SO, YOU LIKE TATTOOS?
The risks of life-long toxic-mediated inflammation
By Joachim Bartoll, February 2016, for Classic Muscle Newsletter #20, 2016
Tattoos have become increasingly popular over the last 20+ years; to the extent that the once somewhat daring self-statement have become diluted as people get them without even thinking.
I remember discussing tattoos as a teenager in the late 80’s. Back then, the only reason we could think of to get a tattoo was if it could truly symbolize something extremely important to you – as your kids or your life’s mission.
10 years later, in the late 90’s, I started to read up on inflammation and the problems with piercings (since I had clients with stubborn fat and a lot of inflammation around their umbilicus piercings). Then I began to theorize around tattoos and what actually happens when you get a tattoo and how your body would possibly deal with the ink and dye in your dermis (deep layer of skin) – something that would cause a detox response and inflammation from trying to clean out and heal the area. Also, what if some of the particles within the ink would penetrate the dermis and reach the blood stream? Since there were no studies I could find on the subject, I simply decided for myself that without knowing exactly what happens in the skin and the body when getting a tattoo, I would not risk unnecessary stress by getting one, especially since I already had asthma and allergies. And besides, I love the human body as it is, there’s no need to cover it up with ink.
And after that I pretty much put the whole issue of tattoos and the possible health risks on the shelf until a few years ago. In 2013 I started to notice a thread with some of my clients that have a lot of tattoos – I discovered that they’re all likely to be more susceptible to stress and inflammation. Many of them needed a more “delicate” approach to nutrition, dieting, and stress management.
Considering all sources of stress on the body in today’s modern society, such as pollution, beauty products (should be called suicide products), deodorants, skin lotions (better known as skin lesions), junk food, information overload, stimulants, antibiotics, unnecessary medications, reduced sleep quality, constant fear or anger from being stuck in the “hamster wheel”, and so on – tattoos might very well be the tipping point for some people, simply because that exposure is permanent and every other stressors are added on top of it.
The other stressors you can manage with lifestyle changes, the tattoos, not so much.
What actually happen when you get a tattoo?
If we do our research and look closer at what actually happens when you get a tattoo, we learn what many of us have suspected all along: tattoos are actually a complicated inflammatory process – an ongoing balancing act between your body and the dye that’s invading it.
It turns out your tattoos are kind of like a permanent infection – because your body keeps on trying to clear it out forever.
When you get a tattoo, the needle punch through the epidermis, the outer layer of skin, and drive the ink into the dermis, the deeper layer that’s mottled with nerves, sweat glands, sebaceous glands, and blood vessels. The small needles puncture the skin at a frequency of 1000 to 3000 times per minute! Every time the needle penetrates, it causes a wound that alerts the body to begin the inflammatory healing process. That signal sends “immune system” cells racing to the site of the wounds.
Special cells called macrophages come to the rescue, eating up the dye in an attempt to “clean up” the inflammation it’s causing by transporting some of the dye to the lymph nodes. But they can only handle that much. And as the healing process begins, the rest of the dye gets soaked up by skin cells called fibroblasts within the dermis. The fibroblasts, along with many of the macrophages, stay suspended in the dermis in perpetuity – and the body will keep on trying to get rid of it, causing chronic inflammation. While the damaged cells in the deeper dermis is locked in, the cells of the outer layer of the skin get replaced, which is the reason why the color may look less deep and vibrant as when all the cells carry the dye in the initial wound.
There’s also the question of different inks, as some fade over time or fade when they are exposed to sunlight. What exactly happens to that ink? What is the chemical reaction and where does it go?
The research is young
The first “study” of complications with tattoos were done only a few years ago – and it consisted of simple survey interviews with about 300 tattooed adults in New York’s Central Park during June of 2013. The researchers behind that study later draw the conclusion that there is an enormous lack of regulatory oversight and no research at all into the true scope of the complications tied to tattooing – noting that the chemical composition of colored inks used in the process is poorly understood and not standardized among dye manufacturers. The team of researchers also noted that the lack of a national database or reporting requirements hinders reliable monitoring. Simply put, there were no data available of risks, complications, or medical cases.
After wading through all present research on tattoos and possible complications, it’s clear that almost all studies focus on short-term complications such as swelling, allergies, rashes, infections, acute immune responses, etcetera. The only long-term complications that researchers have yet discovered are pigmentary changes, hypopigmentation and hyperpigmentation, paradoxical darkening of cosmetic tattoos, and allergic reactions (such as swelling and itching even years after getting the tattoo.) However, these are complications that are easily identified. Chronic inflammation and chronic “immunological” complications are much harder to identify and understand.
Or to quote Leger, one of the researchers, “The skin is a highly immune-sensitive organ, and the long-term consequences of repeatedly testing the body’s immune system with injected dyes and colored inks are poorly understood.”
In 2011, a study in The British Journal of Dermatology revealed that nanoparticles are present in tattoo inks, with black ink containing the smallest particles (white ink had the largest particles and colored inks were in between).
Nanoparticles are able to readily penetrate your skin and travel to underlying blood vessels and thereby enter your bloodstream. Evidence suggests that some nanoparticles may induce toxic effects in your brain and cause nerve damage, and some may also be carcinogenic.
Further, nanoparticles from tattoo ink were found to exist in both the collagenous network of the skin as well as around blood vessels, according to the University of Bradford researchers. This suggests the ink particles are leaving the surface of your skin and traveling elsewhere in your body, where they could potentially enter organs and other tissues.
While colored ink, and red ink in particular, are associated with chronic skin reactions and those that are allergic in nature, black ink is also implicated in health problems. According to research, black tattoo inks are usually based on soot, and even the finest inks contain hazardous polycyclic aromatic hydrocarbons (PAHs). Some of the PAHs can stay in skin where they absorb UV radiation and generate singlet oxygen, which may affect skin integrity. PAHs are also known to be carcinogenic, which is even more troublesome if they enter the bloodstream and are absorbed into our organs.
Another study from 2013 found that 10 of 11 black inks had PAH concentrations exceeding the European Council’s recommended level, and all 11 exceeded the recommended level for benzo(a)pyrene.
Even if inks and dye become more strictly regulated, there will always be an immune response and inflammation from introducing foreign particles to the dermis of the skin. It’s unavoidable.
Those who already have tattoos should prioritize their health and reduce stressors and make sure they get some extra antioxidants. Stay away from beauty products and commercial skin lotions. Use natural fats instead, such as bacon fat, tallow, or coconut oil/shea butter. And if you’re thinking about getting a tattoo, think again, and think long and hard.
References and further reading
Complications of decorative tattoos: recognition and management.
Simunovic C, Shinohara MM.
Am J Clin Dermatol. 2014 Dec;15(6):525-36. doi: 10.1007/s40257-014-0100-x.
Complications of Tattoos and Tattoo Removal: Stop and Think Before you ink.
Khunger N, Molpariya A, Khunger A.
J Cutan Aesthet Surg. 2015 Jan-Mar;8(1):30-6. doi: 10.4103/0974-2077.155072.
Carbon black nanoparticles and other problematic constituents of black ink and their potential to harm tattooed humans.
Jacobsen NR, Clausen PA.
Curr Probl Dermatol. 2015;48:170-5. doi: 10.1159/000369319.
Dermatofibroma Tumors Arising within a Black Tattoo.
Alejandro Lobato-Berezo, Micaela Churruca-Grijelmo, Marcela Martínez-Pérez, Adrián Imbernón-Moya, María Elena Vargas-Laguna, Eva Fernández-Cogolludo, Antonio Aguilar-Martínez, Miguel Ángel Gallego-Valdés.
Case Rep Dermatol Med. 2014; 2014: 745304.
Squamous-cell Carcinoma Arises in Red Parts of Multicolored Tattoo within Months.
Felix Julian Paprottka, Stiliano Bontikous, Jörn A. Lohmeyer, Detlev Hebebrand.
Plast Reconstr Surg Glob Open. 2014 Mar; 2(3): e114.
At the dark end of the rainbow: data gaps in tattoo toxicology.
Schreiver I, Luch A.
Arch Toxicol. 2016 May 1
Chronic tattoo reactions cause reduced quality of life equaling cumbersome skin diseases.
Carlsen KH, Serup J.
Curr Probl Dermatol. 2015;48:71-5. doi: 10.1159/000369644.
Cutaneous and systemic complications associated with tattooing.
Presse Med. 2016 May 5. pii: S0755-4982(16)00082-8. doi: 10.1016/j.lpm.2016.02.016.
Medical Complications of Tattoos: A Comprehensive Review.
Chang C, Selmi C, Generali E, Huntley A, Teuber SS, Gershwin ME.
Clin Rev Allergy Immunol. 2016 Apr;50(2):273-86. doi: 10.1007/s12016-016-8532-0.
Self-reported tattoo reactions in a cohort of 448 French tattooists.
Int J Dermatol. 2015 Oct 24. doi: 10.1111/ijd.13030.
Tattoo complaints and complications: diagnosis and clinical spectrum.
Serup J, Carlsen KH, Sepehri M.
Curr Probl Dermatol. 2015;48:48-60. doi: 10.1159/000369645.
Tattoo ink nanoparticles in skin tissue and fibroblasts.
Colin A Grant, Peter C Twigg, Richard Baker, Desmond J Tobin.
Beilstein J Nanotechnol. 2015; 6: 1183–1191.
Black tattoo inks induce reactive oxygen species production correlating with aggregation of pigment nanoparticles and product brand but not with the polycyclic aromatic hydrocarbon content.
Høgsberg T, Jacobsen NR, Clausen PA, Serup J.
Exp Dermatol. 2013 Jul;22(7):464-9. doi: 10.1111/exd.12178.
Self-reported adverse tattoo reactions: a New York City Central Park study.
Brady BG, Gold H, Leger EA, Leger MC.
Contact Dermatitis. 2015 Aug;73(2):91-9. doi: 10.1111/cod.12425.
Tattooing to “Toughen up”: Tattoo experience and secretory immunoglobulin A.
Christopher D. Lynn, Johnna T. Dominguez, Jason A. Decaro.
American Journal of Human Biology, 4 March 2016, DOI: 10.1002/ajhb.22847