Imma Perfetto
Cosmos science journalist
With the rising trend in tattooing among the population, concerns about the potential medical complications associated with these procedures have increased.
A 2-part series of papers in The Lancet Microbe has now explored reports of problems in the medical literature which detailed the incidence, patterns and causes of microbial infections linked to tattoos.
“Despite increased awareness and public health initiatives, the incidence of microbial infections related to tattoos has increased since 2000,” the authors write in the second paper.
The researchers caution that data on the incidence of tattoo-related microbial infections is scarce, and the number of infections is believed to be highly under-reported: “…not only owing to a low number of accurate epidemiological studies, but also because typically only individuals with severe infections seek medical attention.”
“Additionally, tattoo-related infections are often mistakenly attributed to other sources, especially in case of a delay in the onset of symptoms,” they write.“Despite advancements in public health policies and increased awareness of tattoo-related risks, a notable rise in both the number and diversity of microbial infections has been observed with an increase in the population opting for tattoos, particularly since 2000.
“Specifically, cases of bacterial infections have increased, whereas viral, fungal, and parasitic infections have been reported consistently.”
They say this increase has prompted a “re-evaluation of tattoos as a serious public health risk” and that “…although rare, the tattooing process can occasionally lead to life-threatening infections and fatalities.”
The first paper found that 320 outbreaks of tattoo-related microbial infections, affecting 1044 individuals around the world, occurred between 1820-2023. According to the second paper, these tattoo-related infections arose from 4 main sources.
Insufficient hygiene practices during the tattoo, such as the use of non-sterile water or tattoo instruments, were responsible for 63 cases. Tattoo ink contaminated with pathogenic microorganisms caused 27 cases.
Tattooists, who can serve as a potential carrier of pathogens and pose the risk of transmitting infections from sources such as saliva, were responsible for 16 cases. And inadequate aftercare and healing practices were associated with 13 cases.
“Tattoos by both professional and non-professional artists were associated with infections, suggesting that regulated environments do not necessarily eliminate risk,” the authors write.
However, trends in the causes of tattoo-related infections changed over time. For example, while tattooist-related infections were the main source of infection before the year 2000, there haven’t been any cases reported since.
Many countries began implementing legal regulations on tattooing in the 2000s.
Cases from insufficient hygiene practices, which has been a major source throughout all periods, have risen noticeably since 2010. Infections from contaminated tattoo inks, which were non-existent before 2000, have increased to 12 cases from 2000–09 and 15 cases from 2010-2023.
They say that the insights from both papers sheds light on the historical aspects of tattoo-related infections and contributes perspectives for future preventive measures and development of effective public health guidelines.
