How to Identify and Treat a Tattoo Allergy

Allergy symptoms vary by severity. Some are simply skin-deep and resolve in a few days.

Mild allergic reactions can cause:

• itching
• rashes or bumps
• redness or irritation
• skin flaking
• swelling or fluid buildup around tattoo ink
• scaly skin around tattoo
• skin tags or nodules

More severe reactions can affect your entire body. See a doctor or other healthcare provider if you begin to experience:

• intense itching or burning around the tattoo
• pus or drainage oozing from the tattoo
• hard, bumpy tissue
• chills or hot flashes
• fever

Seek emergency medical help if you develop swelling around your eyes or have difficulty breathing.

Although the symptoms are often similar, there are a few key differences that may help you distinguish between the two.

Allergic reaction

These symptoms only affect the skin near your tattoo. Think localized itching, burning, swelling, and redness. You shouldn’t have any allover symptoms.

If the ink is to blame, your symptoms will only appear around the offending pigment. Red ink is the most common allergen.

Often, your symptoms will only last for a few days. In some cases, symptoms may last for a few weeks before disappearing entirely.

Infection

Infection can also cause redness, irritation, and itching, but these symptoms typically extend beyond the tattooed area.

Surface symptoms may be present in addition to those that affect your entire body, such as fever or chills.

Infection symptoms also tend to last much longer — anywhere from a few days to a week or more.

Not all tattoo reactions are the same. Your reaction could result from:

• an immune system response
• a skin condition
• overexposure to light or other allergens

Acute inflammatory reactions

You don’t have to be allergic to the ink or other materials to have reactions to tattoos. Sometimes, the process itself can irritate your skin.

Many people experience mild redness, swelling, and itching after getting a tattoo. These symptoms typically clear up within a couple of weeks.

Photosensitivity

The ingredients in certain inks can react with sunlight or other bright lights. This can cause swelling, redness, and itchy bumps.

Yellow, black, red, and blue inks are the most common offenders.

Dermatitis

If you’re allergic to the ink itself, you may develop symptoms of contact dermatitis. This includes swelling, itching, and flaking.

Contact dermatitis is often associated with red inks.

Granulomas

A number of ink ingredients are known to cause granulomas, or red bumps. These ingredients include:

• mercury salts
• iron oxides
• cobalt chloride
• manganese

Overall, they’re most commonly tied to red inks.

Lichenoid reactions

A lichenoid reaction happens when small, discolored bumps appear around where the ink was injected. It’s most common with red inks.

These bumps aren’t usually irritating or itchy, but they can appear beyond the area where ink was injected.

Pseudolymphomatous reactions

If your symptoms don’t immediately appear after getting your tattoo, you may be experiencing a pseudolymphomatous reaction. It’s usually in response to red inks.

In these cases, rash, red skin growths, or other irritation may not appear for several months afterward.

Tattoo allergies are often caused by ingredients in tattoo inks, such as pigments, dyes, or metallic substances.

Some inks now contain dyes made from the same components used in car paint and commercial printing. These can all stimulate an immune response as your body attempts to remove the ink as if it’s a foreign invader.

Tattoo ink isn’t regulated by the Food and Drug Administration (FDA), so you may not always know exactly what’s in your ink. But the FDA does compile reports of people’s negative responses to certain ingredients.

It’s best to ask your tattoo artist for the inks they use and look for any ingredients that may cause a reaction or may be documented as potentially harmful.

Here are some ingredients that may cause allergic reactions:

• aluminum
• aminoazobenzene
• brazilwood
• cadmium sulfide
• carbon (also called “India ink”)
• chromic oxide
• cobalt aluminate
• cobalt chloride
• ferric hydrate
• ferric oxide
• iron oxide
• lead chromate
• manganese
• mercury sulfide
• phthalocyanine dyes
• sandalwood
• titanium oxide
• zinc oxide

Notice any swelling, oozing, or other signs of irritation? Stop by your tattoo shop to let your artist know what you’re experiencing.

Also ask your artist about the inks they used and the processes they followed to inject the ink. These details will help a doctor or other healthcare professional determine what exactly caused the reaction and how to best treat it.

Once you have this information, see a doctor right away. Let them know that you recently got a tattoo, and tell them about your symptoms. Make sure you relay any information that you got from your tattoo artist too.

If your symptoms are mild, you may be able to use over-the-counter (OTC) medications to find relief.

OTC antihistamines like diphenhydramine (Benadryl) may help reduce overall symptoms. Topical ointments, such as hydrocortisone or triamcinolone cream (Cinolar), may help soothe local inflammation and other irritation.

If OTC methods aren’t working, your healthcare provider may be able to prescribe a stronger antihistamine or other medication to help ease your symptoms.

Infections will likely require taking antibiotics.

Removal isn’t usually necessary. If you take care of the affected area, your symptoms will likely fade after a few days without leaving any visible marks or scars behind.

In severe cases, untreated allergic reactions and infections can disrupt the ink and disfigure the tattoo.

Identifying the reason for your reaction can help you decide what to do next. Your artist may be able to touch up or add on to the tattoo to hide the blemishes.

If your skin is unable to endure additional ink and you don’t want to leave the art as is, removal may be an option. See a doctor or other healthcare provider to discuss your options.

The best way to prepare is to learn more about your reaction to other allergens and to research your potential tattoo artist.

First, take the following into account before you decide to get any tattoo:

• Find out whether you have any common allergies. If you can, make an appointment with an allergist and tell them about your previous allergic reactions. They may be able to test for related allergens and help you identify other ingredients or triggers to avoid.
• Find out whether you have any underlying skin conditions. Some conditions, such as psoriasis and eczema, may make you more prone to adverse reactions.
• Don’t get a tattoo if you’re sick or your immune system is weakened. A weak immune system can make you more susceptible to allergic reactions.

Then, make sure you choose a reputable artist and shop. Run through the following checklist before getting a tattoo:

• Does the shop have a license? Licensed tattoo shops are regularly inspected for health and safety violations.
• Does the shop have a good reputation? Check out online reviews or ask friends who have tattoos. Visit a few shops before you decide on one.
• Does the shop use ink with safe ingredients? Ask your tattoo artist about the inks they use. Make sure you tell them about any previous allergic reaction.
• Does the artist observe safe practices? Your artist should put on a new pair of gloves before setting up new sterilized needles to use during your appointment.