Risks, which get under the skin
BfR informs about health risks of tattoos and their removal
Tattooing can involve undesirable effects such as infections, cicatrisation or allergic reactions. Moreover, long-term health effects of tattooing agents applied under the skin are possible. However, the removal of tattoos is likewise not without risk: for some time already there has been increasing advertising for processes in which liquid tattoo removal agents are used. These are solutions which contain as a rule 40 % L(+) lactic acid and are injected like tattoo agents under the skin. Cases have been reported to the Federal Institute for Risk Assessment (BfR) in which undesirable effects occurred after the application of liquid tattoo removal agents. In some instances severe inflammation reactions of the skin with cicatrisation occurred. An alternative to chemical tattoo removal is the use of laser techniques. In this connection it is, however, so far not clear what chemical compounds arise during the treatment and what undesirable effects can be caused by these compounds. "Against the backdrop of the health risks consumers should think twice before they have themselves tattooed", says Professor Dr. Dr. Andreas Hensel, President of BfR. Whoever decides in favour of a tattoo or its removal should get as far as possible detailed information in advance about the agents and processes used and have himself/herself treated by expert personnel.
About 10 % of all Germans are tattooed; in the age group of 16-29-year-olds this share reaches almost 25 %. Tattooing agents are injected under the skin in the same way as permanent make-up colours. For decorative tattoos agents are used in most cases which contain organic pigments; for permanent make-up iron oxides and soot are often applied. Undesirable side effects of a tattoo or permanent make-up can be infections, inflammations, cicatrisation or allergic reactions. In addition, long-term effects are possible in respect of which hardly any findings are available so far. There is currently a debate about the decomposition of colouring agents under the skin and the migration of pigments and their cleavage products to other organs. For tattooed persons colour pigments were for instance detected in lymph nodes.
The removal of tattoos and permanent make-up is likewise associated with health risks: liquid tattoo removal agents are injected under the skin just as tattooing agents. As an active ingredient they can contain 40 % lactic acid. Lactic acid has an irritant effect on skin and the mucous membrane; the irritant effect can already occur at a concentration of 20 % in formulations. Cases have been reported to BfR in which partly severe undesirable effects occurred after the application of lactic acid to remove tattoos and permanent make-up. In the worst cases severe inflammations of the skin and cicatrisation can occur. The inflammation reactions are attributed to the use of lactic acid. Moreover, it is possible that during the treatment sterile conditions are not observed and germs can get under the skin.
In medicine tattoo removal is currently based on laser technology. Short-pulsed laser beams, which are adjusted to the respective colour pigment in terms of wave length, decompose the pigments under the skin. However, also for these methods side effects are possible. It is not yet clear what chemical compounds develop during laser treatment and what health risks are triggered by them.
Against the backdrop of the health risks which are associated with tattoos and their removal, consumers should think twice about the stitching of a tattoo. Whoever decides in favour of a tattoo or permanent make-up should obtain as far as possible comprehensive information about the agents used in advance and make sure that the treatment is carried out by expert staff. Hygiene standards should by all means be complied with. The same applies to tattoo removal. Here, too, consumers should obtain detailed information about the removal method, possible side effects and the expert knowledge of the staff.
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