Allergic Reactions to Tattoo Dyes

Mercury, chromium, cobalt and cadmium salts can produce allergic reactions, and tattoo artists who purchase pigments from outside the U.S. or who use cadmium salts put their clients at risk. Allergic reactions to red pigments occur despite the 1976 FDA restrictions on the mercury content of red dyes.

Delayed hypersensitivity can occur from a few days to years after exposure. The typical response is an itchy swelling, followed by an eczematous or granulomatous reaction. Often, the reactions are activated by sun exposure.

Infections due to tattoos are painful rather than pruritic and usually respond to antibiotics without recurrence.

(Kaplan DL. Future doesnąt look rosy for some tattoos. Consultations. 1998;38 (11): 2592.)

Comment: School nurses can educate students who are determined to get tattoos to ask about the dyes and to watch for signs of an allergic reaction as well as infection.