When a tattoo feels elevated, bumpy, or swollen from the skin’s surface, it is considered “raised.” While some instances of tattoo raising are a normal part of the healing process or temporary responses to external factors, persistent or sudden elevation can signal various underlying issues. Understanding the differences can help identify when a raised tattoo is a minor concern or requires closer attention.
Expected Reasons for Temporary Raising
A new tattoo is essentially an open wound, and the body’s natural response involves inflammation and swelling. This initial raising is a normal part of the healing process, particularly in the first few days or weeks. The tattoo may appear most raised the morning after application, gradually settling as the skin heals and encapsulates the ink.
Even fully healed tattoos can experience temporary raising due to various factors. Changes in body temperature, such as during exercise or exposure to warm or cold weather, can cause the skin to swell slightly, including tattooed areas. Stress or an immune system reaction during illness or allergy season can also cause tattoo lines to become temporarily raised and itchy. These instances are brief and resolve on their own as the body returns to its normal state.
Common Causes of Persistent Raising
Persistent raising of a tattoo beyond the initial healing period can indicate several lasting concerns. Allergic reactions to tattoo inks are a frequent cause, particularly with certain colors like red, yellow, blue, and green, or preservatives found in the ink. Symptoms often include persistent itching, redness, swelling, small pimple-like bumps, or raised, scaly patches, which may appear immediately or years after the tattoo was done. An allergist can perform tests to identify the specific allergen.
Infections, whether bacterial, viral, or fungal, can also cause a tattoo to become raised. These often occur if proper aftercare instructions are not followed or if the tattooing environment was unsanitary. Signs of infection include increasing pain, warmth, spreading redness, pus or fluid oozing from the area, fever, chills, and tender, swollen lymph nodes. Such infections can range from superficial to deep and require prompt medical attention to prevent complications.
Scarring is another common reason for a tattoo to remain raised. Hypertrophic scars are raised, red, and confined to the original wound area, often resulting from excessive tension during healing or deep tattooing. Keloid scars are raised, lumpy, and extend beyond the original boundaries of the wound, forming due to an overproduction of collagen. Both types of scarring can result from the trauma of tattooing or an individual’s predisposition to scar formation.
Other Factors and Underlying Conditions
Beyond common causes, other factors and underlying conditions can lead to a tattoo becoming raised. Granulomas are small, firm bumps that form from an inflammatory reaction to foreign material, such as tattoo ink, in the skin. These reactions are thought to be a hypersensitivity to metallic ions in the pigment and can appear months or years after application. Red, green, blue, and purple pigments are most commonly associated with granulomatous reactions.
Sarcoidosis, a systemic inflammatory disease, can sometimes manifest in tattooed areas, causing them to become raised or inflamed, even decades after the tattoo was acquired. In such cases, the tattoo pigment may act as a nidus for granuloma formation, and these tattoo reactions can be the first or only visible sign of systemic sarcoidosis. The raised appearance may be accompanied by symptoms like itching, scaling, pain, blurred vision, fever, and fatigue, indicating broader systemic involvement.
Pre-existing skin conditions, such as eczema, psoriasis, or lichen planus, can cause a tattoo to raise during flare-ups if the condition affects the tattooed area. The tattooing process itself can sometimes exacerbate these underlying conditions. Excessive sun exposure can also irritate or reactivate older tattoos, leading to temporary or persistent raising due to photoallergenic dermatitis, especially with certain yellow and red dyes.
When to Consult a Professional
While temporary raising of a new tattoo is a normal part of healing, certain symptoms or persistent raising warrant medical attention. Consult a doctor or dermatologist if you experience persistent pain, warmth, or increasing redness around the tattoo that extends beyond the tattooed area. Other concerning signs include pus or abnormal fluid drainage, the development of white spots, or the formation of hard, raised tissue.
Systemic symptoms such as fever, chills, abnormal shivering, or general malaise accompanying a raised tattoo also indicate a need for prompt medical evaluation. These symptoms can suggest an infection or a more serious underlying condition. Early consultation with a healthcare professional can lead to a proper diagnosis and appropriate treatment, helping to prevent potential complications and ensure the health of your skin and tattoo.