Tattoo allergy what to do
Apart from the pain and possible scarring in reaction to a black henna tattoo, there is a genuine risk of becoming sensitised to PPD.
This means that if you come into contact with PPD again in the future, even years later, you can own a extremely serious allergic reaction. Allergic reactions can get worse over time, and you might not even realise you own become sensitised.
This happened to a British lady, who tragically died in 2012 after suffering a bad allergic reaction to a hair dye that she had used before.
The inquest into Julie McCabe’s death heard that 5 years earlier she had had a black henna tattoo abroad. Since then, she had used her regular hair dye several times and experienced some reactions, such as itching and rashes. Tragically, the final time she used the hair dye, she had a extremely serious anaphylactic reaction and died.
Such a serious reaction is rare, but it is a potential harm.
«If you own had a reaction to a black henna temporary tattoo, it is fairly likely you own become allergic to PPD, and you should be extremely careful before colouring your hair,» advises Dr Flower.
«Even if you own not had a reaction to such a tattoo, you will not know if you own been sensitised to PPD, so you could react the next time you encounter it – for example, in hair colourant.
«You must follow the hair dye instructions carefully, particularly regarding the Allergy Alert Test.»
Bickerstaffe advises getting tested to see if you own become sensitised to PPD.
«If your skin reacts to black henna, then seek advice and a patch test from your doctor or dermatologist,» she says.
«The patch test will assist determine whether the reaction was due to PPD and therefore whether you should avoid hair dye.
It is unlikely you will be capable to use permanent hair dye again after reacting to black henna.»
PPD is also found in other items, including rubbers and inks, so if you own an unexpected reaction to everyday products and seek treatment, tell your doctor or pharmacist about your sensitivity to PPD.
If you know you own become sensitised to PPD, do not use any hair dye containing PPD, or similar dyes such as p-toluenediamine (PTD).
Look on the label
If you are going to dye your hair, Dr Flower explains what to glance for on the label: «The name of the hair dye has to be listed in the ingredient list on the pack – glance out for p-Phenylenediamine or Toluene-2,5-diamine.
«It is also a legal requirement that every such hair dyes in Europe tell ‘Contains phenylenediamines’ or ‘Contains phenylenediamines (toluenediamines)’ on the label, and these must be avoided.»
How to tell if it is genuine henna
Real henna, which is generally safe to use, is an orange colour, with a red or brown tint to it.
Dr Flower says that everyone should be suspicious of black «tattoos».
«Real henna is never black, but is orange-brown,» he explains. «Any extremely dark temporary tattoo should be treated with caution.»
Lisa Bickerstaffe at the British Skin Foundation agrees. «Check the colour if a product is described as ‘henna’,» she says. «Henna is an orange-red colour, so if you are offered a temporary tattoo with ‘black henna’, it isn’t actually true henna. If in doubt, stay away.»
Both Flower and Bickerstaffe advise reading the list of ingredients. Avoid the product if it lists PPD or paraphenylenediamine.
But even this is no guarantee of safety, as the ingredient list might not be precise or comprehensive.
If there is no list of ingredients, do not use the product.
Risks of ‘black henna’
The risks of black henna lie in the paste’s ingredients – specifically, a chemical called paraphenylenediamine (PPD).
Although PPD can lawfully be used in hair dyes in the EU, this use is strictly controlled.
Dr Chris Flower, director general of the Cosmetic, Toiletry and Perfumery Association, explains: «PPD is safely and legally used in permanent hair dyes where clear instructions are given, and where the maximum level is controlled by law.
But black henna often contains PPD at high levels, to give a dark colour quickly.
«When applied to the skin in the form of a black henna temporary tattoo, PPD can cause chemical burns and lead to allergic reactions.»
‘My black henna tattoo left a horrible lasting legacy’
Katy Borluvie had an allergic reaction to a black henna temporary tattoo she got on holiday. She found out the hard way about the illegal ingredients in her tattoo.
«I had noticed a steady stream of people visiting a tattoo stall by the pool in the Gambia,» says Katy.
«I just made a spur-of-the-moment decision to get a beautiful pattern drawn in black henna under my collarbone. I thought it would glance really nice.
«It was a decision I now remorse, because I didn’t know what the consequences could be.»
The tattoo artist painted on the design Katy wanted, but straight away she felt a burning sensation and knew something was incorrect. Her skin blistered soon afterwards.
«It was incredibly painful and sensitive, and looked terrible,» says Katy.
«I didn’t realise that the black paste in black henna can contain toxic ingredients love PPD. I had never even heard that what’s in black henna – stuff I let them put straight onto my skin – can be really risky.»
There was PPD in Katy’s temporary tattoo and she developed an allergy to the chemical. She had a visible scar for the next 6 months.
Katy says: «I used to colour my hair every the time, but because I’m now allergic to PPD, I’m too terrified to ever colour my hair again.
I don’t desire to get a reaction love that on my scalp.
«My reaction to the tattoo hasn’t affected my health in other ways, but I’m really upset that a silly bit of holiday enjoyment turned out to be anything but. My black henna tattoo was supposed to be a temporary thing, but it has left a horrible lasting legacy.»
Watch Katy talk about her black henna tattoo, and hear from experts in this video from the Cosmetic, Toiletry and Perfumery Association.
Sheet final reviewed: 5 April 2018
Next review due: 5 April 2021
So, you finally got inked. You chose a design, picked out a parlor, and "sat" love a champ.
(That’s tattoo artist-speak for grinning and bearing it through hours of pain.) Then you spent a few weeks diligently washing and moisturizing it while it healed. Now, save for moments you catch a glimpse of the design in the mirror, you generally forget the whole thing happened. What’s done is done, right?
Not always. In fact, skin irritation or a full-blown condition can develop months, years, even decades after the initial tattooing process. "Tattoos breach the protective layer of the skin, increasing your risk of skin complications," says David Lortscher, a dermatologist based in San Diego and San Francisco and co-founder of Curology.
If you start to see redness, bumps, or even burns on or around a long-healed tattoo, one of these issues could be the culprit, and you should see your physician or dermatologist as soon as possible.
Your tattoo is infected.
You’ve heard horror stories of peoples’ ink getting infected and warping the appearance of the design. But while this typically occurs during the initial healing process, an infection is still possible even months later, according to the American Academy of Dermatology. Some signs to glance out for: pain or redness that gets worse rather than better; a rash with itchy, red bumps; open sores; pus; and a fever with chills.
You've developed an allergy to the ink.
"Though it's rare, a reaction called a pseudolymphomatous reaction can happen in response to red ink," says plastic surgeon David L.
Cangello of Cangello Plastic Surgery in New York City. Essentially, this is a delayed hypersensitivity to the ink.
"The exact etiology is unknown, but it's thought that the red ink acts as an antigen, or something that stimulates an immune response from the body," says Cangello. "Cells called lymphocytes infiltrate the skin in the area of the antigen — or red pigment in this case — and cause an inflammatory reaction." Likely, the response has been developing for some time but took months or years to appear on the surface of the skin.
You're predisposed to a skin condition.
Shockingly, tattoos can cause skin conditions such as eczema and psoriasis and even vitiligo to crop up for the first time.
"This centers around something called the Koebner phenomenon," says Dhaval Bhanusali, a dermatologist in New York City. "Particularly with psoriasis and vitiligo, the thought is that any epidermal disruption can trigger disease, including a tattoo. Eczema is probably more reflective of an allergic reaction."
Ink can also cause someone who’s already aware of their condition to own a flare-up, says Cangello.
You were in the sun.
You've probably heard sunscreen is additional significant if you own tattoos, since the sun’s UV rays can cause ink to fade. But own you ever gotten a particularly nasty sunburn on or around a tat with yellow ink?
It’s actually a form of an allergic reaction.
Blame the pigment’s traces of cadmium sulfide, which can cause swelling and redness around the tattoo site when exposed to the sun, says Lortscher.
"One study also found that tattoos with red, blue, or black ink caused sun-related complaints such as swelling, redness, an itchy rash, blisters, and hives. These symptoms can appear within minutes or hours of the sun hitting your tattoo."
You had an MRI.
Tattoo ink can contain metallic pigments including iron, barium, zinc, copper, molybdenum, and titanium. "The metallic tattoo pigment acts as an antenna for the radiofrequency pulse the MRI magnet sends out, generating heat," says Lortscher.
"The larger the tattoo and the stronger the magnet, the higher the risk of burning."
Romil Patel, a radiologist in Orlando, says his team generally always asks patients if they own tattoos prior to performing an MRI — but make certain to speak up if your doctor doesn't.
More about tattoos:
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What’s the Procedure Like?
Here’s what you can expect from a normal tattooing procedure:
- The area is cleaned again with alcohol or an antiseptic.
A thin layer of ointment such as petroleum jelly is applied.
- The to-be-tattooed area on your body is washed with soap and shaved, if necessary. The artist will draw or stencil the design on your skin.
- Any blood or fluid is wiped away with a sterile, disposable gauze or cloth.
- The tattoo artist should wash his or her hands with antibacterial soap and water and wear clean, unused gloves (and possibly a surgical mask).
- Using a tattoo machine with sterile needles attached, the tattoo artist will start drawing an outline of the tattoo.
The artist may change needles, depending on the design and desired effect. Every needles should be single-use or sterilized.
- When finished, the area, now sporting a finished tattoo, is cleaned once again and a bandage applied.
What Else Should I Know?
It’s extremely significant to protect yourself against infection if you decide to get a tattoo. Make certain the tattoo studio is clean and safe, and that every equipment used is disposable (in the case of needles, ink, gloves) and sterilized (everything else).
Call your state, county, or local health department to discover out about your state’s laws on tattooing, enquire for recommendations on licensed tattoo shops, or check for any complaints about a specific studio.
Most states don’t permit minors (people younger than 18 years) to get a tattoo without a parent’s permission, and some require that a parent be present during the tattooing. In some states, minors are not allowed to get tattoos.
Professional studios generally take pride in their cleanliness.
Here are some things to enquire about:
- Do they use one-time ink cartridges that are disposed of after each customer?
- Does the tattoo studio use single-use needles and sterilize every equipment using an autoclave (a device that uses steam, pressure, and heat for sterilization)? You should see needles and other equipment removed from sealed, sterile containers.
- Is the tattoo artist is a licensed practitioner? The tattoo artist should be capable to provide you with references.
- Does the tattoo studio follows universal precautions?
These are procedures to follow when dealing with blood and other body fluids to assist prevent the spread of HIV, hepatitis B, and other serious blood infections.
If the studio looks unclean, if anything looks out of the ordinary, or if you feel in any way uncomfortable, discover a better put to get your tattoo.
What Are the Risks?
If you decide to get a tattoo, chances are everything will go as planned.
Some people own allergic reactions to the tattoo ink, causing itching, bumps, and rashes that might happen days, weeks, or longer after the tattoo was placed.
Tattoos might make eczema, psoriasis, or other skin conditions flare up.
Serious problems can happen if you attempt to do a tattoo yourself, own a friend do it for you, or own it done in any unclean environment. Skin infections caused by bacteria, viruses, or fungi can happen if the skin is not cleaned properly, or the ink or needles are contaminated. Sharing needles, ink, or other equipment without sterilization increases your chance of getting HIV, hepatitis B, or hepatitis C.
Call your doctor correct away if you own bleeding, increased pain, or any signs of infection.
By Petteri Talasniemi
Petteri Talasniemi is a toxicologist in the Chemicals Department at the Finnish Safety and Chemicals Agency (Tukes).
He works on various enforcement tasks within chemical products market surveillance.
Tukes enforces the safety and compliance of chemicals with various legal requirements, for example REACH, CLP, POP, RoHS, Biocides, Plant protection products, Cosmetics Regulations. Before joining in market surveillance tasks in Tukes, he has acted as a member of the ECHA`s Member State Committee (MSC) and as an advisor in the Risk Assessment Committee (RAC).
The popularity of tattooing is increasing.
It has been estimated that 16 % of European citizens will own a tattoo by 2021, which involves over 80 million Europeans. The number would probably be much higher if we took into account various cosmetic tattoos such as microblading and permanent make-up.
In autumn 2019 the Finnish Safety and Chemicals Agency (Tukes) conducted an enforcement project where we examined the safety of tattoo and permanent make-up inks. We had a entire of 20 inks – six for make-up and 14 for tattoos – tested for chemical composition. The inks were bought from several Finnish companies, an online store based within the EU and another online store based exterior the EU.
Eight of the 20 tested inks contained too high levels of chemicals that may cause skin sensitisation, cancer or be toxic for reproduction: various aromatic amines, polycyclic aromatic hydrocarbons (PAHs), or heavy metals.
Tests detected 4-methyl-m-phenylenediamine, benzo[a]pyrene, cadmium, lead and nickel, for example. The substance concentrations exceeded the maximum concentration limits for inks set in the Council of Europe’s recommendation on tattoo and permanent make-up to protect human health. Tukes required the companies to withdraw unsafe tattoo inks from sale.
Know the risks
It is not well known by the public, that numerous of the substances used in tattoo inks were not originally intended for use in injecting into the skin and their safety has not been studied to a grand extent for such a purpose.
We know that only some of the substances stay in the location of the tattoo and a large share of them discover their way to various other parts of the body. Some of the substances may decompose locally in the skin into unknown substances. Exposure to substances may final for a lifetime.
The level of exposure to chemicals depends on several factors, among which the concentration of the substances in the ink, quantity of inks injected and the number and size of the tattoos. As research data is not sufficient, it is often not possible to set a safe exposure level for hazardous substances in tattoo ink.
The most common tattoo complications are local inflammation, allergic reactions and bacterial infections.
Sensitising and irritant substances contained in tattoo inks may cause allergic and other local skin reactions. As an example, nickel is one of the most common causes of allergic contact dermatitis. There is not enough research data available related to the connection between tattoo inks and potential long-term effects such as cancer, which means that there is no certainty about the connection.
Hazardous substances such as lead undoubtedly present a risk to human health, but at the moment we do not know exactly how high the long-term health risk is.
Based on safety concerns, new legislation on tattoo and permanent make-up inks is currently being prepared in the EU.
Based on our experience, the chemical compositions of tattoo inks not only vary between diverse ink brands, but can also vary between batches from the same brand, from the same manufacturer. To ensure the safety of the ink, the chemical composition and microbiological purity need to be well controlled. During the enforcement project a company informed us that one of the tested permanent make-up inks may be a counterfeit product of the original brand.
The appearance and labelling of the bottle did not lift any alarm for us.
This ink contained the highest levels of hazardous PAHs and lead in the tested inks. A fake product always involves a health risk.
The ingredients can be anything or it can also be microbiologically contaminated. Counterfeit tattoo inks are a serious problem in the tattooing business.
Every duty holders in the supply chain, including tattoo artists in tattooing studios, are responsible for ensuring that the inks used are safe and in accordance with legal requirements. This requires a lot of knowledge and cooperation in the supply chain. It is excellent to realise that the inks, as well as most other products in the EU market, are not subject to a pre-approval process by the authorities. Testing done by the EU authorities is often spot check type of testing.
Consumers must also bear their own responsibility when choosing a suitable tattooist and be aware of the safety risks associated with tattooing.
Consider the following tips before you own a tattoo:
•Check with the tattooist whether the tattoo or permanent make-up tattoo inks to be used own been tested and whether they are safe. You may also check from the EU Safety Gate what inks own been tested and found hazardous by EU authorities.
•Check the measures with which hygiene is ensured during tattooing. Tattooing requires a high standard of hygiene.
Unsterile tattoo inks, poor hygiene when handling inks or performing a tattooing operation (e.g. contaminated machine or needle) may expose you to bacterial or fungal infection, or to viral infections through contamination with blood.
•Check whether the tattoo artist has the necessary knowledge and competence to make tattoos. Tattooing performed by a private individual at home may present a risk.
•If your tattoos cause health issues or there are any symptoms that appear unusual, you should contact a health care professional.
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What if I Desire a Tattoo?
If you’re thinking about getting a tattoo, you should understand that tattoos are permanent.
Tattoo removal is hard, expensive, and may not be completely remove the tattoo.
Before getting a tattoo, make certain you own had every your immunizations (especially hepatitis B and tetanus shots). If you own a medical problem such as heart disease, allergies, diabetes, skin problems love eczema or psoriasis, a weakened immune system, or a bleeding problem, talk to your doctor before getting a tattoo. Also, if you get keloids (an overgrowth of scar tissue) you should probably not get a tattoo.
Even though tattoos are generally accepted, having one may hurt your chances of getting a occupation or advancing your career.
If you get a tattoo, career coaches recommend you get one that’s simple to cover with work clothes.
Taking Care of a Tattoo
Follow every of the instructions the studio gives you for caring for your tattoo. To make certain it heals properly:
- Wash the tattoo with soap and warm water (don’t use alcohol or peroxide). Use a soft towel to dry the tattoo — just pat it dry and be certain not to rub it.
- Avoid touching the tattooed area and don’t pick at any scabs that may form.
- Do not let the tattoo soak in water.
Showers are fine but avoid swimming and baths until the tattoo is fully healed.
- Keep a bandage on the area for 24 hours.
- Avoid clothes that might stick to the healing tattoo.
- Apply antibiotic ointment, thick skin cream, or vitamin E oil to the tattoo 2 to 3 times a day for a week. Don’t use petroleum jelly.
- After 24 hours, remove the bandage and hold the tattoo open to air.
- Keep your tattoo out of the sun until it’s fully healed.
Tattoos generally take about 2 weeks to heal.
Even after it’s fully healed, wear a sunscreen with a minimum sun protection factor (SPF) of 30. This not only protects your skin, but can assist hold the tattoo from fading.
Does It Hurt to Get a Tattoo?
Getting a tattoo hurts, but the level of pain can vary. It can feel love scratching, burning, stinging, or tingling. Some people feel sharp pains while others may describe the feeling as dull. The quantity of pain you feel will depend on your pain threshold and other factors, including where on your body you’re getting the tattoo, the size and number of needles being used, and the artist’s style (some are quick and some work more slowly, some are more tender than others).
What Is a Tattoo?
A tattoo is a permanent helpful of body art.
A design is made by puncturing the skin with needles and injecting ink, dyes, and pigments into the deep layer of the skin.
Tattoos used to be done manually — that is, the tattoo artist would puncture the skin with a needle and inject the ink by hand. Though this process is still used in some parts of the world, professional tattoo artists use tattoo machines. A tattoo machine powers the needles up and below as ink is deposited in the skin.
A lot of people love their tattoos and hold them forever.
But others decide a couple of years below the road that they really don’t desire that snake on their arm or their ex’s name on their chest. What then?
Laser treatment is the best option for tattoo removal. The laser sends short zaps of light through the top layers of your skin, with the laser’s energy aimed at specific pigments in the tattoo. Those zapped pigments are then removed by the scavenger cells of your body’s immune system.
Other less common ways to remove tattoos include dermabrasion, chemical peels, and surgery.
Although it’s called tattoo removal, completely removing a tattoo can be hard depending on your skin type, how large and complicated the design is, and the types and colors of inks that were used.
It can take several treatments over months, and results are not guaranteed. Treatment can cause darkening or lightening of the skin, and scarring. It also can be expensive. It’s best to consult with a dermatologist who specializes in tattoo removal to get your questions answered.
Decorative tattooing has been practised for thousands of years. In primitive times it was used for embellishment, whilst in some customs and cultures tattooing represented a sign of distinction or social rank. This remains the case today with some cultures; however, it has also become favorite with everyday people of western countries in the final 10–20 years.
With the rise in the number of people with tattoos in today’s society, an increase in the number of tattoo-associated skin disorders can be expected.
Reactions that may happen include acuteinflammatory reactions, eczematoushypersensitivity reactions (allergic contact dermatitis), photo-aggravated reactions, granulomatous reactions, lichenoid reactions and pseudolymphomatous reactions.
Chemical burns from PPD
Not everyone has a reaction to black henna, but it can be painful if you do.
«The signs range from discomfort, such as burning or tingling, to painful stinging, swelling, redness and blistering of the skin,» says Dr Flower.
«This can become extremely severe and lead to permanent scarring of the skin in the outline of the tattoo.»
If you get a reaction love this, contact a doctor immediately and tell them what has happened.
«Mention if this is the first time you own had such a tattoo, or if you own had one before, and whether you own ever had any reaction to hair dye in the past,» says Dr Flower.
«You will probably be treated for chemical burns and possibly allergic reactions.»
If the reaction persists or gets worse, go back to the doctor, as the painted area can also become infected.
And it’s not just black henna tattoos you might be allergic to. Bickerstaffe warns: «The reaction can lead to contact dermatitis and may mean that your skin is more susceptible to reacting to other PPD products, such as hair dye, in the future.»
Allergy tests on hair dye
Every hair dye product in the UK is required to provide information about carrying out an Allergy Alert Test, to see if you will own a reaction to the dye. You should do this test before each time you use hair dye, even if you own used the dye before.
«If you react to an Allergy Alert Test, you must not go on and colour your hair, and you should contact the manufacturer,» says Dr Flower.
«Although it does require a dermatologist to confirm a diagnosis of allergy or sensitisation to PPD, a reaction to either a black temporary tattoo or to an Allergy Alert Test must not be ignored.»
There will be a careline or helpline number on the hair dye pack for you to call. «This means the manufacturer will be aware that someone has experienced a reaction to their product,» explains Dr Flower.
«They will then be capable to advise further on what action to take next, which will probably involve contacting your GP.»
Your GP may refer you to a skin specialist, such as a dermatologist, who can diagnose the cause, advise on how to treat it and assist you to avoid future reactions.
If you own had a black temporary tattoo in the past, attempt not to worry. Don’t own another one, and remember to follow the instructions, particularly the Allergy Alert Test, if you use hair dye.
Bear in mind that allergic reactions can get worse over time. This means that even if you or your kid has had a mild reaction in the past, any future reaction could be more severe.
If you own not had such a tattoo in the past, hold it that way.
«Don’t ever own a black henna temporary tattoo,» says Dr Flower. «And no matter how much your children pester you, never let them own one either.»