[Tattooing agents and adverse reactions]

Abstract

Background: Tattoos are regarded as body jewelry and have become widespread in all parts of society. Despite introduction of the tattooing agents' regulation (Tätowiermittelverordnung) in Germany in 2009, consumer protection is incomplete.

Objectives: Prevalence of tattoos and their legal basis, ingredients of tattooing agents, clinical findings of adverse reactions, pathogenesis and therapy.

Methods: The work is based on a selective literature search in PubMed and on the clinical experience of the authors.

Results: Adverse reactions by tattooing are a particular problem, because the causing substances are not biodegradable within the tissue. In addition to an agonizing pruritus, the clinical picture is characterized by erythematous plaques. Histopathology reveals different patterns of inflammation, including pseudolymphomatous reactions. Treatment is problematic. In many cases, extensive surgical excision is necessary, which is associated with cosmetic consequences.

Conclusion: A regulation to assess the safety of tattooing does not exist.

Keywords: Excision; Inflammation; Plaques; Pruritus; Tattoos.