As of: March 20, 2024 5:15 p.m. | from the Norddeutscher Rundfunk logo
Pigments, binders, solvents, additives: the rough formula for tattoo inks sounds relatively harmless. But they can also contain substances that are harmful to health or even carcinogenic.
Itchy and “chubby” – that’s how Jennifer Vetter describes her first two black tattoos, which she got in her early 20s. “Sometimes it drives me crazy because it itches so much,” says the now 50-year-old. According to a 2010 survey of 3,411 respondents, six percent reported long-term health problems with their tattoos.
One of the few who focuses on research on this topic is the toxicologist Ines Schreiver. She heads the Dermatotoxicology Study Center at the Federal Institute for Risk Assessment. Using skin models, she and her colleagues are investigating, among other things, how cells react to different color pigments.
Her first tattoo still causes Jennifer Vetter to itch violently.
“There are various side effects or undesirable health effects that can occur: infections, allergies, or even foreign body granulomas (tissue reaction to allergic-infectious or chronic inflammatory processes/ed.) – the numbers vary between one and six percent depending on the study “, says Schreiver. “And then there are even less serious effects that can occur more frequently, such as impaired sensitivity to heat, cold and pain.”
Intervention in the body – with unclear consequences
When tattoos are pierced, the skin barrier is disrupted, making it easier for pathogens to penetrate the skin and cause infections. Hygiene is therefore the be-all and end-all when tattooing, says Düsseldorf dermatologist Arne Gerber. But not all complications can be avoided in this way: “The side effect that we see most often in dermatological practice is an intolerance, especially to red tattoo pigments – keyword allergy,” says the dermatologist.
The reason for this is probably that red, but also orange or yellow tattoo inks contain a certain group of pigments, the so-called azo pigments. “They can split particularly easily, either through sunlight or through laser light, for example during laser removal,” says Schreiver. This can release potentially carcinogenic substances, so-called aromatic amines.
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But black tattoos can theoretically also cause allergic reactions – as happened with Jennifer Vetter. They can also contain so-called polycyclic aromatic hydrocarbons, or PAHs for short. The group of PAHs includes more than 100 substances, eight of which are classified as carcinogenic. However, there is still no real research into whether tattoo inks are related to tumor diseases.
More than 4,000 substances banned in the EU
In the EU, the European Chemicals Agency, or ECHA for short, determines which substances may not be contained in tattoo inks in the so-called REACH regulation. It came into force in a revised form in 2022. In addition to carcinogenic substances, it also lists mutagenic substances and those that can affect reproduction. According to the regulation, more than 4,000 substances in tattoo inks are now banned – either completely or in certain concentrations.
Nicole Homfeldt (32 years old) in her Hamburg tattoo studio on Stresemannstraße. In addition to her, five other tattoo artists work there.
“At the beginning of 2022, tattoo inks were virtually no longer allowed from one moment to the next, and we didn’t know what would happen next,” says Nicole Homfeldt. She has been running the Hamburg tattoo studio “farbenkollektiv ” since 2016. The paint manufacturers launched new colors at the end of 2022 – but the debate has remained. “It would be nice if there was a scientific effort behind it to find out what is really harmful to health and what is not, so that we really have reliable information.”
According to experts, regulations need to be improved
The REACH regulation has many weak points and also contradictions, says Wolfgang Bäumler from the Clinic and Polyclinic for Dermatology at the University Hospital Regensburg: “Science is an ongoing process that constantly needs updates. But these updates do not currently exist. What would be needed is some kind Committee for tattoo inks, which always tries to adapt new developments on both sides, as is already the case with cosmetic substances.”
The physicist has been researching tattoos for more than two decades. It does make sense to ban certain substances. “But that alone doesn’t help, I think that we should give the companies something to hand. That’s why it would make sense to develop a so-called positive list. In other words, a list of ingredients that you can say with a clear conscience In terms of risk profile, it’s significantly better than some others.”
Especially since the use of the substances is not checked enough in practice, says Bäumler. “Many colors don’t meet the ECHA requirements, and that makes you ask yourself: What are people tattooed with?” This creates uncertainty not only for customers, but also for tattoo artists like Homfeldt. “You have to rely on it that the online shop you are ordering from is trustworthy. We only order from German shops that only sell colors that are approved in Germany. At the same time, there is also the option of ordering starter sets from abroad via Amazon, and of course we don’t know whether the quality is guaranteed.”
Pigments migrate to the lymph nodes
But researching tattoo colors is not easy. On the one hand, because they can consist of hundreds of individual substances. And on the other hand, animal testing with tattoo inks is generally not permitted in Germany because tattoos are legally equivalent to cosmetics.
One thing is certain: When tattooing, the pigments come into direct contact with blood and lymph fluid and thus reach the lymph nodes, among other things. “Our data actually shows that there are more pigments in the lymph nodes than in the skin. And this already in the wound healing phase, within the first seven days,” says Schreiver. This can lead to temporary lymph congestion and thus to enlargement and sometimes inflammation of the lymph nodes.
Large tattoos – risk of kidney problems
A completely normal reaction of the body, according to Bäumler, because tattoo ink is a foreign body material for human skin. “Ideally, the body tries not only to drag it into the lymph nodes, but also, if possible, to excrete it again via the liver or kidneys,” he says. “There are patients who experience temporary problems with their kidneys after a large tattoo.”
Closing the data gap on tattoo inks
The new colors are more expensive and often less vibrant compared to the old ones, says tattoo artist Nicole Homfeldt.
To date, tattoo inks have not been researched enough to be able to rule out long-term health risks with certainty. It is important to close this data gap, says Bäumler. “If there are risks for certain diseases, in the worst case also tumor diseases, you can only manage this with large numbers of cases. Because people are also exposed to other risks at the same time: they drink alcohol, they smoke. You have to take into account the additional possible risk, which may be tattoos can be calculated sensibly statistically.” A study with national cohorts in Germany has now been launched in France.
Because you have to be aware, says Bäumler: “Pigments such as those found in tattoo inks are manufactured for purely technical purposes – to paint something colorful or to color plastic, for example.” They contained at least ten to 20 percent impurities. “In technical application this may not matter, but when such pigments are introduced into the body, these impurities can of course play a role.”
Further information
In this FAQ, the Federal Institute for Risk Assessment provides, among other things, an overview of the possible health risks of tattoo inks.
This review summarizes the current state of knowledge about the chemical properties of tattoo inks and possible consequences for our health. external
This report from the European Commission summarizes the current state of knowledge on the safety of tattoos and permanent make-up. external
Questions and answers about the cooperative study led by the BfR to detect tattoo color pigments as nanoparticles in lymph nodes. external
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