A tattoo involves repeatedly puncturing the skin to deposit pigment into the dermis layer. Because this process creates thousands of microscopic wounds, it carries an inherent risk of illness or adverse reaction. While most tattoos heal without incident, complications can range from minor, localized skin irritation to severe, life-threatening systemic infections. Understanding these potential health consequences is important before undergoing the procedure. The potential for a tattoo to make you sick depends on the sterility of the environment, the composition of the ink, and the care taken during the healing phase.
Common Localized Infections and Skin Issues
The most frequent health issues associated with a new tattoo remain localized to the skin itself. A certain degree of temporary redness, swelling, and soreness is a normal part of the inflammatory response following the skin trauma. However, when the skin barrier is broken, bacteria or other microbes can enter the wound, leading to an infection that may require medical attention.
Signs of a superficial bacterial infection, often caused by Staphylococcus or Streptococcus, include excessive warmth, increasing pain beyond the boundary, and thick, yellow, or foul-smelling pus. The skin may also become raised or bumpy, indicating a need for treatment, typically with oral antibiotics. Ignoring these signs allows a localized infection to potentially deepen and spread.
Other non-infectious skin issues can occur, such as a rash or delayed healing characterized by abnormally thick or persistent scabbing. Some people experience the Koebner phenomenon, where the trauma triggers an outbreak of a pre-existing skin disorder like psoriasis or lichen planus within the tattoo lines. These localized problems can distort the artwork’s appearance and require specific dermatological care.
Severe Systemic Illnesses and Bloodborne Pathogens
Infections that become systemic affect the entire body. These severe illnesses are typically transmitted through cross-contamination, the reuse of unsterilized equipment, or the use of contaminated water or pigments. The most concerning risks are bloodborne pathogens, which are infectious microorganisms transmitted through contact with infected blood or bodily fluids.
The reuse of needles or non-sterile equipment poses a direct risk for transmitting viruses like Hepatitis B (HBV) and Hepatitis C (HCV), which cause serious liver infections. Although the risk of Human Immunodeficiency Virus (HIV) transmission is extremely low, it remains a concern if sterilization protocols are ignored. Hepatitis B is particularly hardy, capable of surviving on surfaces for up to seven days, emphasizing the necessity of a sterile environment.
A severe bacterial infection can turn systemic, leading to life-threatening conditions like sepsis, or blood poisoning. This occurs when a localized infection, perhaps caused by antibiotic-resistant bacteria like Methicillin-resistant Staphylococcus aureus (MRSA), is left untreated and enters the bloodstream. Symptoms of sepsis include high fever, severe chills, rapid heart rate, confusion, and a general feeling of being unwell, necessitating immediate emergency medical intervention. Infection from atypical mycobacteria, often found in contaminated tap water used to dilute pigments, is another concern, causing persistent, painful nodules weeks or months after the procedure.
Immune Reactions to Tattoo Ink
The body’s immune system can react negatively to the foreign pigment itself. Tattoo inks contain various metals and compounds, and the body may develop a hypersensitivity or allergic reaction to specific components. Red pigments are the most common culprits for allergic reactions, often containing mercury sulfide, but blue, green, and black inks can also cause issues.
An allergic reaction can manifest as an itchy, swollen rash confined to the area of the offending color, sometimes appearing years later. The immune system may also attempt to encapsulate the foreign material, leading to the formation of small, firm bumps called granulomas. These reactions involve chronic inflammation and may require steroid injections or surgical excision for resolution.
The trauma of the needle can trigger an overgrowth of scar tissue, resulting in a raised, thickened scar known as a keloid. Keloids extend beyond the original boundaries of the wound and can be disfiguring. These immune and foreign-body reactions can be chronic, persisting for years and causing discomfort and cosmetic distress that is challenging to treat.
Minimizing Health Risks Before and After Getting Tattooed
Most serious health risks can be reduced by carefully selecting the artist and meticulously following aftercare instructions. Before getting tattooed, choose a licensed, reputable studio that adheres to strict hygiene standards. Confirm that the artist uses new, single-use needles and tubes, and that the pigment is dispensed into new, disposable ink cups for each client.
During the procedure, observe that the artist washes their hands, wears fresh disposable gloves, and cleans the area with a disinfectant. After leaving the studio, protect the open wound from contamination by following the artist’s instructions. This generally includes gently washing the tattoo two to three times daily with mild, unscented soap and water, and applying a thin layer of recommended moisturizer.
For the initial two weeks, avoid submerging the new tattoo in water, including swimming in pools, hot tubs, or natural bodies of water, to prevent bacterial exposure. Also avoid direct sun exposure, which delays healing and causes pigment reactions. If you notice signs of serious infection—such as fever, red streaking, or worsening pain—contact a healthcare professional immediately to prevent the infection from becoming systemic.