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An in-depth examination of the short-term and long-term health effects of temporary or permanent tattoos, as described in published case studies and a large population study involving more than 11,000 participants over 10 years.
You've no doubt noticed that the popularity of tattoos has grown astronomically in recent years.
It has become somewhat acceptable even in professional settings, which was definitely not the case when I worked in corporate America.
I've wanted to write an article about the health effects of tattoos for years, but put it on hold until major research on the long-term health effects was finally published.
Common sense would seem to suggest that tattoos are unsafe, but even without specific, published studies, many people continue to get tattoos without a second thought. The same applies even to people who are interested in their health.
Let's take a closer look at the health effects of tattoos and what major population studies have revealed about their long-term risks.
This is especially important because getting a tattoo is usually a permanent decision.
How many people have tattoos?
According to the most recent Pew Research conducted in 2023, 32% of American adults have a tattoo and 22% have at least one tattoo. (One)
Not surprisingly, most people who get tattoos are younger.
About 41% of people under 30 have at least one tattoo, and slightly more (46%) of people ages 30 to 49 have a “tattoo.” (2)
This suggests that the popularity of tattoos is starting to decline slightly, with younger millennials and Gen Z more often choosing not to have tattoos.
What really surprises me is how many health conscious people have full sleeve tattoos, a common sight on people shopping at health food stores or farmers markets.
This indicates, to me at least, that while people get tattoos for a variety of reasons, it is often a sign of a rebellious spirit, although research is lacking!
short-term health risks
When it comes to short-term health risks from tattoos, the most obvious are contaminated needles and ink.
According to the CDC, poor infection control while tattooing or piercing can result in the spread of infectious diseases, especially hepatitis C.” (3)
Therefore, it is of the utmost importance that you only get tattooed at a licensed, reputable tattoo facility with proper hygiene practices.
Long-Term Tattoo Dangers
What about the long-term health risks from tattoos?
Of course, it would seem logical that injecting chemical ink deep into the skin, which often does not cause severe burns, would have detrimental health effects.
In the end, it certainly is.
rich in chemicals
Tattoo ink contains a variety of toxic chemicals. Depending on the color and ink manufacturer, these include:
- Neurotoxic formaldehyde
- heavy metal
- Hormone-disrupting phthalates
- antifreeze
- printer toner
- Metal salts (oxides, sulfides, selenides)
- carcinogenic amines
- Chemicals Used in Car Paint (No Kidding)
The most shocking thing is that the FDA does not study or even regulate what ingredients are allowed in these dyes!
Because of other public health priorities and a lack of previous evidence of safety concerns, the FDA has not traditionally regulated tattoo inks or the pigments used in them. (4)
The fact that tattoo materials and manufacturing are not regulated was probably the biggest shock to me while doing research for this article.
For example, a 2011 study found that 10% of unopened bottles of tattoo ink were contaminated with bacteria. (5)
The FDA plans to issue contamination warnings and guidance to tattoo ink manufacturers, but as of this writing, safety regulations are not yet in place.
Amazing changes in the way your skin sweats
A 2017 study found that compared to natural skin, tattooed skin produces about 50% less sweat.
Maurie Luetkemeier, a physiology professor at Alma College in Michigan, also found that the salt concentration in sweat from tattooed skin was much more concentrated. (6)
When sweat glands produce sweat, the skin tends to reabsorb sodium and other electrolytes from the sweat before it appears on the skin's surface.
This study may indicate that tattoos may partially block the body's reserves of important electrolytes and may contribute to deficiencies.
People with small tattoos are unlikely to experience significant changes, but people with larger skin with tattoos may be at serious risk of mineral depletion.
This important study indicates a need for people with tattooed skin to increase their intake of mineral-rich sea salt.
Anecdotally, a good way to counteract this may be to actively increase electrolytes through daily pure water intake.
Increased risk of melanoma
In the past, there were only case studies of people developing cancer from tattoos.
In one such study, men with multicolored tattoos developed malignant melanoma only in the area marked with red ink. (7)
Other small case studies have shown that skin cancer can occur during the actual tattooing process.
The tattooing process involves incorporating metal salts and organic dyes into the dermal layer of the skin. The low-grade chronic inflammation that can result can stimulate “malignant transformation.” (8)
Finally! Large population survey of tattoo health risks
Although the short-term risk of infection from dirty needles and contaminated ink is concerning, along with a few case studies of skin cancer, the fact is that most people who want to get a tattoo will not be deterred until long-term studies are published.
In June 2024, this highly anticipated study was finally published online in the Journal. eClinical Medicine Peer-reviewed and published lance. (9)
The large population study group consisted of 11,905 individuals and identified all cases of malignant lymphoma diagnosed in individuals aged 20–60 years between 2007 and 2017 in the Swedish National Cancer Registry.
Tattoo prevalence was 21% in cases and 18% in controls.
Inked individuals had a significantly higher adjusted risk of overall malignant lymphoma.
The risk of lymphoma was highest in individuals who had less than 2 years between the time of their first tattoo and the year of the study.
The risk decreased for intermediate exposure periods (3 to 10 years), but the risk increased again for individuals who had their first tattoo more than 11 years before the study year.
The most important data to me from this study is that there is no evidence that risk increases with greater area of total body surface tattooed.
So whether you have one small tattoo, permanent makeup, or a full sleeve, the increased risk of malignancy is the same.
The risk associated with tattoo exposure appears to be highest for diffuse large B-cell lymphoma and follicular lymphoma.
Studies have shown that exposure to inked skin increases the risk of malignant lymphoma, and the size or number of tattoos does not matter.
What about temporary henna tattoos?
Permanent tattoos have demonstrated short-term and long-term health risks that are now documented in published literature, but what about temporary tattoos using natural henna ink?
Unfortunately, the ink in henna tattoos contains paraphenylenediamine (PPD), a dark brown dye, and other toxic chemicals. (10)
That means henna isn't the only thing that goes into temporary tattoo ink!
PPD in henna tattoos can cause delayed allergic reactions and hypersensitivity reactions, which can permanently prohibit the use of some personal care products such as sulfa antibiotics, PABA sunscreens, benzocaine, and hair color.
Fragrance sensitization may also occur. In some cases, it can cause skin necrosis, scarring, and hypopigmentation.
So while henna tattoos are likely better than permanent tattoos, they carry their own health risks and are not the “natural” tattoos they are sometimes claimed to be.
What if I already have Tats?
For those who already have one or more tattoos and are regretting their decision, Dr. Peter McCullough MD suggests active surveillance for signs of developing lymphoma.
These include new, persistent rashes, fever, night sweats, recurrent illness, or swollen lymph nodes that do not resolve. (11)
An additional suggestion is to eat and live as cleanly as possible by implementing a consistent detoxification protocol to protect your body from excess toxins that can overwhelm your lymphatic system.
Although tattoo removal may be helpful, as of this writing, there is no solid research supporting tattoo removal as anything more than a cosmetic procedure.
References
(1, 2) 32% of Americans have tattoos, 22% of whom have at least one tattoo.
(3, 7, 8) Hidden dangers of tattoos
(4, 10) The truth about tattoos: health risks, toxicity, and more
(5) Microorganism status and product labeling of 58 types of genuine tattoo ink
(6) Skin tattooing changes sweat production and Na+ concentration.
(9) Tattoo as a risk factor for malignant lymphoma (population-based controlled study)
(11) Tattoos linked to increased risk of lymphoma
