This patient’s story inspired scientists from Lund University in Sweden, who decided to investigate whether tattoos could promote lymphoma. To do this, they used data collected in the National Cancer Registry. They identified nearly 3,000 Swedish residents aged 20 to 60 who were diagnosed with lymphoma in the period 2007-2017. They sent them questionnaires asking about lifestyle factors that could increase the risk of lymphoma, such as smoking and age, and whether they had any tattoos.
Based on this data, scientists determined that tattoos may cause lymphoma, and that the risk of developing this malignant tumor is 21 percent higher. It is higher in people who have at least one tattoo compared to people who do not have such a tattoo on their body. “Tattoos, regardless of their size, cause mild inflammation in the body, which can lead to cancer,” says study co-author Christel Nielsen, an assistant professor in the Department of Occupational and Environmental Medicine at Lund University, in the journal eClinicalMedicine.
– The connection between tattoos and lymphoma seems logical. The ink is a foreign body that constantly stimulates the immune system, including lymphocytes, which develop into lymphomas – says Prof. Radosław Śpiewak from the Department of Experimental Dermatology and Cosmetology of the Jagiellonian University.
wandering cells
The professor’s patient learned how immune system cells can travel throughout the body. Irina Walika, who came to the clinic after getting a tattoo. His tattoo healed properly, but he was concerned that there was scattered pigment and lots of little dots around the drawing. It looked as if the skin around it was dirty and couldn’t be washed. It turns out that the pigment molecules have moved. – It is possible that macrophages, which are cells of the immune system, absorbed the dye and carried it to other parts of the skin – explains the professor. Walecka, Head of the Department and Clinic of Dermatology and Pediatric Dermatology at the Center for Postgraduate Medical Education, State Medical Institute of the Ministry of Internal Affairs and Administration in Warsaw, Regional Consultant in the field of Dermatology and Venereology.
Doctors have been dealing with similar problems for some time now. It has been shown that tattoos can complicate the diagnosis and assessment of the development of melanoma. – As part of the diagnosis of this cancer is called the sentinel node, which is the closest to the melanoma that was removed. The tattoo pigment molecules settle in the lymph nodes, and the melanoma cells in the “sentinel node” do not appear among the cells loaded with black pigment from the tattoo. In such circumstances, detecting melanoma cells can be very difficult or even impossible – says Prof. Singer.
The relationship between tattoos and lymphoma has not been fully confirmed. In the article, scientists from Lund wrote that more research is needed to verify whether this relationship actually exists. To date, the scientific literature contains case reports of many patients in whom cancer could develop under the influence of tattoos, but this is not enough to show that tattoos cause cancer, says the professor. Walika.
Professor Walika admits that one of these patients came to her clinic as well. After getting several tattoos, the man began experiencing skin problems that initially looked like typical lesions of atopic dermatitis. When such lesions appear in an adult, we routinely perform a biopsy to rule out lymphoma. This is what we did in this case. We took several skin samples from the patient, but the pathologist did not find anything suspicious in the histological image. After two years, the patient suffered from widespread dermatitis, severe alopecia and loss of nail plates – says the professor. Walika. Doctors again took several samples from him, which this time confirmed that he had cancer. But it is not known whether the ink components are the causative factor or whether it is a mere coincidence, says the professor. Walika.
Car paint
A common problem for people with tattoos is allergic reactions to the pigments in the inks. This mainly applies to colored pigments, which until recently consisted mainly of salts of heavy metals. – In 2017, we analyzed tattoo and permanent makeup pigments. The pigments included: chromium, manganese, titanium, iron, aluminum, barium, strontium, copper, and zirconium, – lists Prof. Singer.
In 2022, tattoo pigments became subject to EU regulation and many of these ingredients can no longer be used in tattoo inks. – Inks containing heavy metals have disappeared, but have been replaced by organic compounds whose allergenic properties will be widely reported within a few years – says the professor. singer. A patient who recently made a tattoo using a preparation that meets all today’s standards has already reached the professor. – It turned out that she was allergic to acrylates, compounds with known allergic effects, which are found not only in new mascaras, but also in many cosmetics, nail styling materials and dental materials – says the professor. singer.
Covering a large surface of the skin with drawings may impair the body’s ability to cool down and lead to overheating on hot days – Prof. Radosław Śpiewak from the Department of Experimental Dermatology and Cosmetology of the Jagiellonian University
It also happens that the tattoos are made with pigments that are not approved for use on humans. “I had a patient come to me with an inflammatory infiltrate inside her tattoo. The tattoo was literally crawling out of her skin, and there was a serous fluid coming out. I asked her to bring a sample of the pigments she used for testing. The patient brought a bottle of car paint for touch-ups,” the professor says.
Colored tattoos are also more difficult to remove than black tattoos. – There are special lasers designed to remove tattoos, but such treatment may lead to scarring, discolouration or discolouration. You should also remember that some tattoos cannot be completely removed – says the professor. Walika.
This applies primarily to large tattoos, covering large areas of skin and encircling the perimeter of the arm or leg. – Tattoos around the calf are a serious problem. As a rule, they cannot be removed surgically, because if we cut the skin around the limb, we will cut the lymphatic vessels, which can lead to peripheral lymphedema – explains Prof. Singer. In his opinion, laser removal is also questionable. – Dispersed pigments can penetrate deeper into the body, including into the lymph nodes, which can aggravate the allergic reaction – explains Prof. Singer.
Some tattoo parlors conduct allergy tests. They have to check whether the ink given does not cause an allergy in the person who will be tattooed. – But this does not guarantee that an allergy will not occur. It may appear only after some time or during the next tattoo. I have had patients who were loyal customers of the tattoo parlor, and after some time they developed an allergy, but I have also had patients who had allergic reactions to the first tattoo – says the professor. The conditions in which the tattoo is done are conducive to the development of allergies, the singer notes. – Tattooing causes tissue damage, disruption of its continuity, inflammation and mobilization of the immune system, and all this encourages the development of an allergic reaction – adds the professor. Singer.
sun and sweat
Most allergic reactions are caused by colored dyes, but black inks aren’t completely safe either. Carbon gives the ink its black color. It is neutral and is believed to have no effect on the body, but this is not the whole truth, because black ink contains adhesives that bind ink particles and increase the viscosity of the ink, such as methacrylate, which may cause allergies, says Professor Moghni.
Apart from the risk of sun allergy, black tattoos can cause a burning sensation. – Two years ago, at the European Eczema Society conference, I listened to a lecture by scientists who had conducted research on people with tattoos on Danish beaches. It turned out that most of them reported a burning sensation at the tattoo site. This is not surprising because black pigment absorbs the sun’s heat, so the tattooed skin heats up to a higher temperature [niż skóra bez rysunków – przyp. D.R.] Hence the inconvenience – says the professor. singer.
Covering a large surface area of skin with tattoos can impair the body’s ability to cool down and lead to overheating on hot days. Researchers at the University of Kentucky College of Medicine have shown that tattooed skin does not sweat as much as areas of the body that do not have tattoos. Tattooed areas emit about 15% less sweat. This may be due to damage to the sweat glands during the piercing.
bacteria and viruses
Tattoos disturb the continuity of tissue, which encourages various infections, such as hepatitis B virus – hepatitis B virus is very difficult to destroy, even with proper disinfection or sterilization. Therefore, every unvaccinated person should take into account the risk of infection – says the professor. singer.
You can also get hepatitis C in tattoo parlors, as there is no vaccine for it. – People were mainly afraid of AIDS, but HIV is very unstable. Leaving an infected needle for an hour at ambient temperature neutralizes HIV, – reassures Prof. Śpiewak, but adds that you can get infected not only with viruses inserted with a poorly disinfected needle, but also with microorganisms on the skin. – There is no chance of 100% disinfection of the skin, – adds Prof. Singer.
Most tattooed patients who visit dermatologists have a bacterial infection. – The puncture wound is red, swollen, and oozes serous fluid. The patient receives treatment with antibiotics and the infection usually disappears after a few days, reassures the professor. Walecka, but cautions against wrapping freshly made tattoos in food foil. The tattooed area must be washed and disinfected with an antiseptic, then a sterile medical bandage should be placed on the wound. People with tattoos should not sunbathe, use a sauna, or exercise intensely, for example in the gym, for two or three weeks. In general, tattoo owners should not use a solarium at all, because exposure to it leads to fading of the tattoo, advises the professor. Walika.
compromised immunity
Professor Walika advises against tattooing for people with various types of chronic skin diseases. This applies to patients with active psoriasis or lichen planus, because new lesions may appear at the injection site, and to patients with atopic dermatitis, because patients with this disease are particularly sensitive to all allergens, or to people prone to granulomas.
Contraindications also include active viral infections such as herpes and shingles, bacterial and fungal infections, pregnancy and breastfeeding, cancer during treatment, as well as uncontrolled diabetes, because people with diabetes usually have very sensitive skin, which is easy to develop and develop. Ulcers.
People with autoimmune diseases should also not decide to get a tattoo. – After the ink is introduced into the skin, the entire chain of reactions may accelerate, leading to the development of inflammation, organ damage and disruption of their functioning. We don’t even recommend fillers for patients with autoimmune diseases, because they theoretically disappear after six months or a year. Tattoos are not recommended because they remain for years and during this period they constantly stimulate the cells of the immune system – explains the professor. Some medications can also weaken the immune system, Walecka adds. This means that people who take it should not get tattoos.
