Cited by 35Contact Dermatitis and AllergiesTattoo and Body Piercing ComplicationsDrug-Induced Adverse Reactions

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Hypersensitivity to permanent tattoos: Literature summary and comprehensive review of patch tested tattoo patients 1997–2022

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Schubert, Steffen, Kluger, Nicolas, Schreiver, Ines·2023·Contact Dermatitis

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Abstract

We outline constituents of tattoo and permanent make‐up ink with regard to inflammatory tattoo reactions and population‐based confounders. The comprehensive review of patch‐tested tattoo patients between 1997 and 2022 shows that tattoo allergy cannot be reliably diagnosed via patch testing with today's knowledge. Weak penetration and slow haptenization of pigments, unavailability of pigments as test allergens and a lack of knowledge concerning relevant epitopes hamper the diagnosis of tattoo allergy. Patch testing p‐phenylenediamine and disperse (textile) dyes is not able to close this gap. Sensitization to metals was associated with all types of tattoo complications, although often not clinically relevant for the tattoo reaction. Binders and industrial biocides are frequently missing on ink declarations and should be patch tested. The pigment carbon black (C.I. 77266) is no skin sensitizer. Patch tests with culprit inks were usually positive with cheap ink products for non‐professional use or with professionally used inks in patients with eczematous reactions characterized by papules and infiltration. Tape stripping before patch testing and patch test readings on Day 8 or 10 may improve the diagnostic quality. The meaningfulness of the categorical EU‐wide ban of Pigment Green 7 and Pigment Blue 15:3 is not substantiated by the presented data.

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1 retracted

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Background

See all 35

Authors: Schubert, S., Kluger, N., & Schreiver, I.
Affiliations: Universitätsmedizin Göttingen (DE)
University of Helsinki (FI)
German Federal Institute for Risk Assessment (BfR) (DE)
Corresponding author: Schubert, Steffen
ORCID: Schubert, Steffen
Kluger, Nicolas
Schreiver, Ines
Venue: Contact Dermatitis
Publisher: Wiley
Published: 2023-02-20
Volume: 88
Issue: 5
Pages: 331-350
ISSN: 0105-1873 (ISSN-L)
1600-0536
DOI: 10.1111/cod.14291
OpenAlex: W4320032477
Cited by: 32
References: 167
Citations by year: 2026: 4 · 2025: 13 · 2024: 13 · 2023: 2
FWCI: 1.46
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Contact Dermatitis (publishedVersion)
PubMed (publishedVersion)
Työväentutkimus Vuosikirja (submittedVersion)
OpenAgrar (submittedVersion)
Topics: Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
Social Sciences › Cultural Studies › Tattoo and Body Piercing Complications
Health Sciences › Medicine › Pharmacology (medical) › Drug-Induced Adverse Reactions
Keywords: patch testing, haptenization, metal sensitization, carbon black, p-phenylenediamine, textile dyes, ink binders, biocides, tape stripping, eczematous reaction, tattoo complications
MeSH terms: Allergens, Coloring Agents, Humans, Inflammation, Ink, Metals, Tattooing, Dermatitis, Allergic Contact

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Hypersensitivity to permanent tattoos: Literature summary and comprehensive review of patch tested tattoo patients 1997–2022

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