Almost every tenth German wears a tattoo, according to a survey by a major German opinion research institute. There is also an increase in the number of those who have their skin inked with so-called permanent makeup as a substitute for makeup only on certain areas of the face. The BfR (Federal Institute for Risk Assessment) points out as a precaution that bearers of tattoos thereby possibly enter into a health risk, which at present can be estimated scientifically only conditionally. When tattooing and applying permanent make-up, color pigments are introduced into the middle layer of the skin (dermis) with the help of needle pricks. From there, they can also reach deeper layers of the skin, from where they can be distributed and transformed in the body via the bloodstream.
Risk allergy
Severe allergic skin reactions as well as inflammation are the most common undesirable consequences of tattooing, according to communications from German dermatologists. Allergic reactions are attributed in most cases to the substance para-phenylenediamine (PPD). It is used in henna for darkening and consequently gets onto or into the skin when making black henna tattoos. PPD can cause serious dermatoses. Persons once sensitized to PPD may have lifelong allergic reactions to the substance or to dyes with a similar chemical structure. Metal-containing components of the paint mixtures may also cause allergies.
Other hazards
Other hazards include impurities in the paint mixtures and certain azo dyes that can be broken down into carcinogenic aromatic amines. Such azo dyes also pose a hazard when tattoos are removed using laser technology. They can potentially be cleaved by laser beams into carcinogenic amines, which are then distributed throughout the body via the bloodstream. Other possible consequences of tattoo removal include scars, pigmentation disorders of the skin and inflammation.
Used colors are not tested for this purpose
The BfR expressly draws the attention of consumers and especially the parents of adolescents and children to these risks associated with tattoos and permanent makeup. Unlike the dyes in cosmetic products for application to the skin, such as blush, eye shadow or eyeliner, the colors used for tattoos and permanent makeup have not been tested for their health effects. Also, nothing is yet known about the long-term effects of these foreign substances in the body, although they usually remain there for a lifetime. While cosmetic products that are applied to the skin are legally regulated by the German Foodstuffs and Consumer Goods Act, the European Cosmetics Directive and the German Cosmetics Regulation, tattoo inks are currently not subject to any comparable regulation. There are no legally established regulations regarding the purity, quality and health safety testing of tattoo inks. Tattoos and permanent make-up, like make-up, serve to decorate the body and thus have cosmetic purposes. However, because the colors are injected into the skin during tattooing, they are not cosmetic products according to the valid legal definition.
Recommendation
The BfR therefore recommends that, until a legal regulation is in place, only colorants that meet the requirements of the European Cosmetics Directive and the German Cosmetics Regulation and that have been tested and approved for use in cosmetic products should be used for tattoos and permanent makeup. However, even this does not guarantee with certainty that no undesirable reactions can occur. The BfR calls on the medical profession to report to the BfR any adverse health effects that may have been caused by tattoo inks.
