What Is a Tattoo Allergy? Symptoms, Causes, and Treatment

Tattoos are a popular form of self-expression, but there are some risks involved. Most tattoo artists use a handheld machine that has needles that pierce the skin repeatedly to create a mark or design, inserting tiny drops of ink into the top layer of the skin with every puncture.

Nearly all allergic reactions to tattoos are mild and localized to the skin. Some reactions can be more persistent or bothersome, but it's extremely rare for a tattoo allergic reaction to be serious or life threatening, says Shinohara.

According to Anne Chapas, MD, a dermatologist and the medical director at UnionDerm in New York City and an American Academy of Allergies and Immunology expert, the most common signs of a tattoo allergy can include:

• Redness
• Swelling
• Itching
• Rash

Allergies can happen at almost any step of the tattoo process, says Shinohara, including from the solution used to clean the skin, the tattoo ink, the bandage applied after tattooing, or special creams or lotions used to take care of it.

Most tattoo allergies don't show up immediately, but instead take a little while to develop, says Shinohara. It can take days, weeks, months, or in rare cases even years to show up. “Reactions that happen within one to two days after tattooing are often infections,” she says.

An infection may cause blisters, nodules, or scaly patches. If any of these issues develop, “it’s important to check in with a healthcare provider to differentiate between an allergy and an infection,” says Dr. Chapas.

People who have more severe symptoms, such as intense swelling, pain, open sores, a fever, swollen lymph nodes, or anaphylaxis — a life-threatening reaction — should seek immediate medical attention, says Chapas.

Other factors, such as poor tattooing practices, contaminated ink, or preexisting skin conditions, can also contribute, says Chapas.

“There are also people who can be allergic to other things they come into contact with during the tattoo process,” says Chapas. “For example, artists often wear latex gloves and apply antibacterial spray during the tattoo. Another common allergen is to the adhesive used in the protective bandages applied afterward, commonly referred to as Tegaderm or Saniderm.”

If you have allergies to latex or adhesive bandages, let your tattoo artist know before they begin the process.

There hasn’t been much research in this area to say with certainty who’s at risk for a tattoo allergy, says Shinohara. But she says anyone with a chronic skin condition should check with their dermatologist before getting a tattoo, and she also discourages tattoos for people with medical conditions that put them at higher risk for infection or who are immunosuppressed.

“There are also certain skin conditions which are more likely to occur in injured skin, like psoriasis and keloid scars,” she says.

Chapas says that anyone with sensitive skin, eczema, psoriasis, or a history of contact allergies is at higher risk for tattoo allergies.

If you have itching or a rash at your tattoo site, that could mean the body is reacting to the tattoo ink, and the symptoms may not go away on their own, says Chapas.

“If they persist beyond a few days, worsen over time, or include severe swelling, pain, or fever, it’s important to seek medical attention,” she says.

What Kind of Doctor Would Typically Diagnose a Tattoo Allergy?

“A dermatologist is the best specialist to consult, as they can differentiate between an allergy, infection, or another skin condition like contact dermatitis,” says Chapas. “An allergist may also help if the reaction is systemic or hard to diagnose.”

If someone doesn't already see a dermatologist, they could start by scheduling an appointment with their primary care provider, says Shinohara. But if symptoms are severe or there are other symptoms that may indicate an infection, like fever, she recommends going to urgent care or the emergency room.

How a Tattoo Allergy Is Diagnosed

A dermatologist typically diagnoses a tattoo allergy through a physical exam and medical history. Some tattoo reactions can be diagnosed just by looking at the tattoo, and patch testing may be used to identify specific allergens in the ink, says Chapas.

“Oftentimes a skin biopsy is necessary,” says Shinohara. “Skin biopsies are common procedures done by dermatologists in the office with local numbing. They are usually quick procedures and done within normal office visits.”

The dermatologist will numb the skin and then take a small sample (usually the same size or smaller than a pencil eraser) and send it to the lab. Results take about a week to come back, and the provider might recommend some topical treatments to help with symptoms in the meantime, says Shinohara.

Treatment for a tattoo allergy depends on the severity of the reaction. If the symptoms are mild, they may be treated with topical corticosteroids or oral antihistamines to reduce itching and swelling. It’s also wise to cover the tattoo with a bandage to avoid sunlight exposure.

• Choose a reputable tattoo artist. Ensure that the artist is properly trained, uses sanitary equipment, and places ink in new disposable single-use cups.
• Avoid sun exposure. Keep the tattoo out of the sun until it heals.
• Keep tattooed skin clean. Wash the area at least twice a day with soap and water but don’t scrub. Pat the area dry.
• Use moisturizer. Use a mild moisturizer several times a day to keep skin hydrated.
• Don’t go swimming. Avoid pools, hot tubs, lakes and other bodies of water until the tattoo heals.

• Tattoo allergies can develop when the immune system responds to ink ingredients, often causing symptoms like itching or a rash.
• Some of these skin reactions may be an infection rather than an allergy. If you’re running a fever or have severe symptoms, see a dermatologist or other healthcare provider.
• Mild allergic symptoms can be treated with creams and antihistamines, but severe reactions may require stronger medications or, in rare cases, tattoo removal.
• Reduce your risk of allergies and infections by choosing a licensed artist that follows proper hygiene.