Adverse effects related to tattoos in the community setting: a systematic review

Abstract

BackgroundTattoos were historically associated with deviant behaviours or religious and other social purposes, but in the last decades, they have gained increasing popularity and have become a mainstream. The aim of this systematic review is to assess the literature evidence about decorative tattoos complications, considering both infective and non-infective risks.MethodsThis systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. We searched the following electronic bibliographic databases: PubMed, Scopus and Web of Science (science and social science citation index).ResultsThe literature search resulted in 6473 studies. A total of 207 full articles were considered potentially relevant and were reviewed independently by researchers. After full-text evaluation, 152 of 207 articles were excluded, as they did not meet selection criteria. The remaining 55 studies were included in the systematic review and their quality assessment was performed. Ten studies reported microbiological complications, 37 reported non-microbiological effects and eight reported either microbiological and non-microbiological complications.ConclusionsSeveral well-known and uncommon risks are associated with tattooing and tattoo after-care. Public health authorities could take into account health education programmes for tattooists and customers in order to prevent health complications in people with tattoos.PROSPERO registration numberCRD42020177972.

Assessing Undergraduates’ Perception of Risks Related to Body Art in Italy: The SUPeRBA Multicenter Cross-Sectional Study

“…An open end of the jewelry is introduced into the rear blunt end of the needle and pulled through this opening, and the needle and stopper are removed. Modern body piercing jewelry contains substances such as stainless steel, titanium, gold, niobium, acrylic, or nickel, which may cause adverse reactions [1,[5][6][7].…”

“…Besides, wound healing after tattooing or piercing depends on many factors, e.g., tissue characteristics (blood supply, cohesiveness), location and size of the puncture area, following aseptic procedures, reactivity of the human body to substances applied on/in the skin and deeper tissues [8]. In addition, allergic reactions to metals, inks, local anesthetic, and antiseptic cream employed during these procedures and other toxicity aspects of colorants have been reported in the literature [7][8][9][10][11].…”

“…They apply single use inks obtained from commercial vendors, sterilized needles, and disposable barriers to cover any parts of the equipment that may be exposed to body fluids [6]. However, tattoos/piercings applied in nonprofessional parlors, which are often made using household, non-sterile equipment, and improvised techniques, are still common throughout the world and may favor the development of complications [5,7]. Tattoos and piercings may be done in unregulated stores, jewelry shops, homes, by unlicensed personnel who have learned procedures from magazines, videos, or from other people.…”

What about Your Body Ornament? Experiences of Tattoo and Piercing among Italian Youths

“…Piercing is made by creating openings through the skin or cartilage to insert decorative ornaments, such as rings, studs, or pins generally fabricated of stainless steel, titanium, gold, niobium, or acrylic [ 5 ]. Therefore, both these procedures require that sharpened tools pass through the skin/mucous barrier, which may lead to the penetration of infectious agents coming from skin, pigments, or instruments in the underlying tissues [ 1 , 3 , 6 , 7 , 8 , 9 ]. Bacterial local (e.g., abscesses, necrotizing fasciitis) and systemic infections (e.g., endocarditis, septic shock), so as the transmission of cutaneous and bloodborne viruses (human papillomavirus, herpes simplex virus, hepatitis B, hepatitis C, and human immunodeficiency viruses) were associated with tattooing [ 10 , 11 ].…”

“…In addition, hypersensitivity and allergic reactions to metals, inks, local anesthetic, and antiseptic creams employed during tattooing and piercing are common [ 7 , 8 , 9 , 13 ]. Nonallergic inflammatory reactions (for example, cutaneous granuloma and pseudolymphoma) as well as allergic reactions occurring during or after wound healing were associated with tattooing [ 13 ], and allergic contact dermatitis caused by metal allergens is a usual reaction to body piercing [ 14 ].…”