Outbreak: The largest cluster of tattoo infections was found in Rochester, New York, where 19 people who went to the same artist caught the bug
While not life-threatening, the bacteria can cause itchy and painful pus-filled blisters that can take four months or longer to clear up, and involve treatment with harsh antibiotics with unpleasant side effects.
Some ink manufacturers add witch hazel or an alcohol preservative to lower risk of certain viruses, but the hardy chelonae bacteria are resistant to disinfectants, she added.
Investigators found the bacteria in opened and unopened bottles of ink at the New York tattoo parlor. They did not find it in water at the shop, meaning that the artist was not the one who diluted the ink, MacCannell said.
Health officials say tattoo customers should ask what kind of ink is being used and what measures are in place to prevent infections.
Source of outbreak: A tattoo artist from upstate New York said he bought the ink linked to the infection at a large trade show in Arizona
But in all the New York cases, the tattoo artist wore disposable gloves and sterilized his instruments. The problem, investigators concluded, was in the ink, which the Rochester artist bought at large trade show in Arizona, according to NBC.‘Even if you get a tattoo from a facility that does everything right, it's not risk free,’ said Dr Byron Kennedy, deputy director of the health department in New York's Monroe County.
He is lead author of a report on last fall's Rochester cases was released by the New England Journal of Medicine on Wednesday.
In the past year, there have been 22 confirmed cases and more than 30 suspected cases of the skin infection in Colorado, Iowa, New York and Washington state, health officials said.
The infections were tied to ink or non-sterile water used to dilute the ink, according to health officials.
Tattoos breach the skin, which means that skin infections and other complications are possible. Specific risks include:
- Allergic reactions. Tattoo dyes — especially red, green, yellow and blue dyes — can cause allergic skin reactions, such as an itchy rash at the tattoo site. This can occur even years after you get the tattoo.
- Skin infections. A skin infection — which might cause redness, swelling, pain and a pus-like drainage — is possible after tattooing.
- Other skin problems. Sometimes bumps called granulomas form around tattoo ink. Tattooing can also lead to keloids — raised areas caused by an overgrowth of scar tissue.
- Bloodborne diseases. If the equipment used to create your tattoo is contaminated with infected blood, you can contract various bloodborne diseases — including tetanus, hepatitis B and hepatitis C.
- MRI complications. Rarely, tattoos or permanent makeup might cause swelling or burning in the affected areas during magnetic resonance imaging (MRI) exams. In some cases, tattoo pigments can interfere with the quality of the image — such as when a person who has permanent eyeliner has an MRI of the eye.
What's formaldehyde and antifreeze doing in your skin?Tattooing is an art form that has been used for centuries by tribal societies in religious rites and as a natural part of life. At first banned and then appropriated by Western culture, tattoos have recently developed as a decorative art of self-expression; used by some to celebrate events, memorialize a departed loved one, or as a show of commitment to a life partner. There is one thing for sure: all tattoos have a story. What's not so clear is exactly what we're injecting into our skin for art's sake.
A far cry from their tribal predecessors made with dyes from the natural environment, many of today's tattoos contain an unknown conglomeration of metallic salts (oxides, sulphides, selenides), organic dyes or plastics suspended in a carrier solution for consistency of application.3 In the European Commission's report on the health risks of tattooing, they note that close to 40% of organic colorants used in permanent tattoos in Europe are not even approved for use on the skin as a cosmetic ingredient and just under 20% of the colorants studied contained a carcinogenic aromatic amine. Many of the chemicals found were originally intended for use in writing and printer inks, as well as automobile paints.4 These inks are injected deep enough into the skin that often tattoos will not even be destroyed by severe burns.5
In America, the FDA regulates some of the ingredients in cosmetics worn on the skin, and vitamins, drugs and food additives ingested into the body, but it does not regulate these toxic inks we put under our skin. Their official stance:
"Because of other public health priorities and a previous lack of evidence of safety concerns, FDA has not traditionally regulated tattoo inks or the pigments used in them."6
The FDA also does not require ingredient disclosure on the inks—they are considered proprietary (trade secrets)—and so tattoo inks may contain any chemical, including those known to be mutagenic (capable of causing mutations), teratogenic (capable of causing birth defects), and carcinogenic (capable of causing cancer), or involved in other biochemical reactions in the body that might take decades to appear.3 Surprisingly, the FDA does not list cancer in their list of potential tattoo risks, citing only infection, removal problems, allergic reactions, granulomas, keloid formation, and MRI complications.6 The job of testing and legislating the use of tattoo pigments in permanent cosmetics is left to the state. In California, specific ingredients are prohibited and the state will even legally pursue companies who fail to disclose tattoo pigment ingredients to the consumer. They recently brought suit against nine pigment and ink manufacturers for inadequate labeling.5
What's in a tattoo?
Without full disclosure of ingredients, it is impossible to know for sure what is in tattoo ink. Added to this, each color and each brand of ink has completely different ingredients, according to a 2005 study out of Northern Arizona University.7
The carrier solution itself might contain harmful substances such as denatured alcohols, methanol, rubbing alcohol, antifreeze, detergents, or formaldehyde and other highly toxic aldehydes.3
The question of toxicity is multifaceted; there are others factors that may exponentially increase the serious health risks associated with tattooing. When alcohol is used as part of the carrier base in tattoo ink or to disinfect the skin before application of the tattoo, it increases the skin's permeability, helping to transport more chemicals into the bloodstream. Alcohol also works synergistically with mutagens, teratogens, and carcinogens to make them even more harmful, increasing the chance that they may cause mutation or disease, both at the site of the tattoo and systemically.3
Other health risks.
In addition to allergic reactions and the unknown long-term health effects from the metal salts and carrier solutions that make up tattoo inks, there are other health risks involved. Skin infections, psoriasis, dermatitis and other chronic skin conditions, and tumors (both benign, and malignant) have all been associated with tattoos. Due to the use of needles in tattoo application, there is also the risk of contracting infectious diseases such as tetanus, herpes simplex virus, staph, HIV, AIDS, Hepatitis B and C, and even Syphilis. And those with tattoos might not be able to get a life-saving MRI (Magnetic Resonance Imaging) test if they need one—some hospitals and testing locations will refuse to do an MRI on people with body tattoos due to the metal particles in the tattoo, which may cause a burning pain during the test.10
If you plan on having your tattoo removed, you should be aware that some of the pigments used (especially Yellow #7) are phototoxic and may break down into toxic chemicals in the body when removed with UV light or laser, common techniques used in tattoo removal. The toxic end-products eventually wind up in the kidneys and liver, adding to your total body burden.5
Think for yourself.
In an ideal world, the 'trade secrets' clause that allows companies to put profit over public health would be disallowed for all products used topically, trans dermally, or ingested into our bodies. However, in the absence of federal regulation to protect the consumer from unqualified tattoo artists, unhygienic tools and application methods, and highly toxic inks, the best advice for the youth of today is abstinence from tattoos. At the very least, one should find out if their state has any regulations on tattoo inks, and always ask to see the Material Safety Data Sheet (MSDS) for any pigment or carrier used to see basic health and safety information for the ingredients involved. Skin tests should be performed prior to tattoo application to see if you are allergic to any of the ingredients. Although certain tattoo ink ingredients may be plant-based or otherwise considered safe and non-toxic, the truth is that no long-term studies have been performed confirming that they are safe to inject as a permanent cosmetic. Bottom line: don't trust the government, tattoo ink manufacturers, or tattoo artists to give you accurate and complete information on the toxicity of the pigments and dyes being used—at least not just yet.
What do the states require to become a tattoo artist? It varies but most:
High school diploma or proof of GED completion is usually required
Most states require tattoo artists to be 18 years of age or older; some shops prefer or require artists to have visible tattoos themselves
And to buy a license from the State for around 30.00 dollars.
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