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Wednesday 5 January 2011

Tattoo-associated skin reactions


Hello! My name is Al Girvan. When people ask me what I do to keep active and I tell them I work on my cook-book and websites, they give me a blank look. Most days I do spend time working on my hobby websites and I also spend some time in our games room; where I am presently conducting clinics to give beginners a proper foundation in the techniques of pool. And, these activities do serve to keep both my body and mind active. Isn't that a lot better than; as many people do, spending ALL my life watching TV or playing computer games.

My blogs are not commercial in nature. This isn't a commercial project and is only intended to benefit everyone on the internet.  If you feel that posting any images violates or infringes on any copyright or trademark rights, please notify me immediately and I will remove the image(s) and or link to the owner. Anything so posted amounts to FREE ADVERTISING for that owner and site.

I DO NOT OWN ANY OF THIS MATERIAL AND MAKE NO SUCH CLAIM. BECAUSE IT IS MY BELIEF THAT ANYONE THINKING ABOUT GETTING A TATTOO SHOULD BE AWARE OF WHAT THEY ARE GETTING THEMSELVES INTO AND THE POSSIBLE SIDE EFFECTS; I HAVE POSTED THIS BRIEF SUMMARY. FOR MORE INFORMATION, OR TO VIEW THE FULL, ORIGINAL, COPY RIGHTED VERSION GO TO:http://www.google.ca/m/search?site=images&source=mog&hl=fr&gl=ca&client=safari&q=tattoo%20reaction

Decorative tattooing has been practised (some would have you believe, even in the Americas; but then, how would anybody  actually know?) for thousands of years. In primitive times it was used for embellishment, whilst in some customs and cultures tattooing represented a sign of distinction or social rank. This remains the case today with some cultures; however, it has also become popular with everyday people of western countries in the last 10-20 years.
With the rise in number of people with tattoos in today's society, an increase in the number of tattoo-associated skin disorders can be expected. Reactions that may occur include acute inflammatory reactions, eczematous hypersensitivity reactions, photo-aggravated reactions, granulomatous reactions, lichenoid reactions and pseudolymphomatous reactions. 

Carla McPhie of Ajax, Ontario, thought that getting her tongue pierced would be fun, until it caused a brain infection 10 months later. She began getting throbbing headaches, eventually fell into seizure and was rushed to hospital where she had a large piece of her skull removed to treat a brain abscess.


While this is an extreme case, the rate of infection in Canada from tattoos and piercings is relatively high. It is caused by the breaking of the skin, which usually protects the body from being infected by bacteria. This may happen through the use of a contaminated needle or by bacteria entering the body through the break in the skin.

Although the punctures are not USUALLY as deep, because tattooing pierces the skin a far, far greater number of times; more infections have been reported after tattooing than after body piercing. Piercing and tattooing have both transmitted diseases such as Hepatitis B, Hepatitis C, HIV/AIDS, warts, herpes, toxic shock syndrome, skin tuberculosis, inoculation leprosy, and bacterial skin infections.

Other problems include allergies to tattoo pigments, reactions to metals in body jewellery and scar tissue formation. Malignant melanoma, a type of cancer, HAS BEEN LINKED TO TATTOOING.

Acute inflammatory reactions

This reaction is in direct response to the piercing of the skin with needles impregnated with highly poisonous, pigment dyes prepared from metal salts. There may be transient redness and swelling of the area that disappears within 2-3 weeks. It is an expected side effect of the tattooing process.

Skin infections

Skin infections are not common after tattooing. Impetigo, cellulitis, herpes simplex and viral warts are concerns. Transmission of syphilis, leprosy, viral hepatitis and HIV have all been reported.

Eczematous hypersensitivity reactions

The two most common hypersensitivity reactions to tattoo pigments are allergic contact dermatitis and photoallergic dermatitis. The reaction usually appears as an inflamed red rash or may sometimes be scaly and flaky (exfoliative dermatitis). Red tattoo pigments cause the most reactions, particularly those made from mercury sulfide (cinnabar). Hypersensitivity reactions to pigments used to make black, blue and green tattoos are much less common.
Composition of Tattoo Pigment Colours
ColourComposition
Red
  • Mercury sulfide (cinnabar)
  • Ferric hydrate (sienna)
  • Sandalwood
  • Brazilwood
Black
  • Carbon (India ink)
  • Iron oxide
  • Logwood
Brown
  • Ferric oxide
Blue
  • Colbalt aluminate
Green
  • Chromic oxide
  • Lead chromate
  • Phthalocyanine dyes
Yellow
  • Cadmium sulfide
Purple
  • Manganese
  • Aluminium
White
  • Titanium oxide
  • Zinc Oxide
Contact dermatitis has also been reported in people with henna tattoos. Henna tattoos are non-permanent tattoos where henna dye is painted onto the skin with an artist's brush resulting in a brownish stain. Henna itself should be safe, but the dye is often mixed with paraphenylenediamine (PPD), a chemical substance that is well known for causing allergic reactions in people sensitive to it. In this case the dye is black in colour, so-called black henna.

Photo-aggravated reactions

Yellow tattoos created from cadmium sulfide are at most risk of causing hypersensitivity reactions when they are exposed to sunlight. Swelling and redness develop around the tattoo site. This phototoxic reaction caused by cadmium sulfide can also occur in red tattoos, as trace amounts of cadmium are added to brighten red tattoo pigment.

Granulomatous reactions

The term granuloma refers to the particular kind of cells that cause the reaction. A foreign body reaction to pigment may cause raised red bumps at the site of the tattoo that are made up of epithelioid cells, lymphocytes and a few giant cells. Most commonly red, but also, green, blue and purple pigment tattoos have been associated with granulomatous reactions.

Lichenoid reactions

These types of reactions are much less common than eczematous hypersensitivity reactions. Their signs and symptoms are the same as those in lichen planus, although the reaction is usually confined to the red parts of the tattoo. Hence, red pigment is responsible for most lichenoid tattoo reactions.
Lichenoid reaction to red pigment of tattoo

Pseudolymphomatous reactions

These are usually the result of a delayed hypersensitivity reaction to tattoo pigment. Again, red pigment is the main cause but it has also been reported with green and blue pigments. Pseudolymphomas caused by tattoo pigment are characteristically plum to red coloured nodules and plaques. They need to be clinically distinguished from cutaneous lymphomas that may be the cause of serious malignant conditions.

Removal of tattoos

Tattoos are most often treated with Q-switched lasers. In most cases, 5 to 12 treatments are required, at 6 to 8-week intervals. Complete clearance is not always possible.
The laser may be selected according to the colour of the tattoo pigment:
  • Nd:YAG (1064 nm) for black and blue pigment
  • Alexandrite (755nm) for black, blue and green pigment
  • Ruby (694nm for black, blue and green pigment
  • Frequency doubled Nd:YAG (532 nm) for red, orange and purple pigment
  • Flashlamp-pumped pulsed dye (510 nm) for red, purple, orange and yellow pigment
White and yellow pigment appears to be the most difficult to eradicate. Complications may include:
  • Scarring
  • Unwanted colour changes including darkening of tattoo e.g. brown to black (ferric oxide becomes ferrous oxide)
  • Spreading of allergic reaction as tattoo granules disperse

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