There is the potential for pigments used in tattoo inks to be contaminated with bacteria, mould and fungus. Studies performed by health departments, the CDC, the FDA, scientists and medical researchers around the world seem to show that tattoo inks contaminated with bacterium are far from uncommon. Even the most diligent tattoo artist with a perfect standard of hygiene is usually unaware that the tattoo inks being used are already contaminated. Contaminated tattoo inks in most instances, show no visual sign of contamination. Recently EU REACH Compliant Tattoo ink manufacturers have begun offering single use sterile vials of tattoo ink to reduce the products risk of contamination. A recent study by the European Journal of Dermatology tested over fifty tattoo ink bottles from various manufacturers. The tests found ten percent of the tattoo inks were contaminated with microbially containing a variety of bacterium whilst the tattoo inks were still sealed.
Tattoo inks penetrate directly into the dermis, the second layer of skin. As broken skin and bleeding result from the needles it’s important to ensure the tattoo is performed safely. It is extremely important for any one showing signs of a skin lesions or infections to seek medical advice immediately. Ointments provided by tattoo artists for wound care are not suitable for treatment of infections. Cutaneous mycobacterial infections are not readily contracted, but should be considered in cases where skin lesions do not respond to standard antimicrobial therapy. If an infection from a tattoo occurs to help control such outbreaks it’s vital to contact the health authorities in your country and contact the tattoo artist so they can prevent any further immediate instances of contamination occurring.
One contaminant particularly concerning is the family of bacteria called nontuberculous Mycobacteria (NTM). (NTM)and other mycobacteria have been associated with pulmonary disease resembling tuberculosis, lymphadenitis, skin disease, or disseminated disease. M. chelonae,another NTM species which is a fast growing bacteria that can be found in tap water and has been linked to a number of serious health issues such as lung disease, joint infection and eye damage. M. chelonae infections most commonly occur in immunosuppressed patients but can also be seen in otherwise healthy individuals. Infections are often difficult to diagnose as they can look like a mere allergic reaction. NTM infections usually require treatments which often last six months or more. Some of the antibiotics used can cause unpleasant side effects such as nausea or gastrointestinal problems. Without prompt medical treatment these infections can spread beyond the tattoo and risk becoming a secondary infection.
A recent outbreak of illnesses linked to contaminated tattoo inks were reported in America in 2012. FDA’s CORE (Coordinated Outbreak Response and Evaluation) Network initiated an investigation with state and local health departments. The investigation began in January 2012 where seven people in Monroe County, New York were confirmed to have NTM infections. All cases where linked to the same tattoo artist who confirmed to have used the same brand of ink on each person infected. The infections occurred on new tattoos resulting in red bumps appearing soon after the tattoo had healed. Twelve more cases of the NTM infection were later linked to the same tattoo artist. Tests later discovered the water used to dilute the tattoo ink was the cause of the NTMcontamination.
The FDA have since made recommendations that tattoo inks are formulated or processed to insure they are free from any risk of bacterial contamination. By no longer using non sterile water to dilute the tattoo inks or prepare the skin for tattooing will greatly reduce any chance of contamination.
In Australia a thirty two year old man obtained extensive tattoos on his thigh and arm by a tattoo artist in Sydney. Three weeks later he developed skin lesions and sought treatment from his local GP. After treatment the lesions showed no sign of improvement and he soon became extremely sensitive to any touch near the tattooed areas. A skin biopsy later confirmed contamination by Mycobacterium chelonae. As the affected area of skin was so substantial, covering around about ten per cent of his body surface, surgery was not an option. Systemic antimicrobial therapy was started immediately as the organisms are extremely resistant to most antimicrobials. The treatment was continued for four months finally resulting in a significant improvement. Some deep scarring occurred but no recurrence of the infection was present. A second skin biopsy demonstrated no further mycobacterial growth.
Public health standard requirements for tattoo parlours are high in America and Australia. Even with these standards, numerous instances of NTM infection have still occurred. It is advised by all health authorities to seek immediate medical attention if any signs of skin irritations develop after receiving a tattoo.