Science unveils sinister side to tattoo crazePUBLISHED: 01 Oct 2013 14:50:38 | UPDATED: 02 Oct 2013 06:18:57PUBLISHED: 02 Oct 201
Science unveils sinister side to tattoo crazePUBLISHED: 01 Oct 2013 14:50:38 | UPDATED: 02 Oct 2013 06:18:57PUBLISHED: 02 Oct 2013 PRINT EDITION: 02 Oct 2013
As tattoos have become more fashionable they have attracted more scientific research and concern is now emerging about a possible long-term health risk. This photo shows an allergic reaction to red ink, with thickening and crusting.
Jill Margo Health editor
As tattoos have become more fashionable they have attracted more scientific research, and concern is now emerging about a possible long-term health risk.
There is solid science to show that many of the inks used in tattoos contain carcinogens. This means people are having cancer-producing particles injected directly into their skin.
But oddly enough, they are not developing skin cancers. One explanation is that these particles are stable. If they were not stable, the tattoo would not be permanent.
However, when people want to remove a tattoo, lasers are often used. Lasers shatter the pigments, making the particles unstable and more likely to flow into the body’s lymph system.
If they are small enough they may then pass into the blood stream and come to rest anywhere in the body.
Even nanoparticles can contain potentially harmful chemicals. If these settle in an area, the harm could build slowly and only declare itself decades later, perhaps in the form of a cancer.
When this destabilising effect was scientifically demonstrated, academic skin clinics and regulatory authorities in some countries questioned the value of laser removal and there was a downturn in use.
“Laser removal of tattoos almost stopped in Germany because of this risk,” says Jørgen Serup, a world leader in research into the chemistry of tattoo inks and how the body deals with them.
Serup, professor of dermatology and chief physician at the Bispebjerg University Hospital in Copenhagen, says surgery is more effective in removing tattoos than lasers, although it too can have side effects.
While small tattoos can be cut out, large ones are removed using a process called “dermatome shaving” which takes off thin layers of skin until the tattoo disappears.
Last year, Serup contributed to an extensive report for the Danish government entitled Chemical Substances in Tattoo Ink which analysed 65 inks. In July this year, he co-published a study on black ink, the most commonly used colour.
Ink linked to cancer
It showed 10 out of 11 black inks that were studied contained concentrations of the carcinogen, polycyclic aromatic hydrocarbon, at levels that exceed European safety recommendations. This carcinogen is also found in soot, tar and cigarette smoke.
Although carcinogenic inks pose a clear theoretical risk, he says it is not known if they have a hidden impact on cancer. What is being seen in the laboratory is not being seen in the clinics.
The concern, however, goes beyond the effects of lasers. While pigment is largely stable the first few weeks after being injected, it may move locally in the skin. Over time it may also be degraded by factors such as sunlight.
In these cases, loose particles may enter the lymphatic system and come to rest in regional lymph nodes from where there is direct contact with the bone marrow and the immune system.
Serup says a high percentage of people unknowingly have their lymph nodes tattooed. Neither the tattooist nor the subject is aware of this because the lymph node is not visible.
“Often pathologists will find green pigment in the lymph node of that area. The node is a filter and stops most pigment from entering the circulation. But we don’t know the degree to which particles enter because some, like the black ones, are nanoparticles and can get through and reach the blood stream.”
These nanoparticles could have an effect similar to the one that happens with metal-on-metal hip replacement joints.
As the components of these joints move against each other, they can release ions, such as cobalt and chromium, into the bloodstream.
These accumulate and have been associated with effects on the heart, skin, endocrine and nervous system.
“It took years to convince the medical community that there may be a problem with these joints, so I would not exclude tattoos having a hidden impact on a cancer in any organ system,” says Serup.
“But, with 100 million Europeans now inked, it is surprising tattoo-related skin cancers are not being seen in skin clinics. Our clinic has never seen a skin cancer arising in a tattoo due to a suspicious pigment.”
A major review published in The Lancet Oncology traced 50 cases of skin cancer in tattoos but Serup says this number is insignificant given how many spontaneous cancer