Tattoos are a prevalent form of body modification, as they allow for self-expression through permanent art. However, while it doesn’t take much to get a tattoo, there’s a lot of effort required in taking care of the ink both proactively before your appointment and diligently during the aftercare process. And if you don’t put in that effort—by choosing an unsafe tattoo studio or neglecting your fresh ink, for example—several serious risks could arise that could ultimately harm you and your tattoo.
We enlisted two dermatologists, Joshua Zeichner, M.D. of Zeichner Dermatology and New York-based Michele Green, M.D., to weigh in. Here are the five most important tattoo risk factors to know before making your next appointment.
Something that many people don’t think about when getting a tattoo is that it’s completely possible to be allergic to your new ink.
“Allergic reactions to tattoo pigments are rare, but more commonly occur with colored pigment as opposed to black pigment,” says Zeichner.
Tattoo allergies are triggered by pigment ingredients like dyes or metallic substances, particularly in red ink. Your body can register these materials as foreign invaders and attempt to reject them in an immune response. To be safe, talk to your tattoo artist about the inks they use and do your research to ensure that the ingredients are generally safe and work for your body.
If you have a mild allergic reaction, you may experience rashes or bumps, skin flaking, swelling, scaly skin, redness, irritation, and itching. However, a more severe one may cause hard, bumpy tissue, a fever, intense itching or burning, and oozing pus. While you may make it out of the aftercare period without seeing any of these symptoms, that doesn’t necessarily mean you’re in the clear. “The allergic reaction can even occur years later after you get a tattoo,” says Green.
Although it’s uncommon to have an allergic reaction to a tattoo, “if it does occur, it can lead to scarring,” says Green. While scarring may feel like a normal part of a tattoo, it’s actually a side effect to watch for. There are many causes of scarring aside from allergic reactions, including issues during healing, scratching at a new tattoo, an infection, or even tattoo removal.
Tattoo scarring looks similar to healing; slightly red skin and inflammation are the first signs, but they’re also common and non-harmful effects of new ink. However, the way to tell is to track how long these symptoms persist. If you observe them after your tattoo has fully healed, you may also see a scar. Watch out for raised linework, distortion of the skin, and unusual coloring, as well, as they tend to be signs of scarring.
One of the most serious risks of getting a tattoo is an infection, which typically causes a red, bumpy, painful reaction.
“The infection can range from something as simple as warts to something more serious such as bacteria such as Staph or MRSA, mold, cutaneous tuberculosis, Hepatitis B, or HIV,” says Green.
Methicillin-resistant Staphylococcus aureus (MRSA), a type of staph infection that doesn’t respond to typical antibiotics, is especially concerning, considering there are documented cases of the infection being transferred during a tattoo session. There’s a heightened risk due to its ability to transfer quickly; it can be spread through skin or tool contact without being detected.
The best way to prevent MRSA—and really any infection—is by being proactive in choosing a safe studio and an experienced artist. Many serious infections are caused by tattoo instruments that have not been properly sterilized or safety guidelines that aren’t followed. Before getting inked, visit the tattoo studio to ensure that stations are being regularly cleaned, only single-use needles are being used, and that your artist is familiar with the Universal Precautions required by law.
Infections may also be caused by other symptoms that have been ignored, so keep an eye on your tattoo while it’s healing; the aftercare process requires more than just washing your new ink. If you spot swelling, pain, redness, or pus around the tattoo site, or if you develop a fever, consult a medical professional.
While it’s extremely rare for tattoos to affect your liver, it is a possibility. If you’re someone who has gotten tattooed a lot, you may have inadvertently exposed your body to toxins that can strain the liver, as well as other detox organs. These poisonous metals, like lead and mercury, are sometimes present in ink used by tattoo artists—particularly in colored inks like yellow or red. In decent amounts, these toxins can affect cognitive functions and generally damage our health, even going so far as to cause liver enzymes usually only present in those with liver failure.
To avoid accidentally poisoning your body, communicate with your artist to ensure they’re using safe, nontoxic pigments, as well as keeping their workplace safe and sterile. If you’re anxious, you can always consult a medical professional about your organs' proficiency or any possible effects of past tattoos before getting inked.
While not a physical side effect, it is important to consider that you may later grow to regret getting tattooed. Getting one from an inexperienced artist or committing to a design you don’t love may cause you to consider a cover-up or removal in the future—both of which require more time, decisions, and money. Tattoo removal, in particular, is a more involved process, taking anywhere from five to 15 sessions to be completely removed. It also comes with a handful of risks on its own, including infection, hyper- or hypo-pigmentation, and scarring.
“Ultimately, even with tattoo removal, your skin may never look the same again,” says Green.