Tattoos have become increasingly popular in recent years. In the United States, the estimated percentage of adults with one or more tattoos increased from 14% in 2008 to 21% in 2012.1 the process of tattooing exposes the recipient to risks of infections with various pathogens, some of which are serious and difficult to treat. Historically, the control of tattoo-associated dermatologic infections has focused on ensuring safe tattooing practices and preventing contamination of ink at the
tattoo parlors — a regulatory task overseen by state and local authorities.2 In recent months, however, reported outbreaks of non-tuberculous mycobacterial infections associated with contaminated tattoo ink have raised questions about the adequacy of prevention efforts implemented at the tattoo-parlor level alone. The Food and Drug Administration (FDA) is reaching out to health care providers, public health officials, consumers, and the tattoo industry to improve awareness, diagnosis, and reporting (through the MedWatch program) in order to develop more effective measures for tattoo ink–related public health problems.
New Research-Tattoo Infections Linked To Contaminated Tattoo Inks
Some tattoo inks are tainted with non-tuberculosis Mycobacteria which can cause serious infections, including lung diseases, eye problems, several organ infections, and infection of the joints, the US FDA (Food and Drug Administration) informed today. The Agency added that Mycobacteria-linked infections are not easy to diagnose and require treatment that may last over six months.
The FDA says it has received reports of serious infections which started coming in last year in at least four states. The Agency is calling on all personnel involved in the tattoo industry, including artists, manufacturers of tattoo ink, consumers, as well as health care professionals, public health officials to be aware of this potential infection risk.
Tattoo inks and pigments may also be contaminated with fungi and mold
Apart from pathogens from the non-tuberculosis Mycobacteria family, tattoo pigments and inks may also infect people with fungi and molds.
Linda Katz, M.D., M.P.H., director of FDA's Office of Cosmetics and Colors, urges anybody involved in tattooing or its consequences, including health care professionals, to report any tattoo-linked complication to its MedWatch program. Doctors especially need to become aware of the signs and symptoms so that the risk of misdiagnosis may be reduced.
Tattoo ink contamination is not always visible
Tattoo artists need to be fully knowledgeable about this potentially serious complication. Even the most scrupulous tattoo artist who follows strict hygiene practices may not be aware that an ink or pigment is tainted. Katz informed that without proper equipment, it is often hard to tell whether there is contamination.
The FDA says that it has two priority objectives at the moment:
To encourage tattoo artists to take special precautions
Encourage tattoo customers to seek medical care immediately if any of the signs and symptoms associated with infection are detected Katherine Hollinger, D.V.M., M.P.H., an epidemiologist who works at the Office of Cosmetics and Colors, said, Reporting an infection to FDA and the artist is important. Once the problem is reported, FDA can investigate, and the artist can take steps to prevent others from being infected.
Tattoo inks come under FDA jurisdiction
The FDA oversees the quality and safety of tattoo inks and pigments in the USA. When a safety issue comes to the Agency's attention, it intervenes, as it is doing now. An investigation started in January of this year, it was coordinated and initiated by the CORE (Coordinated Outbreak Response and Evaluation) network, part of the FDA. It was through its MedWatch reporting program that officials at the regulatory agency got to know about the problem. Seven tattoo customers in Monroe Country, New York, all of whom had used the same artist, had confirmed nontuberculous Mycobacteria infections. Soon after their tattoos had healed they noticed red bumps had appeared.
Not long afterwards, reports came in of another 12 clients with the same problem; they too had used the same artist as the seven others. All the 19 clients had used the same brand of tattoo ink. 14 of them were found to have exactly the same type of nontuberculous Mycobacteria infection. In an online communiqué, the FDA wrote "An NTM sample from a sealed container of the same type of ink used to tattoo the affected individuals was a perfect match to the NTM linked to these infections."
The CDC (Centers for Disease Control and Prevention), FDA district offices as well as regional and local health departments liaised closely during the investigation. Soon other states, including Colorado, Iowa and Washington started reporting similar infections among tattoo customers. It became apparent that this was not a case of one ink manufacturer and a single artist. Tattoo artists can take measures to reduce the risk of infections by acquiring inks that are known not to be have been contaminated with pathogenic bacteria. They should make sure that only sterile water is used to dilute the inks. Distilled, filtered, bottled or tap water are examples of non-sterile water.
Three tips to avoid skin infections from tattoos
1. Use tattoo parlors registered by a local board of health. “Every establishment must be licensed by a city or town, usually the health department, since there’s not a state license,” Jones said. You should see a copy of the facility license and practitioner’s license hanging on the wall.
2. Watch to make sure the tattoo artist follows appropriate hygienic practices. The practitioner should be wearing gloves and should sterilize all equipment in an autoclave. “Watch the set up,” Jones advised. “Make sure the artist opens sterile packets to remove the needles.”
3. Understand that tattoos aren’t risk-free. Problems in licensed facilities are rare, said Jones, but there’s no way to protect completely against infections from the ink or a needle piercing the skin.