title: A medical-toxicological view of tattooing.
abstract: Long perceived as a form of exotic self-expression in some social fringe groups, tattoos have left their maverick image behind and become mainstream, particularly for young people. Historically, tattoo-related health and safety regulations have focused on rules of hygiene and prevention of infections. Meanwhile, the increasing popularity of tattooing has led to the development of many new colours, allowing tattoos to be more spectacular than ever before. However, little is known about the toxicological risks of the ingredients used. For risk assessment, safe intradermal application of these pigments needs data for toxicity and biokinetics and increased knowledge about the removal of tattoos. Other concerns are the potential for phototoxicity, substance migration, and the possible metabolic conversion of tattoo ink ingredients into toxic substances. Similar considerations apply to cleavage products that are formed during laser-assisted tattoo removal. In this Review, we summarise the issues of concern, putting them into context, and provide perspectives for the assessment of the acute and chronic health effects associated with tattooing.
authors.affiliation: German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Laux
authors.affiliation: German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany.
authors.forename: Tewes
authors.initials: T
authors.lastname: Tralau
authors.affiliation: German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany.
authors.forename: Jutta
authors.initials: J
authors.lastname: Tentschert
authors.affiliation: German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany.
authors.forename: Annegret
authors.initials: A
authors.lastname: Blume
authors.affiliation: German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany.
authors.forename: Sascha Al
authors.initials: SA
authors.lastname: Dahouk
authors.affiliation: Klinik und Poliklinik für Dermatologie, Universität Regensburg, Regensburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Bäumler
authors.affiliation: Main Line Center for Laser Surgery, Ardmore, PA, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Bernstein
authors.affiliation: Istituto Superiore di Sanità (ISS), Rome, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Bocca
authors.affiliation: Istituto Superiore di Sanità (ISS), Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Alimonti
authors.affiliation: Ministry of Health New Zealand, Wellington, New Zealand.
authors.forename: Helen
authors.initials: H
authors.lastname: Colebrook
authors.affiliation: AZ Sint-Jan, Brugge, Belgium.
authors.forename: Christa
authors.initials: C
authors.lastname: de Cuyper
authors.affiliation: Surflay Nanotec, Berlin, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Dähne
authors.affiliation: Kantonales Laboratorium Basel-Stadt, Basel, Switzerland.
authors.forename: Urs
authors.initials: U
authors.lastname: Hauri
authors.affiliation: US Food and Drug Administration, National Center for Toxicological Research, Jefferson, AR, USA.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Howard
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Janssen
authors.affiliation: US Food and Drug Administration, College Park, MD, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Katz
authors.affiliation: Duke University Medical Center, Research Park, Durham, NC, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Klitzman
authors.affiliation: University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Kluger
authors.affiliation: Smithsonian Institution, Washington, DC, USA.
authors.forename: Lars
authors.initials: L
authors.lastname: Krutak
authors.affiliation: German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Platzek
authors.affiliation: Royal Infirmary of Edinburgh, Edinburgh, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Scott-Lang
authors.affiliation: Bispebjerg University Hospital, Department of Dermatology, The Tattoo Clinic, Copenhagen, Denmark.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Serup
authors.affiliation: BASF Schweiz AG, Basel, Switzerland.
authors.forename: Wera
authors.initials: W
authors.lastname: Teubner
authors.affiliation: German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany.
authors.forename: Ines
authors.initials: I
authors.lastname: Schreiver
authors.affiliation: German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany.
authors.forename: Elena
authors.initials: E
authors.lastname: Wilkniß
authors.affiliation: German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany. Electronic address: andreas.luch@bfr.bund.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Luch
mesh_terms: D063646:Carcinogenesis; D004396:Coloring Agents / Q000009:adverse effects; D017449:Dermatitis, Allergic Contact / Q000209:etiology; D004866:Equipment Contamination; D033161:Government Regulation; D006801:Humans; D007239:Infections / Q000209:etiology; D007281:Ink; D053685:Laser Therapy; D013653:Tattooing / Q000009:adverse effects* / Q000331:legislation & jurisprudence
chemical_list: D004396:Coloring Agents