Understanding The Risks Associated With Tattoo Ink
- As Saturday Night Live’s Pete Davidson works towards getting most of his 200 tattoos removed, a newly published study is suggesting that tattoo ink exposure may increase one’s risk of lymphoma and skin cancer.
- According to a recent Pew Research Center survey, approximately 32% of adults in the U.S. have a tattoo, including 22% who have more than one, meaning millions have some form of body art.
- As for the safety of ingredients, Dr. Ilene Rothman, Associate Professor of Oncology in the Department of Dermatology at Roswell Park Comprehensive Cancer Center, previously told SurvivorNet, “Some tattoo inks contain ingredients that are potentially carcinogenic. Current inks are believed less likely to contain potentially carcinogenic substances, but since the composition and sale of tattoo inks is not regulated, this is not known definitively.”
- It’s important to know that as of now, there is no scientific proof to link tattoos with skin cancer diagnoses. However, regular skin checks and examinations can help everyone whether you’re inked up or not. It’s recommended that you check your skin at least once a month to make sure everything checks out, and visit your physician if you believe something might be suspicious.
Although Davidson’s reasoning for removing his tattoos isn’t due to the potential of heightening cancer risk, his decision to obtain a new, clean look is a good reminder on being aware of what substances make up tattoo ink and it’s effects on the body.
Read MoreHis commentary comes as a new Danish study, published in the journal BMC Health, suggests “an increased hazard of lymphoma and skin cancers among tattooed individuals, demonstrated through two designs: a twin cohort and a case-cotwin study,” as per the study authors.
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The study authors explain, “We are concerned that tattoo ink interacting with surrounding cells may have severe consequences. Studies that pinpoint the etiological pathway of tattoo ink induced carcinogenesis are recommended to benefit public health.”
The case-control study found that tattoo ink can raise one’s risk of skin cancer between 33% and 62%, and that tattooed individuals were at a heightened risk of skin cancer.
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Additionally, increased risk was found for skin cancer and lymphoma when tattoos were bigger than the palm of a hand.
The study authors explain in their discussion, “Larger tattoos may show a stronger effect either due to higher dose of exposure or longer time of exposure (from tattoos acquired over time).
“Likewise, absence of red ink shows an effect; however, some ambiguity arises due to color effects, as many colors are typically present at the same time. We are cautious about interpretation and recommend more detailed studies of size and color.”
It’s also important to note that this study isn’t the first of it’s kind, just last year a Swedish population case-control study suggested that tattoos were a risk factor for malignant lymphoma.
Another Swedish study, (EClinicalMedicine) from Lund University, published last year, found a possible link between tattoos and lymphoma.
“We have identified people diagnosed with lymphoma via population registers. These individuals were then matched with a control group of the same sex and age, but without lymphoma. The study participants answered a questionnaire about lifestyle factors to determine whether they were tattooed or not”, says the study’s lead researcher Christel Nielsen.
“After taking into account other relevant factors, such as smoking and age, we found that the risk of developing lymphoma was 21 percent higher among those who were tattooed. It is important to remember that lymphoma is a rare disease and that our results apply at the group level.”
Meanwhile, a study from Binghamton University researchers, also published last year, has found that 90% of U.S. tattoo inks have unlisted ingredients—something which is concerning as approximately 32% of adults across the country have body art.
Researchers from Binghamton University (Bing U), New York, recently analyzed 54 tattoo inks, varying from top U.S. brands to smaller manufactures, and discovered the alarming number of tattoos with significant labeling discrepancies. They found additives and pigments in the inks which were not listed in the printed ingredients.a
Is Tattoo Ink Dangerous?
Tattoos have changed dramatically over the years, and so have safety precautions. In the past, red tattoo ink contained dangerous substances such as mercury. This is hardly the case anymore, as tattooists now use safer red ink since people can have life-threatening allergic reactions to mercury. However, the type of ink in your tattoo can depend largely on your tattoo artist and the studio you go to.
A leading expert previously spoke with SurvivorNet about whether there is an official link between tattoo link and cancer, and shared some guidance for those who might be worried.
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“First of all, it is very important to note that the jury is definitely still out on whether there is a link at all,” Dr. Ilene Rothman, Associate Professor of Oncology in the Department of Dermatology at Roswell Park Comprehensive Cancer Center, tells SurvivorNet, referring to how tattoos and their link to skin cancer.
According to a recent Pew Research Center survey, approximately 32% of adults in the U.S. have a tattoo, including 22% who have more than one, meaning millions have some form of body art.
Additionally, the study found that the most commonly cited reason people get tattoos “is to honor or remember someone or something,” which 69% of tattooed adults say “this is either a major or minor reason they got any of their tattoos.”
“Just under half (47%) say they got a tattoo to make a statement about what they believe, and 32% say they got at least one to improve their personal appearance,” the survey found.
Dr. Rothman also pointed out that over a 40-year period there have only been reported 64 cases of skin cancer occurring within a tattoo. That being the case, and given the fact that there’s no official research on this topic, it’s too soon to deduce whether there’s a scientific link between the two.
“These cases may certainly be coincidental, [meaning] skin cancers occurring on skin that just happens to be tattooed,” Dr. Rothman said. “We just don’t know at this point because there have been no long-term large-scale studies.”
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As for the safety of ingredients, Dr. Rothman explained, “Some tattoo inks contain ingredients that are potentially carcinogenic. Current inks are believed less likely to contain potentially carcinogenic substances, but since the composition and sale of tattoo inks is not regulated, this is not known definitively.”
The main issue between tattoos and skin cancer isn’t in the ink itself, but rather that among people with many tattoos, skin cancer diagnoses can be missed. If more surface area of the skin is covered in tattoos, it makes it more difficult for dermatologists to examine the skin effectively. Without a proper examination, it’s possible moles and other signs of skin cancer could be undetected.
“Tattoos can camouflage skin cancers to both dermatologist exam and self-exam,” says Dr. Rothman. “Additionally, the instruments we use to examine the skin help us analyze patterns of skin pigment and other skin features, and tattoos can impede this to some extent. For patients who have numerous moles, we sometimes look for, and encourage our patients to look for, what is known as the ‘ugly duckling sign’ which refers to a mole that stands out from the rest.
“This is definitely confounded by extensive tattoos. We can certainly still diagnose skin cancer on tattooed skin, but tattoos can make it harder for people to find skin cancer on their own skin or on a friend’s or family member’s skin,” she added.
Back in 2022, a study out of State University of New York (SUNY) took samples of 56 different tattoo inks, and found that nearly half had azo compounds, or synthetic compounds, that can possibly mutate under ultra-violet light/sunlightor when exposed to certain bacteriainto cancer-causing chemicals.
Additionally, the researches found that many of the ink samples had substances that were not listed on the label.
Leading chemist on the study Dr. John Swierk told DailyMail.com at the time, “It’s possible that you might have pigments that by themselves are safe, but that photodecompose into something of concern.
“Big companies manufacture pigments for everything, such as paint and textiles. These same pigments are used in tattoo inks,” Dr. Swierk further explained in a news conference.
The tattoo industry, they say, is “largely unmonitored,” therefore these experts are focused on building a “comprehensive database of ingredients in different tattoo inks” in the United States.
The European Union banned two specific types of pigments, blue 15:3 and green 7, after similar finding in a 2020 study. However, experts in Germany reportedly said that they found both had a “low level” of toxicity.
We do know that tattoos, in some cases, can cause bacterial infections, and experts also say that tattoos can potentially affect doctor’s findings with an MRI scan, making it harder to diagnose cancer and other conditions.
Dr. Swierk also noted that they have concerns about laser tattoo removal and cancer risk, “since we don’t understand how the laser is transforming the pigments.”
How Can You Protect Yourself?
It’s important to know that as of now, there is no scientific proof to link tattoos with skin cancer diagnoses. However, regular skin checks and examinations can help everyone whether you’re inked up or not. It’s recommended that you check your skin at least once a month to make sure everything checks out, and visit your physician if you believe something might be suspicious. When checking your skin, there’s a helpful guide to follow, and it’s called the ABCDE system.
- Asymmetrical moles make sure the moles are equal on both sides
- Borders examine whether the edges of the moles are jagged, irregular, or not smooth
- Colors check if the there are different colors in the mole
- Diameter Measure the mole to see if it’s larger than 6 millimeters
- Evolution The most important step in the process. Routinely check to see if the mole change over time, whether it’s in color, size, shape, or it’s itchy and painful.
Cancer Patients Turning to Tattoo Art
Still, while we believe that these are valid concerns and more regulation is necessary, many cancer patients turn to body art as a form of expression, while mainly seeking comfort after beating the disease.
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Many breast cancer patients have been able to embrace their new bodies after mastectomies, the removal of their breasts, with the help of artists who tattoo nipples and other artwork on their breasts.
Dr. Raheem Nazerali, a breast reconstructive surgeon at Stanford Health Care, explained the nipple tattooing process in a previous interview with SurvivorNet.
“Nipple tattooing is generally for patients who have undergone a skin sparing mastectomy or a delayed reconstruction,” Dr. Nazerali explained. “So patients who are not eligible for nipple-sparing mastectomies can have a nipple reconstructed by their plastic surgeon.”
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“Generally I tell patients that there’s three different types,” he continued. “There’s a 2D reconstruction, a 3D reconstruction, and a 4D reconstruction.”
The 2D is basically just the tattoo done by either a tattoo artist, or done by a physician assistant, or an advanced practitioner, that provides color to where the nipple was supposed to be.
When getting a nipple tattoo, or any other tattoo, just do your research to make sure the benefits to you as a person outweigh the potential risks. Many cancer warriors have overcome so much and choose to not live in fear, but we also have to take into account how toxic certain products can be. Everything in moderation, they say. You do you!
“The 3D tattoo involves shading, so different amounts of shading just like makeup can make things look either flat or can make things look, in three dimension,” he said. “And utilizing color and shading, tattoo artists are able to provide excellent 3D reconstructions of a nipple that appear from the front to have a papule of the nipple, or the center portion of the nipple, with the surrounding color.”
Contributing: SurvivorNet Staff
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