In line with the presumed pathophysiology, chronic allergic tattoo reactions occur months or years following body art completion. They typically present as, localized to the red tattoo area, swelling, granulomas, ulceration, pruritis or hyperkeratosis [4,5,13].
It is possible to have reactions to the inks or the metals in the needles used in tattoos, causing swelling and even damage to the skin tissue itself. Allergies to the red dyes are most common.
Tattoo ink can cause allergic skin reactions, such as an itchy rash at the tattoo site. This can happen even years after getting a tattoo. Red ink tends to be more prone to allergic reactions that other tattoo ink colors.
Allergic Reactions
The area around your tattoo might itch or swell, or you could get a rash. It can happen right after you get the tattoo, or years later. If it's mild -- itchy skin and a few bumps -- treat it with a steroid cream. If your reaction is worse or if doesn't go away in a couple of weeks, call your doctor.
Over time, some of the ink particles can be broken down by the body's immune system and absorbed by macrophages, a type of white blood cell. This process can lead to some fading of the tattoo over the years. However, most of the ink remains in the skin, and tattoos are designed to be permanent.
In conclusion, a growing body of evidence suggests a possible role of some tattoo ink compounds as triggers for the immune system, and the lack of extensive studies on different autoimmune diseases does not allow physicians to advise patients with consistent data.
Allergic reactions to tattoos are generally due to an immune response to the ink used. Symptoms can range from mild to severe. Mild symptoms include itchiness, redness, and minor swelling around the tattooed area. Severe allergic reactions might cause hives, angioedema, and even anaphylaxis in rare cases.
Tattoo-associated sarcoidosis with severe uveitis is a condition where inflammation is usually restricted to the tattooed area and the uveal region but lung involvement, including lung nodule and lymphadenopathy, is also reported. This sarcoidosis phenomenon was first published in 1969 with three case reports.
Some infections occur shortly after getting a tattoo. Others develop over time, and you might not notice them until months later.
Granulomatous reactions
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.
An allergy specialist can usually diagnose tattoo ink allergies with a patch test. Patch testing is used to test allergic reactions on your skin. During the patch test, a small amount of the substance is placed on a patch that is then applied to your skin. Positive reactions can be immediate or delayed.
Tattoos inevitably fade. Tattoo fading originates either from light induced decomposition in tattooed skin or from pigment transportation to other anatomical locations in the body via lymphatic system. Migration of pigments via macrophages may explain why lines become blurry.
While tattoo allergies are quite rare, there is a possibility of serious health consequences. The reaction can be seen immediately in some cases but often does not present a reaction until 48 hours or even a few weeks after getting the tattoo. In rare cases, it could happen months later.
Tattoo pigment can precipitate many inflammatory states. The skin is the most common site of inflammation, but tattoo ink can become disseminated and cause systemic inflammation. Granulomatous reactions are a rare type of tattoo reaction, often caused by black tattoo ink, and are challenging to manage.
Tattoos (even older, healed ones) can pose a risk of infection, and sudden inflammation can be an indicator of that. "As with all tattoos, infections can happen, both immediately and delayed, as can other reactions to the tattoo pigment itself," Dr. Marchbein explains.
[9,10] Chronic allergic reactions to tattoo ink are the most common chronic tattoo reaction. These reactions can even occur months to years after getting the tattoo.
Granulomas and Sarcoidosis
A granuloma on the skin may look like a lump of tissue. It's thought that the granulomas form around the ink used in tattoos.
Sarcoidosis of the skin can look many ways. The most common lesions are small bumps and broad, raised skin lesions. They are often red-brown or purple, but can also be flesh colored or shades of tan or brown. They can be smooth or rough.
Tattooed individuals had a higher adjusted risk of overall lymphoma (IRR = 1.21; 95% CI 0.99-1.48). The risk of lymphoma was highest in individuals with less than two years between their first tattoo and the index year (IRR = 1.81; 95% CI 1.03-3.20).
Other skin diseases can also appear within or around a tattoo. If a skin condition that appears, you'll likely see signs of the disease within 10 to 20 days of getting the tattoo. The disease can also appear as early as three days after getting inked. Sometimes, it shows up years later.
Clinical findings appeared 1 to 2 weeks following tattoo placement in all patients, and symptoms included pink, red or purple papules, papules with scales, pustules, granulomatous papules, and lichenoid papules and plaques.
The systemic absorption of tattoo inks can be divided into two phases, which relate to the solvent portion and the pigment portion of the inks. During the tattooing process, the tattoo ink is directly absorbed by the body through contact with the surrounding damaged blood vessels and lymphatic vessels.