Tattoo ink contains dangerous bacteria that can lead to infections, even death: study
A type of ink used in the art of tattooing as seen on 13 January 2022.
The United States Food and Drug Administration (FDA) has found that bottles of tattoo and permanent makeup ink, which were labelled sterile aren’t in fact sterile, but contain millions of dangerous bacteria that could cause infections, sepsis and even death.
Previous studies have linked tattoos to complications such as inflammation, allergic hypersensitivity, bacterial skin infections, skin rashes and cellulitis, a skin infection that is treated through the administering of antibiotics. However, these were often believed to have been caused by inadequate hygiene at the time of tattoo application, and poor care of the skin during the healing phase.
In a study published in Applied and Environmental Biology, researchers bought 75 tattoo and permanent makeup inks from 14 tattoo ink manufacturers to test whether they were contaminated by bacteria.
These included six bottles of each individual ink, with the same lot number. All bottles were confirmed to be intact, and sealed. The information from the samples, such as brand and product (colour) name, safety data sheets, ingredients, sterility claims, expiration dates, and locations of the manufacturer, was then recorded.
They would find that of 75 ink samples, 26 were contaminated with 34 species of bacteria, 19 of which with the ability to cause bacterial infection. Permanent makeup inks were also found to be more likely to be contaminated than tattoo inks.
“This is the first microbiological survey of commercial tattoo and permanent makeup inks that examined bacterial contamination under anaerobic conditions (without oxygen). The results of this study showed that unopened and sealed bottles of tattoo and permanent makeup inks were contaminated with anaerobic and aerobic bacteria, indicating that contaminated tattoo inks can be a source of infection not only with aerobic but also anaerobic bacteria,” says the study.
Oxygenated environment
Aerobic bacteria are bacteria that can survive and grow in an oxygenated environment, while anaerobic bacteria survive and grow in an environment without oxygen.
“Infectious complications from tattoos can range from mild skin infections to systemic infections, such as life-threatening bacteremia and septic shock. Tattooing, which breaches the skin barrier during application, can increase the risk of infection transmission if the tattoo inks used are contaminated with pathogenic bacteria that are embedded deep into the skin throughout the procedure,” says the study.
It further states: “The low-oxygen environment of the dermal layer of the skin further allows a possibility of infection by anaerobic bacteria. Studies have shown infections related to tattoos caused by anaerobic microorganisms, such as Clostridium tetani, the causative agent of tetanus.”
Septic shock, according to Medline Plus, refers to a “serious condition that occurs when a body-wide infection, caused by fungi or bacteria, leads to a dangerously low blood pressure. The body may respond to the toxins with a strong inflammatory response that may contribute to organ damage. It may eventually lead to death.”
The researchers also found that of 49 inks labelled sterile, 16 were contaminated with microorganisms. As such, the researchers believe that the sterilisation process may not “be effective to remove all microorganisms, or the label claims may not be accurate.”
They recommend an evaluation of current sterilisation methods used by tattoo ink manufacturers.
Previous studies by the FDA found that 35 out of every 100 unopened and sealed inks from US manufacturers had bacterial counts as high as 100 million bacteria per gram.
Dr Joseph Wahome Mukundi, a Consultant Toxicologist explains that because the Kenyan beauty industry is largely unregulated, it follows that the products in the industry are also unregulated.
“Being largely unregulated, there are no known certifications on the bottles. There's no way of confirming the safety of tattoo ink. Tattoo ink can cause allergic skin reactions, such as an itchy rash at the tattoo site some clients could get reactions from even uncontaminated ink,” he says while adding that clients should endeavour to ask their tattoo artists questions about their ink, such as source, manufacturer and expiry date.
“Visit a trusted artist, check the cleanliness of the place, and sterility of the equipment being used and make sure the needles used are opened in your presence. Follow after care given including keeping clean, dry, moisturising and other instructions given. See a clinician if you notice any changes not as expected post the tattoo. If it's established the tattoo ink contamination is the issue you could inform the artist and according to the magnitude of the issue, involve county health admins,” Dr Mukundi adds.
His counterpart, Dr Pauline Gacheri, a Consultant Dermatologist explains that there are no known regulations about tattoo and permanent makeup inks in the beauty industry, and thus, there is no body or institution that has been charged with any updates and recalling of such substances.
Dr Gatheri explains that “sensitivity to some ingredients (in the ink) varies among persons and anyone could develop a reaction.”
“Ingredients in tattoo ink that are more likely to cause problems include dichromate salts, cobalt (Co), cadmium, and mercury, considered bases for the colours green, blue, yellow, and red; (and) iron oxide, titanium dioxide, carbon, and manganese (that) are commonly used to create the colours brown, white, black, and violet,” says Dr Gacheri.
Data on the number of people in Kenya who have gotten tattoos or used permanent makeup ink is unavailable.
