Tattooing in the '90s: ancient art requires care and caution - includes related article about health risks

FDA Consumer, Oct, 1993 by Marilynn Larkin

The tattoo should not be exposed to direct sunlight for at least two weeks to prevent sunburn or pigment changes. Sunscreen should be applied during subsequent sun exposure to prevent fading of pigments. Swimming in fresh, salt, or chlorinated pool water is also discouraged during the first few weeks after the application of a tattoo to prevent the pigments from leaching out.

Tattoo Inks

The inks, or dyes, used for tattoos are considered "color additives" under the Federal Food, Drug, and Cosmetic Act. The known incidence of adverse reactions or injury from tattoo ink is "minimal," says Allen Halper of FDA's division of cosmetics and colors. However, consumers should be aware that their safety has not been established. FDA is evaluating its role in the regulation of tattoo ink. At present, many states and local health departments regulate tattooing.

The colors used in temporary tattoos, which fade several days after application, also fall under FDA jurisdiction. Although no adverse reactions have been reported to FDA, the agency has issued an "import alert" for several foreign-made temporary tattoos, says Halper. These tattoos are not allowed into the United States because they don't carry the FDA-mandated ingredient labels or they contain colors not permitted by FDA for use in cosmetics.

Removing Tattoos

Although tattoos applied to the skin with needles are called "permanent," methods exist to remove them, according to Steven Snyder, M.D., a dermatologist in private practice in Owings Mills, Md.

These techniques include surgical removal; using tissue expanders (balloons inserted under the skin for six to eight weeks to stretch the skin, so when the tattoo is cut away there is less scarring); dermabrasion, which involves sanding the skin with a wire brush to remove the epidermis and dermis; salabrasion, the use of a salt solution to soak the tattooed skin (sometimes the solution can seep too deeply into the skin and leave an unsightly scar, according to Snyder); and scarification, which involves removing the tattoo with an acid solution and creating a scar in its place.

Three lasers, regulated by FDA, are also being used for tattoo removal: the Q-switched ruby laser, the neodymium YAG laser, and the Alexandrite laser. These lasers can remove most color with very little scarring. However, the ruby laser does not work very well in removing red, yellow and orange colors, whereas the YAG laser does not work well on green pigment, according to Snyder.

Another problem with laser removal is called "paradoxical darkening," according to Ray Geronemus, M.D., associate professor of dermatology at NYU Medical Center in New York City. Light colors such as beige, pink and white may turn black when treated by the laser. To circumvent this problem, a small spot of color should be tested first to see whether darkening occurs, he says. If the tattoo ink is available, the laser-ink reaction can be tested in a laboratory dish.

Geronemus suggests that tattoo parlors or clients themselves keep records of the dyes used in their tattoos, including the lot number of each pigment, in case the client later wants the tattoo removed. "This would be like a medical record. Rather than dealing with a hodgepodge of inks, the dermatologist would know exactly what dyes were applied, which can assist in removal," he says.