Copenhagen, 9 October 2015. Body adornment is a human characteristic and has been practiced since ancient times in all races and in all continents. Body art includes many temporary decorations such as body painting and henna tattoos, but also several permanent body modification techniques such as permanent tattoos, piercings, dermal anchors, stretching, implanting, branding, scalping and more. The aim of body art is to change appearance, to give a person a special look and/or to increase visual attraction – no wonder body art has become mainstream.
The most popular forms of body art nowadays are tattooing, Permanent Make-up (PMU) and piercing.
Tattooing and Permanent Make Up (PMU) involve implantation of a colorant into the skin. Although health and safety regulations have been established by the Council of Europe, ResAp2008(1)1, focusing on hygiene rules to prevent infections (e.g. that diseases like Hepatitis B and HIV are not transmitted by sharing needles, etc.), tattooing is not without its risks. The quality and sterility of tattoo inks, which are generally not controlled, gives reason for concern. A Danish study2 of bacterial contamination of 58 new inks showed that 10% of the inks are contaminated with bacteria, i.e. Staphylococci, Streptococci, Pseudomonas species and Enterococcus/Coli. These contaminated inks may lead to infection, especially in people at risk (e.g. people with heart diseases, diabetes and patients with a weak immune system). Last August, the FDA3 identified microbiological contamination (including Mycobacterium chelonae) in unopened tattoo inks made by A Thousand Virgins, Inc. The company recalled the products, but the FDA is concerned that tattoo artists are continuing to use these contaminated inks from their current stock.
Allergies and toxicity are other points of concern. The requirements and the restrictions of the ResAp2008(1) on the composition of tattoo and PMU inks are insufficient to guarantee safety. Tattoo inks consist of pigments and dyes, additives and even nano-particulate traces of heavy metals and also impurities of the production process (e.g. polycyclic aromatic hydrocarbons PAH and primary aromatic amines PAA). In many cases, the ingredients and chemicals are not clearly labelled. The market is poorly controlled. Some pigments used in tattoo inks are not listed by the Scientific Committee for Consumer Products (SCCP), an advisory body to the European Commission, and therefore are not allowed in cosmetics. Moreover illegal products of poor quality can easily be purchased on the internet.
”We need a positive list of safe pigments and ingredients. Tattoo inks should at least meet the same standards as cosmetic products”, postulates Dr. Christa De Cuyper, MD (Brugge, Belgium). “We need data on toxicity and biokinetics, and the inks should be tested for their potential toxicity, phototoxicity, substance migration, carcinogenicity, and possible metabolic conversion. We need further research, but as a first step, we need a uniform European standard to protect consumers! And let’s not forget that up to 20% of individuals regret their decision of having a tattoo and ask for medical advice to get it removed! To avoid regret and complications I insist that tattooing should be a well informed decision, performed by a well trained professional, in hygienic conditions and with safe materials.”
(2) Høgsberg T, Saunte DM, Frimodt-Møller N et al. Microbial status and product labelling of 58 original tattoo inks. J Eur Acad Dermatol Venereol 2013; 27(1): 73-80