Infectious Ink? What You Need to Know About the Tattoo Infection Outbreak

by Karan Chhabra

Summer’s winding down, which means opportunities are dwindling to get a regrettable tattoo from that shady spot down the boardwalk. (That is what people do over the summer, right? Is New Jersey getting the best of me?) But some recent reports should give you yet another reason to think twice before getting that tribal face tattoo.

The past few years have seen a spate of tattoo-related infections all over the country. Most recently in January 2012, the New England Journal of Medicine reports:

In this outbreak in Rochester, New York, cutaneous M. chelonae infection developed in 19 patrons of a tattoo parlor, with culture confirmation in 14, after tattooing performed with the use of a premixed gray ink manufactured in Arizona. … Evidence implicated the ink, not the practices of the tattoo parlor, as the common source of infection.

First off: don’t freak out. One in five American adults have tattoos now, and I imagine most got them without incident. But there are a few interesting and alarming things here. For one, the tattoo parlor did everything by the book: “the artists used sterile instruments, wore clean disposable gloves, poured ink into single-use containers, and provided appropriate aftercare to the tattooed site… no dilution or mixing of inks at the parlor occurred, and the artist avoided contamination of ink from tap water at the facility.” So the infections actually resulted from the ink, which had been mixed in Arizona. What this means is that no matter how reputable, clean, and safe a tattoo parlor seems, it’s hard to know whether its ink could leave you with something nasty—because the tattoo artist himself may not know.

The obvious question is, how could something like this happen? Aren’t there safeguards in place to prevent people from injecting bacteria into our skin? Well, there are. As a companion piece in the New England Journal points out,

“historically, the control of tattoo-associated dermatologic infections has focused on ensuring safe tattooing practices and preventing contamination of ink at the tattoo parlors — a regulatory task overseen by state and local authorities.”

But here, obviously, the tattoo parlor was doing everything right. Investigators found the bacterium in unopened bottles of ink, suggesting it was the ink producer at fault. In previous cases, it was the tattoo parlor’s fault, but not this time.

The FDA is responsible for regulating tattoo ink, but by treating it as “cosmetics,” it subjects tattoo ink to much less scrutiny than, say, a drug. Though the color additives in tattoo ink are technically subject to premarket approval, the FDA itself admits that it hasn’t paid them much attention:

…because of other public health priorities and a previous lack of evidence of safety concerns, FDA traditionally has not exercised its regulatory authority over tattoo inks or the pigments used in them.

After these reports, that’s sure to change. In the meantime, what can you do to protect yourself? First—think twice about that tribal design, lest you end up like this guy:

Unfortunately the FDA’s reports don’t offer much concrete advice on how to avoid the bad stuff, besides that “consumers should patronize artists who use sanitary tattooing practices and who can confirm that their inks have undergone a process that eliminates harmful microbial contaminants.” It’s common sense to go to a place with sanitary tattooing practices, but as the Rochester outbreak shows, it’s not enough. I think the important thing is to show that you’re in the know, that you’ve heard about the incidents in New York and that you’re ready to grill your tattoo artist about his ink sources if need be. It might sound like a buzzkill, but on balance I’d say it’s worth the effort. Because imagine how much worse your face tattoo would be with a bumpy red rash all over it.

photo credit

(DISCLAIMER: Though we make every effort to keep you up to date on healthcare news, Project Millennial does not offer medical advice. Please refer to your personal physician for specific medical needs.)

Karan is a first-year student at Robert Wood Johnson Medical School who previously worked in strategic research for hospital executives and graduated from Duke University.

Follow him on Twitter @KRChhabra.

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3 thoughts on “Infectious Ink? What You Need to Know About the Tattoo Infection Outbreak

  1. jc says:

    what ink brand was used I am an artist and owner.

    • krchhabra says:

      Thanks for reading, JC. They kept both the parlor and the ink brand confidential. Though the reports do say, “The tattoo artist originally purchased the ink in April 2011 at a tattoo trade show in Arizona, and he later ordered an additional supply. The product labeling contained no lot number or other unique manufacturing identification.”

  2. MDV says:

    Wondering the same thing. How was there a reorder if there was no identifying information? How are artists and shop owners to know if they posses this ink?

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