Psoriasis, Body Piercing and Tattoos

Printer-friendly version


A tattoo is when a permanent mark is made on the skin by using a needle or similar device to insert a coloured ink or dye, in order to create a decorative pattern on human skin. In animals tattoos are used as a permanent form of identification, this is referred to as branding.

Tattooing has been practiced in many cultures throughout the world and in some cases used for religious or ceremonial reasons.

The first electric tattoo machine was produced in the late 19th century, although this made tattoos more popular, the trend was more likely to be taken up by sailors or those considered to be of dubious character.

Henna tattoos or mehindi tattoos are painted on or applied from a tube. Mehindi is an ancient art form, where a powder made from dried lawsonia inermis leaves is dissolved in hot water. The design is then applied to the skin and left to dry for 30-40 minutes, washed off leaving a temporary ‘tattoo’. There have been reported cases of contact dermatitis where chemical colouring agents have been added; this is sometimes called ‘black henna’. The eruption causes intense itching and burning at the application site. Treatment with systemic steroids and topical antibiotics may be needed in extreme cases.

Body piercing

This is where a whole is made in the skin in order that a ring or other piece of jewellery can be inserted. The most common site would be the earlobe. There are many reason why piercings are done it was believed by sailors that pierced ears improved eyesight, and in some countries ear piercing is seen as an entering puberty ritual.

Psoriasis, body piercing and tattoos

In some people psoriasis can be caused by a trauma to the skin, including cuts, bruises, burns, bumps, vaccinations, tattoos, piericings and other skin conditions. These traumas can cause a flare-up of psoriasis symptoms either at the site of the injury or elsewhere. This condition is called Koebner’s phenomenon. For this reason if you have psoriasis or a family history of psoriasis you may want to think seriously about undertaking such procedures.

If you still want to have a tattoo or body piercing make sure you discuss this with your doctor or healthcare provider, in order to get the facts about how these procedures may affect you.

Remember it is illegal for anyone to tattoo or body pierce anyone under the age of 16, it is also illegal to tattoo or body pierce anyone under the age of 18 without the permission of a parent or guardian.

Other risks to consider

Dirty equipment: Piercing of the skin with a needle or injecting a dye into it, involve some risk of infection – because it means breaking the protective layer on the skin. Instruments used during the process may not be clean, or bacteria/viruses already on your skin may penetrate the immune system. Possible infections you might get if you’re unlucky include serious diseases such as Hepatitis B, Hepatitis C, Herpes and even HIV.

Ask about hygiene procedures.
Make sure that it has an established reputation and is a registered tattoo studio.
Ask to see a certificate from environmental health.

Untested dyes: Many of the dyes used in tattoos are untested and not necessarily designed for the purpose of injecting them into the skin.

Other skin reactions: Apart from psoriasis, some people have skin reactions to tattoos such as swelling, scaling, ulcers or the forming of large scars called ‘keloids.’ Body piercing can trigger rashes or blisters which may be caused by allergic reactions to the metals contained in jewellery. If you have diabetes, problems with your immune system or if you have chemical sensitivities you should also be careful and consult your doctor.

Negative attitudes: Some employers may have prejudices that could make it tricky getting the job you want when you leave education or seek different employment, this could also cause you problems in later life.

If you are still determined to have a tattoo or body piercing, you need to consider that getting a piercing or tattoo is a permanent commitment. You can remove tattoos with laser treatment but it’s very expensive and there are no guarantees – it can leave scarring, a shadow or discoloured skin. Piercing does tend to heal over but may sometimes leave a small scar. If the piercing has been in for a while you may be left with a permanent hole.

Scientific research

In 2003 the European Commission undertook a study called ‘Risks and Health Effects from Tattoos, Body Piercing and Related Practices.’(Ref 1). Which concluded:

The health impacts and risks associated with tattooing and piercing as reported casually in the medical literature shows that a systematic observation and registration of health impacts is widely missing.

The origin and chemical structure of colouring agents used for tattooing are hardly known.

Pigments are mainly industrial organic pigments with high microbiological and impurities and a load of metals such as cobalt and mercury.

The observed health effects, which are potentially associated with tattooing and piercing, include:

  • Viral infections such as hepatitis, AIDS, and cutaneaous infections
  • Bacterial infections such as impetigo, toxic shock syndrome, tetanus, chancroid,
  • tuberculosis and leprosy
  • Fungal infections such as sporotrichosis and zygomycosis
  • Allergic reactions such as cutaneous irritation and urticaria
  • Granulomateus/lichenoid reactions
  • Pseudo-lymphomas
  • Lymphadenopathy
  • Sarcoidosis
  • Malignant lesions such as melanoma and skin cancer
  • Behavioural changes
  • Other skin diseases such as psoriasis, photosensitisation, phototoxicity and photogenotoxicity.

Little is known with respect to the transport and metabolism of the colouring agents in the body both with respect to tattooing and removal of tattoos by laser treatment.

Risk assessment studies for these substances are only emerging. At present, existing knowledge is insufficient to quantify the administered dose of harmful substances.

The scientific evidence reported leads to the following recommendations:

Adverse health effects associated to tattooing and piercing should be avoided by applying only substances and materials (“positive list”), which are not harmful, do not dissolve in the blood stream, do not contain heavy metals and are compatible with the skin and blood vessels.
Ingredients of colours and materials should be properly labelled.
It should be obligatory to have licensed colours and materials to be used in tattoo and piercer studios.
The hygienic conditions of tattoo and piercing studios should be standardized and regularly controlled. Minimal hygiene rules should be made obligatory.
Regular training courses on the potential health impacts should be performed for tattooers and piercers.
An accreditation bureau/laboratory should be established for education of tattoers and piercers and supervision of their studios.
Surveillance of occupational diseases of tattooers and piercer mandatory.
Harmonised schemes should be developed at the European level.
There is a need for epidemiological studies on the prevalence and causal association of tattoo and piecing-related adverse effects.
The debate on epidemiological studies of tattoo and piercing-related viral hepatitis needs to be clarified.

A warning should be given to clients informing them on the potential adverse health effects in vulnerable individuals due to even admissible colours and materials.

Vulnerable individuals include:

  • Pregnant women
  • Children and infants
  • Atopic individuals
  • Individuals with heart diseases
  • Individuals with dermatous diseases
  • Individuals exposed occupationally to heavy metals, VOCs, PAHs, UV.


1. Risks and Health Effects from Tattoos, Body Piercing and Related Practices May 2003 D Papameletiou, A Zenie, D Schwela, W Bäumler - Final draft Ispra May 2003 available on the web at: www. gesundheit-nds. de