Are You Allergic to Your Tattoo?

When I turned 40 in 1989, I rewarded myself for making it that far with my very first, and probably the only tattoo of my life, a small stylized lotus above my left collarbone in blue, yellow and hot pink. It was done by a tattoo artist in San Francisco's North Beach. I wasn't doing anything terribly radical. Tattoos have become an accepted part of our Western culture. It seems like everybody has at least one. Just yesterday at the office, a coworker showed me her new tattoo on the small of her back. She had another one just below it and a third tattoo on her right arm. Tattoos have been around for thousands of years, and most people have no adverse physical reactions to them. But getting a tattoo is not without risk, including the possibility of an allergic reaction.

Like most people, I only experienced a little pain and swelling for a short time after getting my tattoo, which is normal. Others are not so fortunate. Dyes, ointments, and the latex in the gloves worn by tattoo artists can all produce allergic reactions in susceptible people. Medically speaking, hypersensitive reactions to tattoos fall into the categories of allergic contact dermatitis and photoallergic dermatitis (caused by sun exposure).

The biggest culprit is the red pigment called cinnabar, which contains mercury sulfide. Other metal-containing pigments are less likely to cause an allergic reaction, but be aware all dyes contain metal of some kind: nickel, iron, chromium, cobalt, lead, manganese, aluminum, zinc, cadmium, titanium, and carbon. Allergies to nickel in particular are very common.

Other allergen candidates are the temporary black henna tattoos that are painted on instead of injected. The problem in this case is not in the henna but in the chemical called paraphenylenediamine (PPD) mixed in with it. PPD allergy can cause itchiness and swelling that lasts for months and a permanent hypersensitivity to dyes. Because many items of clothing contain PPD, this can be a real hassle for those with PPD-sensitive skin.

Many people have latex allergies. The skin stretching and touching involved in tattooing can produce swelling and irritation. You should inform the artist in advance if you're allergic to latex so she can wear non-latex gloves.

Another concern is the so-called A&D ointment made with cod liver oil that some artists use to cover the finished tattoo. This is a serious issue because an allergic reaction to cod liver oil can ruin a tattoo and cause medical problems that require hospitalization. Make sure your tattoo artist uses Vaseline or an antibiotic ointment if you have a fish oil allergy.

I remember that I was warned not to expose my tattoo to the sun for long periods. Not only can sun exposure fade the tattoo, but the yellow and red dyes that contain cadmium sulfide can react with sunlight and become swollen and inflamed.

An allergic reaction to red, green, blue and purple pigments can cause a granulomatous reaction, or red bumps. Other reactions to red dye are called lichenoid reactions or pseudolymphomatous reactions, which produce reddish nodules.

If you decide you're tired of your tattoo and want to have it erased by laser, you should know that white and yellow pigments are not only harder to take off, but removal can produce an allergic reaction caused by the laser-loosened tattoo granules.

All tattoo inks except for red are available in hypoallergenic versions. If in doubt, try a 24-hour dot test with the colors you want to use in your tattoo to monitor for redness and swelling. And if you decide to go for it, enjoy your tattoo! I still do.