Yikes—Tattoos Can Actually Cause Long-Term Skin Problems (and We’ve Got a Pic as Proof)

This news hurts.

If you’ve ever gotten a tattoo, you probably know that the healing process can be a little…gross. There’s often a little dried blood, scabbing, and sometimes a bit of puffiness. But it eventually goes away, leaving behind a beautiful tattoo—most of the time.

A new survey from NYU Langone Medical Center found that as many as 10 percent of adult New Yorkers have experienced some kind of skin complication from getting a tattoo. Those included a rash and severe itching or swelling that lasted longer than four months. In some cases, it lasted for several years.

For the survey, researchers interviewed 300 adults in New York’s Central Park about any skin complications they experienced as a result of their tattoo.

“I took care of enough patients who had complications from a tattoo that it made me wonder how common it is,” said study author and dermatologist Marie Leger, M.D., Ph.D., an assistant professor of dermatology at NYU.

She and her researchers captured a variety of complications, ranging from infections to reactions that came on at any time. Leger says she’s also seen delayed reaction to a tattoo in her private practice, citing one patient who developed an itchy, puffy skin reaction to red ink in a new tattoo on her foot. At the same time, the woman experienced a reaction on a red tattoo she’d had done a decade before. (Leger notes that allergies to tattoos can come on any time, just like with medications.)

Here’s a photo of an NYU Langone patient’s foot with swelling, rash, and itchiness (lasting more than a year) in response to a tattoo with red ink:

NYU Langone Medical Center

Leger found that almost half of the chronic reactions identified in her survey were to red ink. Why is red ink so problematic? It’s because the dye contains organic azo pigments and quinacridones, which are “very taunting to the skin’s immune system,” says dermatologist Cynthia Bailey, M.D., president and CEO of Advanced Skin Care and Dermatology Inc. As a result, she says, they can trigger delayed reactions.

Some people also have an increased risk of having a reaction to a tattoo, says Michael Shapiro, M.D., a board-certified dermatologist practicing in New York City. He says people with chemical sensitivities, very sensitive skin, or allergies should discuss their condition with their tattoo artist and doctor before getting inked. “If you are allergic to a particular eye shadow or lipstick, definitely discuss this with your doctor,” he says. “Sometimes the same compound found in the pigments of tattoo ink are also found in makeup formulas.”

Of course, plenty of people get tattoos and never have a problem. Brooklyn-based tattoo artist Lalo Yunda says tat-lovers shouldn’t panic at the findings, pointing out that most people who get a tattoo from a reputable establishment and follow proper care instructions never have an issue. He compares it to practicing safe sex: If you use protection and are in a monogamous relationship, you’re probably going to be okay. “But the person who is getting a tattoo drunk on the Lower East Side…those are the people who are more likely to have complications,” he says.

Yunda says people who have gotten a tattoo should keep it covered for a certain period of time (specified by your studio) and wash it regularly with antibacterial soap—just not too often or your tattoo won’t heal. “If you follow the basic instructions from your tattoo artist, you should be fine,” he says.

Leger agrees. “A lot of tattoo places really know what they’re doing,” she says. “Find a place that’s reputable, do your part to keep your tattoo clean, and make sure it doesn’t get infected. Some of the things you can definitely control.”