Tattoo Problems

Topic Overview

Problems after getting a tattoo

Tattoos and permanent makeup have been used by most cultures for centuries and recently have become very popular with both men and women. Most people who have a tattoo do not develop any problems. Home treatment can help speed healing and prevent problems.

A tattoo is a series of puncture wounds that carry dye into the different levels of the skin. At first, the tattoo may be swollen and there may be some crusting on the surface. It is normal for the tattoo to ooze small amounts of blood for up to 24 hours, and it may ooze clear, yellow, or blood-tinged fluid for several days.

Problems with tattoos include:

Infection at the tattoo site.
Minor skin reactions (contact dermatitis) or serious allergic reactions to the tattooing method or dye.
Scarring, which can include raised scar tissue (keloids).
Spread of infectious disease, such as hepatitis B, hepatitis C or HIV (human immunodeficiency virus), if a dirty method or equipment is used.

Be sure to consider all aspects of getting a tattoo. A tattoo should be considered permanent. Tattoo removal is hard and may cause scarring. It may not be possible to completely remove a tattoo and restore your normal skin colour and texture. If you have not yet made a decision about tattooing, see the Prevention section for information about tattooing.

Health Canada recommends that you avoid black henna dyes and pastes for henna tattoos that contain para-phenylenediamine (PPD) because of the risk of an allergic reaction. Health Canada encourages everyone to report adverse reactions to permanent and temporary tattoos to their local health unit.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Do you have a problem with a tattoo?

Yes

Tattoo problem

How old are you?

Less than 12 years

12 years or older

Are you male or female?

Male

Female

The medical assessment of symptoms is based on the body parts you have.

If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
If your symptoms aren’t related to those organs, you can choose the gender you identify with.
If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.

Could you be having a severe allergic reaction?

This is more likely if you have had a bad reaction to something in the past.

Yes

Possible severe allergic reaction (anaphylaxis)

Are there any hives?

Hives are raised, red, itchy patches of skin. They usually have red borders and pale centres. They may seem to move from place to place on the skin.

Yes

Hives

Did the hives appear within the past 3 hours?

Yes

Hives appeared within past 3 hours

Are there any symptoms of infection?

Yes

Symptoms of infection

Do you think you may have a fever?

Yes

Possible fever

Are there red streaks leading away from the area or pus draining from it?

Yes

Red streaks or pus

Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?

"Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps.

Yes

Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area

Is there any swelling near the tattoo?

Yes

Swelling at site of tattoo

Is the swelling severe and rapid?

Severe swelling may cut off blood flow and make the area below the tattoo cool or painful.

Yes

Severe, rapid swelling near tattoo

Is the swelling over a joint, such as the ankle, elbow, or hip?

Yes

Swelling is over a joint

Has swelling lasted for more than 2 days?

Yes

Swelling for more than 2 days

Do you think you may need a tetanus shot?

Yes

May need tetanus shot

Have you had symptoms of an infectious illness in the several months since you got the tattoo?

Yes

Symptoms of infectious illness

Have you had problems with the tattoo for more than 2 weeks?

Yes

Problems with tattoo for more than 2 weeks

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

Your age. Babies and older adults tend to get sicker quicker.
Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, or natural health products can cause symptoms or make them worse.
Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

Try home treatment to relieve the symptoms.
Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

HomeTreatment

RelatedInformation

Symptoms of infection may include:

Increased pain, swelling, warmth, or redness in or around the area.
Red streaks leading from the area.
Pus draining from the area.
A fever.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
Long-term alcohol and drug problems.
Steroid medicines, which may be used to treat a variety of conditions.
Chemotherapy and radiation therapy for cancer.
Other medicines used to treat autoimmune disease.
Medicines taken after organ transplant.
Not having a spleen.

You may need a tetanus shot depending on how dirty the wound is and how long it has been since your last shot.

For a deep or dirty wound that has things like dirt, saliva, or feces in it, you may need a shot if:
- You haven't had a tetanus shot in the past 5 years.
- You don't know when your last shot was.
- You have not received 3 doses of the tetanus vaccine series.
For a clean wound, you may need a shot if:
- You have not had a tetanus shot in the past 10 years.
- You don't know when your last shot was.
- You have not received 3 doses of the tetanus vaccine series.

If proper technique and clean instruments are not used, there is a chance of getting an infectious disease when you get a tattoo or body piercing.

Symptoms of an infectious illness may include:

An overall feeling of tiredness and lack of energy.
Dark urine or light-coloured stool.
A new yellow tint to the skin or the whites of the eyes (jaundice).
Muscle or joint pain that lasts a long time.
Belly pain.
Fever.
Nausea and vomiting.

Symptoms of a severe allergic reaction can start within minutes of eating or being exposed to an allergen. While symptoms usually occur within 2 hours, in rare cases the time frame can vary up to several hours after exposure. Do not ignore early symptoms. When a reaction begins, it is important to respond right away.

Symptoms of a severe allergic reaction can vary from person to person. The same person can have different symptoms each time they have a severe allergic reaction. Symptoms can include any of the following:

Skin: hives, swelling (face, lips, tongue), itching, warmth, redness
Respiratory (breathing): coughing, wheezing, shortness of breath, chest pain or tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny, itchy nose and watery eyes, sneezing), trouble swallowing
Gastrointestinal (stomach): nausea, pain or cramps, vomiting, diarrhea
Cardiovascular (heart): paler than normal skin colour/blue colour, weak pulse, passing out, dizziness or lightheadedness, shock
Other: anxiety, sense of doom (the feeling that something bad is about to happen), headache, uterine cramps, metallic taste

A severe reaction can take place without hives, so make sure to look out for all of the signs of an allergic reaction.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don't have one, seek care in the next hour.
You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

Call your doctor today to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don't have one, seek care today.
If it is evening, watch the symptoms and seek care in the morning.
If the symptoms get worse, seek care sooner.

HomeTreatment

RelatedInformation

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

Make an appointment to see your doctor in the next 1 to 2 weeks.
If appropriate, try home treatment while you are waiting for the appointment.
If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

HomeTreatment

RelatedInformation

Home Treatment

Caring for a tattoo

Most minor swelling and redness (inflammation) from a tattoo can be treated at home. If your tattoo artist gave you instructions, follow them carefully.

If you did not receive instructions for skin care of the tattoo site, try the following:

Stop any bleeding. Minimal bleeding can be stopped by applying direct pressure to the wound. It is normal for the tattoo site to ooze small amounts of blood for up to 24 hours and clear, yellow, or blood-tinged fluid for several days.
Apply a cold pack to help reduce the swelling, bruising, or itching. Never apply ice directly to the skin. This can cause tissue damage. Put a layer of fabric between the cold pack and the skin.
Take an antihistamine, such as a non-drowsy one like loratadine (Claritin) or one that might make you sleepy like diphenhydramine (Benadryl), to help treat hives and relieve itching. Be sure to read and follow any warning on the label. Do not use strong soaps, detergents, and other chemicals, which can make itching worse.
Protect your tattoo with a bandage if it might become dirty or irritated.
- Apply a thin layer of petroleum jelly, such as Vaseline, to a non-stick bandage, such as Telfa.
- Apply the non-stick bandage with the petroleum jelly on it to the tattoo site. The petroleum jelly will prevent the irritated skin from sticking to the bandage. Putting the petroleum jelly on the bandage first will be less painful.
- Apply a clean bandage once a day and change the bandage if it gets wet. If the bandage sticks, soak the tattoo area in warm water for a few minutes or take the bandage off under running water in the shower.
- Leave the bandage off with the skin open to air whenever you can.

Medicine you can buy without a prescription
Try a non-prescription medicine to help treat your pain:
Acetaminophen, such as Tylenol Non-steroidal anti-inflammatory drugs (NSAIDs): Ibuprofen, such as Advil or Motrin Naproxen, such as Aleve Aspirin (also a non-steroidal anti-inflammatory drug), such as Asaphen or Entrophen

Safety tips
Be sure to follow these safety tips when you use a non-prescription medicine:
Carefully read and follow all directions on the medicine bottle and box. Do not take more than the recommended dose. Do not take a medicine if you have had an allergic reaction to it in the past. If you have been told to avoid a medicine, call your doctor before you take it. If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to. Do not give aspirin to anyone younger than 18 unless your doctor tells you to.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

Signs of an infection develop.
An allergic reaction develops.
Your symptoms are not improving after 2 weeks of home treatment.
Your symptoms become more severe or frequent.

Prevention

Preventing tattoo problems

You can prevent problems from developing at your tattoo site. Review the following guidelines and information before making your decision to tattoo a part of your body.

Do not get a tattoo while under the influence of alcohol or drugs.
Get a tetanus shot before your tattooing if you have not had one in the past 10 years.
Choose an experienced person who uses sterile gloves and sterilized equipment to do the tattoo. Ask the person doing the tattoo how he or she cleans the equipment and what safety standards he or she follows. Sterile gloves and sterilized equipment should be used. A fresh pair of gloves should be used for each procedure. Make sure that the operator washes his or her hands before putting on the gloves. Ask the operator to change his or her gloves if he or she answers the telephone or does anything else during your procedure.
Check the studio and see whether it looks clean. Ask the operator about sterilizing techniques and safety standards.
If you think you may want to have your tattoo removed at a later date—dark blue, black, and red are the easiest colours to remove with lasers. Bright colours—blue, green, and yellow—are hard, if not impossible, to remove.
If you have had an allergic reaction to tattoo dye in the past, do not get any more tattoos. Be sure your health professionals know about these allergies.
- Wear medical alert jewellery such as a MedicAlert tag if you have had an allergic reaction after a tattoo.
- If you have had an allergic reaction to the henna used in a temporary tattoo, you have a higher chance of developing a skin reaction to hair dye. Mix up a small amount of the dye solution and paint it on a small patch of skin, such as the inside of your wrist, to see if you are going to have a reaction to it. Do not use the hair dye if your skin turns red or itches.
Check with your local health unit to find out whether there have been any complaints about the studio you are thinking of using.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Questions to prepare for your appointment

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

Who did the tattoo? Where is the tattoo artist located?
When did you have the tattoo?
Where on your body is the tattoo? Have you had previous tattoos?
What are your main symptoms? When did your symptoms start?
Were sterile instruments used?
What home treatment measures have you used to clean or treat your tattoo? Be sure to include any non-prescription ointments or creams you have applied to the tattoo.
What prescription and non-prescription medicines do you take?
When was your last tetanus shot?
Do you have any health risks?

Credits

Current as of: February 26, 2020

Author: Healthwise Staff
Medical Review: William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine
Martin J. Gabica MD - Family Medicine