Even an Older Tattoo Poses a Risk for an Infection or Allergy

A lot of consideration went into your tattoo, between the months you probably spent agonizing over what to get and where to put it and the weeks afterward, when you diligently washed and moisturized it while it healed. Now, aside from occasionally catching a glimpse of it in the mirror, you usually forget it’s even there.

But your tattoo is a lifelong commitment in more ways than the one you’re thinking. Because tattoos breach the protective layer of the skin, skin irritation or a full-blown condition can develop months, years, even decades after the initial tattooing process.  

See your dermatologist if you start to notice redness, bumps, or even burns on or around a tattoo, regardless of its age. They could be a sign of one of the following issues:

Infection.

You’ve probably heard horror stories about infected ink warping the appearance of a tattoo’s design. While that typically occurs during the initial healing phase, infection remains a possibility months after the fact. Keep an eye out for pain or redness that gets worse; a rash with itchy, red bumps; open sores; pus; and a fever with chills.

An allergic reaction.

It’s rare, but a pseudolymphomatous reaction can occur in response to red ink. Basically, it’s a hypersensitivity to the ink. It’s thought that the red ink acts as an antigen, stimulating an immune response from the body and causing an inflammatory reaction. The response likely has been developing for a while, but it’s taken months or years to manifest on the surface of the skin.

A predisposition to a skin condition.

Something called the Koebner phenomenon can cause skin conditions like eczema and psoriasis to crop up for the first time. Eczema is probably more reflective of an allergic reaction, but the thinking generally goes that any epidermal disruption can trigger disease. Tattoo ink can also cause flare-ups of a pre-existing skin condition.

A reaction to the sun.

Your tattoo artist probably warned you that the sun’s UV rays can cause the ink to fade. But there’s more to that. Traces of cadmium sulfide in yellow ink can cause redness and swelling around a tattoo when it’s exposed to the sun. Moreover, one study found that tattoos with red, blue, or black ink caused swelling, redness, an itchy rash, blisters, and hives within minutes or hours of the tattoo being exposed to the sun.

MRI-related burning.

Tattoo ink can contain metallic pigments, which turn the tattoo into an antenna for an MRI’s radiofrequency pulse, generating heat. The larger the tattoo, the stronger the magnetic pull—and the higher the risk of burning. If the radiologist doesn’t ask if you have any tattoos prior to performing an MRI, speak up.