Risks in tattooing

Like everything in this world, tattooing comes with its own risks. However, some of these risks can be minimized by having the tattoo done by a skilled tattoo artist. Customers should be aware of the risks associated with tattoos before considering getting one, so they can adequately prepare for them in advance or refrain from getting the tattoo altogether if the risks seem too high for them. Health protection laws also require tattoo studios to identify the risks associated with their operations, monitor factors affecting them, and prevent and minimize the occurrence of health hazards. Each tattoo studio must develop a safety document and a self-monitoring plan for its operations. In addition, every tattoo artist must provide the customer with comprehensive information, including risks and complications associated with the procedure, as well as written tattoo aftercare instructions, before performing the tattoo.

Factors related to the tattooing process

During the tattooing process, tattoo ink is inserted into the second layer of the skin, known as the dermis, using a needle. Because the procedure is done manually and the skin's surface is breached in the process, getting a tattoo can involve both qualitative and health risks. Despite professional tattoo techniques, hygienic work practices, high-quality materials, and careful aftercare, complications may arise during the tattooing process and its healing. Problems may also occur after the tattoo has healed because tattoo ink is a foreign substance to the body.

A finished tattoo can never match the precision of, for example, a computer printout, no matter how skilled the artist is. Tattoos are made by hand on a living and moving surface, and over time, the tattoo ink fades and spreads somewhat as the tattoo ages. Each customer's anatomy and skin are different, and skin texture also varies depending on the location of the tattoo. The skin's ability to accept tattoo ink also affects the final result. Thus, there may be deviations in the shape and color of the image between the planned design and the finished tattoo.

Tattoo ink can spread under the skin both during tattooing (blowout) and during healing (ink drifting). Blowout usually results from too much ink being worked into the skin, sinking too deeply into the skin. Ink drift appears as a large bruise around the tattoo when the tattoo ink has spread into the fatty tissue. Ink drift is a rare phenomenon and is influenced by tissue type, amount of fatty tissue, and thickness of the skin layer. It may occur more often in thin skin areas such as the armpit and inner thigh.

The conditions during the tattooing process also vary; on some days, for example, a customer's skin may bleed and release tissue fluid more than on others. The tattooing process is painful, so reflexive, jerky movements may occur in the customer, which can affect the appearance of the tattoo. Despite the tattoo artist stretching the skin and applying pressure during the tattooing process, reflex reactions cannot be completely prevented. Strong movements can cause mistakes and unevenness, especially.


Because a tattoo involves an open area of skin until it heals, it's possible to contract infectious diseases through blood contact. In practice, this is also possible through regular wounds or scratches if the wound comes into contact with contaminated surfaces or blood. The greatest risk of wound infection arises from bacteria naturally present on the client's skin, which can be harmful if they enter the wound. During tattooing, the risk of infection is heightened if the tattoo is performed with unsterile, contaminated equipment and supplies, or if the skin to be tattooed is inadequately cleaned.

Diseases that can be transmitted through ordinary wounds and skin injuries (such as tetanus) can also be transmitted through a healing tattoo. A tattoo can also become infected if not properly cared for, just like any other wound, and an untreated infection may lead to blood poisoning.

The most serious bloodborne diseases include hepatitis B and hepatitis C, HIV, and MRSA. Due to the risk of infection, there is a four-month deferral period for blood donation in Finland after getting a tattoo or piercing.

The risk of infection can be minimized by choosing a responsible professional tattoo artist who works hygienically with clean tools and methods, in a tidy and clean environment under the supervision of a health inspector. During the healing process of the tattoo, it is important to follow the given care instructions, ensure that the tattoo does not come into contact with blood or dirt, and prevent the scab from breaking. Hepatitis B and tetanus can be prevented with vaccination.

How do you know if you've contracted an infection?

Some bloodborne diseases are initially asymptomatic, so in practice, only a blood test can confirm one's health status. However, not all diseases, such as HIV, may show up immediately in a blood test. Signs of a skin infection after tattooing include inflammation, itching, warmth, swelling, tenderness, and high fever. However, a transient fever is normal after a longer tattoo session. Abnormal symptoms include increased discharge, spreading redness around the wound, increased pain, and a foul odor from the tattoo wound.

If you suspect that the tattoo is infected, it's a good idea to contact the tattoo artist, who can explain what the normal signs of wound healing are and when to seek medical attention.

Symptoms of a severe infection, or inflammation, include severe fever and severe pain. General symptoms of infection, such as high fever and signs of blood poisoning, may also occur.

Blood poisoning, or sepsis, is a life-threatening systemic infection, and its symptoms include fever and overall malaise - the person is clearly visibly seriously ill. Left untreated, sepsis can quickly become fatal. In such cases, immediate medical attention is necessary.

Allergic reactions

Allergic reactions can occur during the tattooing process due to several factors. These include the gloves used by the tattoo artist (latex allergy), the needles used during tattooing (metal allergy), the ointments used in tattoo care, and the inks/colors used in the tattoo.

Allergic reactions to tattoo inks are relatively rare but, when they occur, they can cause quite severe reactions. In some cases, the body may begin to reject the tattoo ink and attempt to push it out of the skin. Allergic reactions to tattoo ink may occur immediately during tattooing, during the healing process, or as a result of laser treatment on the tattoo. Allergy may also develop years after getting the tattoo. It is possible that a reaction that occurred during the healing process of the tattoo may resolve on its own over time, but there are treatment options available, and the ink may not necessarily be expelled from the tattoo as a result of the reaction.

Prevention of allergic reactions

Many tattoo artists default to using nitrile gloves because latex is more allergenic and fragile material. However, there are exceptions, so if you have a latex allergy, make sure to verify the material of the gloves with your tattoo artist.

The amount of nickel in tattoo needles is so small that they do not cause reactions in people allergic to nickel, unless the person getting the tattoo is extremely sensitive to nickel.

It's advisable to familiarize yourself with the contents of the ointments used in tattoo care and choose the one that is most suitable for you. Over time, one can develop allergies to various active ingredients in creams, such as dexpanthenol, which is used in products like Bepanthen. For this reason, products containing dexpanthenol should not be used unnecessarily.

It is not advisable to perform an allergy test for tattoo inks before getting the tattoo, as it does not indicate the development of an allergy over a long period of time, and because the allergenic pigment may cause a reaction only when it is placed under the skin. The most common colors causing hypersensitivity are red and blue, but there are some differences between tattoo inks produced by different manufacturers.

Symptoms of allergic reactions

Usually, sensitivity manifests as irritation, redness, itching, warmth, swelling, bumps, and rash. A reaction caused by tattoo ink appears as hypersensitivity throughout the area where the problematic ink was used. If the reaction occurs over the entire area of the tattoo rather than to a specific color, it's more likely that the cause of the allergy is the ointment, detergent, or some other foreign substance that came into contact with the wound during the tattooing or aftercare process.

Red tattoo ink is known to trigger reactions more often than other colors, but the reaction may not necessarily be an allergy; it may instead be a foreign body reaction. Tattoo pigment is a foreign substance to the body, and if the body cannot eliminate it through metabolism, it tries to isolate it by forming scar tissue around the pigment. For some reason, this phenomenon primarily occurs with red and its various shades, less so with other tattoo colors.

If you suspect an allergic reaction to tattoo ink, it's wise to discuss it with your tattoo artist and, if necessary, consult a dermatologist, who can prescribe allergy medications or injections. Even severe reactions can be managed with cortisone injections. It's not recommended to get a tattoo with the ink that caused the reaction.

If the reaction is very severe, removing the tattoo ink from the skin may be necessary. However, laser tattoo removal in cases of allergic reaction is questionable, as the laser may exacerbate the reaction by breaking down ink particles, which can then spread elsewhere in the body through metabolism. For this reason, it's preferable to surgically excise the tattooed area.

Some tattoo artists have treated allergic reactions by tattooing witch hazel onto the affected area, allowing the ink to flow out of the wound with tissue fluid. However, this is not a recommended treatment for handling allergic reactions by dermatologists, and it may cause the allergic reaction to spread or worsen.

Granuloma and keloids

Granuloma refers to the overgrowth of connective tissue, which occurs when the immune system tries to isolate substances it considers foreign but cannot remove from the body. These substances include infective organisms such as bacteria and fungi, as well as other materials like keratin and remnants of suture threads. Pigment particles from tattoos can also cause this foreign body reaction. Granuloma is very uncommon in relation to tattoos, but if it does occur, it's advisable to visit a dermatologist. The dermatologist will diagnose the symptoms and provide advice on further steps.

Keloid, or excessive scar formation, is a hereditary condition. Keloids usually form in surgical wounds when the body overreacts to trauma, surgical procedures, or piercings. They may also develop in relation to tattoos or tattoo removal. Keloids are small or large masses formed from scar tissue. They do not bleed or ooze pus and usually do not feel painful. Keloids often need to be removed through hospital treatment or surgery, but it's possible that a larger keloid may form at the site of the incision made during surgery.

If a person is predisposed to keloid formation, getting a piercing is not recommended, and getting a tattoo should be considered carefully because keloids may also develop at the site of the tattoo wound.

Tattoos and healthcare

In general, tattoos do not prevent performing healthcare procedures. However, tattoos can affect some procedures. For example, it may be more difficult to detect veins when drawing blood or inserting a cannula due to the presence of tattoos. Epidural anesthesia is not primarily administered through a tattoo, but there are multiple sites on the back where epidural can be given, and tattooed skin can be stretched away from the injection site if necessary. If unavoidable, an epidural can also be administered through a tattoo.

The lymph nodes of a tattooed individual may become stained and may also swell because tattoo ink is transported to them through metabolism. Tattoo ink does not leave the lymph nodes over time. This complicates cancer diagnosis.

Tattoos are generally not done over moles to allow for monitoring for melanoma. However, moles may develop on tattooed skin after getting a tattoo. Detecting and monitoring moles covered by tattoos can be very challenging or even impossible.

Reactions to magnetic resonance imaging (MRI) are fairly common and transient. MRI may cause warmth or swelling of the skin at the tattoo site. The reasons for these reactions have not been confirmed, but theoretically, they may be due to metal components in some pigments. However, medical MRI should not be avoided due to tattoos. Tattoos are asked about in the MRI screening questionnaire to prepare for potential complications beforehand.

Being unhappy with the outcome of the tattoo

Unfortunately, tattoos don't always turn out as expected. The tattoo industry has a wide range of artists with varying levels of skill, so the quality of work can vary depending on the artist's experience, motivation, and professionalism. It's important to carefully select your tattoo artist and review their previous work. Every tattoo artist should have a portfolio showcasing examples of their previous tattoos. When comparing different portfolios, it's advisable to evaluate both the quality of the work and how appealing the images are to you personally.

In addition to the possibility of the tattoo not meeting expectations, an inexperienced tattoo artist may cause scarring of the skin while working on the tattoo. Scarred skin cannot be restored to its original state even if the tattoo is removed, so it's crucial to seek out a skilled and professional tattoo artist for this reason as well.

Disappointment with the final tattoo design can be avoided by careful planning before getting tattooed. Typically, the tattoo artist creates a draft based on the client's ideas, which is then approved by the client before tattooing begins. This allows the client to influence the final result by requesting any desired changes to the design.

However, over the years, one may grow tired of a tattoo, even if they initially liked it. As tattoos age, they fade and their outlines may blur. The lightest colors fade the most, and the tattoo may no longer look cohesive. Re-coloring can help with fading, but if the subject matter of the tattoo starts to feel outdated over the years, it's possible to get a completely new design tattooed over the old one by a tattoo artist experienced in cover-up tattoos.

Tattoos and mental health

Tattooing can evoke strong emotions, especially when getting a tattoo to commemorate a significant life change or the loss of a loved one or pet. In such cases, there may be high expectations and assumptions associated with the moment of getting the tattoo and the tattoo itself. Additionally, first-time tattoo clients may have unrealistic expectations about the tattooing process or how the tattoo will look after healing. Therefore, it's beneficial to thoroughly research the tattooing process and aftercare beforehand and to communicate with the tattoo artist to gain a realistic understanding of the tattooing process and aftercare.

A tattoo is a permanent change to one's body. It's normal for a new tattoo to initially feel unfamiliar, and it may take some time to adjust to the altered self-image. However, individuals suffering from more severe anxiety disorders, such as body dysmorphic disorder, may experience significant distress and depression after getting a tattoo.

It's important to recognize that while getting a tattoo may coincide with major life changes, the death of a loved one, or similar traumatic events and associated emotions, tattoo artists generally do not have training as therapists, and they are not the appropriate individuals to address these issues and professionally manage the client's mental well-being. The tattoo artist may have experienced challenges in their own lives that could hinder their ability to listen to and handle the client's experiences. Individuals in need of trauma therapy or suffering from anxiety disorders are advised to seek help from mental health professionals.

Tattoo is forever

Removing a tattoo is a long, difficult, and expensive process. However, tattoo removal methods are constantly being developed, so today it is possible to get rid of a tattoo to some extent. However, the skin cannot be completely restored to its pre-tattoo state because removing all tattoo ink is very challenging and the skin may scar both during tattooing and as a result of its removal. The most commonly used removal method today is laser.

Depending on the laser used and the colors in the tattoo, removing a tattoo requires multiple treatment sessions with several weeks between each session, resulting in a significant amount of time and money spent for complete removal. Laser treatment may lead to scarring and pigmentary changes in the skin. In inexperienced hands, a powerful laser can also cause burns and skin damage. The use of laser devices by private practitioners in Finland was completely prohibited at the end of 2011, so today tattoo laser removal is legal only when performed by or under the supervision of a physician.