. late,” she said.

For many people who react to tattoo inks, the most common symptoms are itching, irritation and swelling, says Katy Burris, MD, dermatologist at Northwell Health in Manhasset, NY.

“Usually your immune system eventually learns to accept it, so I wouldn’t say it would be permanent, but it would probably take months to resolve,” Burris says.

No link between tattoo inks and cancer has been established, but concerns exist that carcinogens may be among the ingredients. Ortiz says she saw skin cancers develop soon after the tattoo: “Many types of coincident skin cancers have been reported, such as melanoma, basal cell carcinoma, and squamous cell carcinoma,” says -she. “When it happens so quickly, just a few weeks later, you wonder.”

The authors of the European report consider it a coincidence when skin tumors appear at tattoo sites, but they conclude that it is a link that should be investigated further.

what you can do

Should tattoos be avoided? At present, too little is known to say with certainty. Ortiz and Burris suggest making sure you really want a tattoo before you commit and finding a reputable place that keeps things clean and sterile.

Ortiz says, “At this point, it’s hard to say if the tattoo is safe. This is buyer beware.

They also point out that once you have a tattoo, it’s with you for life, for better or for worse.

“Don’t think that if you don’t like it, you can just laser it off,” Burris warns. “It’s quite expensive and quite painful to have a tattoo removed, and some colors just don’t react to lasers.”

The FDA also provides this guidance:

  • Consumers and tattoo artists should know where their materials come from and should be able to identify and contact the manufacturer in the event of side effects.
  • Be especially wary of products that are not branded or bear the name and place of business of the manufacturer or distributor.
  • If you get a tattoo, watch the area carefully and talk to your doctor if you have any signs of a rash or think you have a reaction or infection where you got the tattoo.
  • Consumers should choose a tattoo artist who is licensed and practices hygienic methods.
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